This is a really common problem, and there are several reasons this could be happening. Most likely the problem is that your basal rate is too low overnight, leading to highs in the morning.
The best way to figure out what is going on is to check your BG overnight. Its a real pain, but it does work:
(1) You need to check your BG just before going to bed. If your BG is normal fine before bed, you’re already off to a great start.
(2) Next, you need wake yourself up in the middle of the night. If you sleep for 8 hours, wake yourself 3-4 hours before you get up and check your BG. If your BG is high then, it is likely a basal issue.
If you’re really low in the middle of the night, you may be experiencing a type of rebound effect called the Somogyi Effect. When your BG goes really low, your body responds by increasing the production of glucose and other hormones leading to high BG in the morning. In this case, you may need to decrease your overnight basal.
(3) If your BG is normal in the middle of the night, and before you go to bed, but you still wake up high (before meals) you may also be experiencing what is called Dawn Phenomenon. Basically, when you sleep your body produces stress hormones that cause your BG to rise usually right before you wake up in the morning.
(4) If you discover that your BG is high when you wake up in the middle of the night, you may need to increase your overnight basal rates. You’ll need several overnight readings to be sure, but this is the usual case (in my experience). If your BG is normal when you wake in the middle of the night, you may need to program the pump to increase your basal just a short while before your wake to help cover your morning meals and high sugars. There are other solutions, such as exercising late in the evening, etc. but if you continue to have issues, I would discuss those with your health care practitioner.
So, here’s a quick summary:
(1) Normal BG at bedtime, low in the middle of the night --> need lower overnight basal
(2) Normal BG at bedtime, high in the middle of the night --> higher overnight basal
(3) Normal BG at bedtime, normal in the middle of the night --> early morning basal increase
You’ll notice the key is to first be normal before bedtime. If you do decide to modify your basal rate, you’ll still need to wake up in the middle of the night to see how its working. And GO SLOW! Don’t make massive changes in your basal, especially overnight, you may end up going way too low!
Good luck, and I hope that this helps! Remember the key with pumping and basal/bolus ratios is to try and stay at 50% basal, 50% bolus. If you’re bolusing too much, it is likely a basal issue.