Post breakfast spike

I wake at 8 am. Bolus for breakfast carbs and a slight correction (120). I don’t eat because I immediately spike up to about 150. It takes over an hour or two before I come back down to about 100 and I finally eat. There is nothing fast acting about this! I am on the Omnipod pump. Help

Does this happen when you inject insulin with a syringe.?

Maybe you have a bad pod. Or a bad site that isn’t absorbing well.

I normally take my insulin 20 min before I eat. I don’t really care what my sugar is really in the mornings I wake up around 110.

I ramp up to 140 at the most and come back down.

At least it usually works like that

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I am on a Medtronic 670 G and CGM. At 8:30, I normally Bolus for a 40 carb breakfast 10 minutes before eating. By 12 I am usually up to 180 sometimes 200. Yet, by 2:30, I am usually down to around 70 and need to snack in order to bring my BGs back to 100.

Couple of thoughts for you… If you are waking up at 120 and spike fast from there, I wonder if you need a higher basal rate starting at 3 or 4 am to start your day closer to 80 or 90. It’s so easy to adjust those rates by hour. Also what carbs are you eating in the AM? Are these higher glycemic?

What I am saying is that I don’t even eat and still spike. I bolus and then just watch my numbers spike while I am hungry

That is my next plan. Thanks

I have an insulin pump.

I have a pump too, I was able to battle the predawn spike by increasing my basal at 4 am. It didn’t always work.
Now with my tandem it manages to flatten my predawn spike so I don’t really even see it

My same breakfast is 7 carbs. Eggs small yogurt and fruit. Not a breakfast to cause big spikes

I was advised to increase my carb ratio at breakfast hours only. (Less carbs per unit of insulin)
It helped!

Hi! Omnipod user here and I have settings adjusting for DP, or FOTF or both or none. My body likes to change it up off and on!

DP or dawn phenomenon, A rise that usually around 5-6 am, getting ready to awaken for the day… FOTF is when your BG goes up after you waken or sometimes when you get out of bed. Both of these are caused by hormone releases and can be very stubborn about coming down.

I still have the DP as an basal option setting to switch to when needed. My FOTF program which is mild for me right now, but mine likes to go up about 1-2 hours after I am awake. No eating involved. When I try to eat I overreact to food and shoot up easily in the am and have to work to get it to come down.

But my Omnipod settings are

12:00-4:00 am .60 units per hour
4:00-8:00 am .80 units per hour
8:00-10:00 am 1.00 units per hour
10:00-11:00 am 1.80 units per hour
11:00-12:00 am .80 units per hour

I’m assuming you have a CGM. You can track when you usually go up in BG level and set your basal higher about 30 minutes before that increase. Of course it can vary how much, when and how early to have different settings. I have a higher IC ratio for the am in case I do have any carbs.

My ratio is 1:2.

Thanks. I’ll look at my settings again

As many have noted already, this morning blood sugar rise can easily occur without consuming any food at all. That’s true in my case. The food you eat, the quantity and quality of carbs eaten, the underlying basal rate, the amount of pre-bolus time you allow, and the insulin to carb ratio you use all affect the post-meal BG rise.

While eggs do not drive blood glucose much, your 7 grams of carbs estimate seems light for yogurt + fruit. What kind of yogurt is it? Is it Greek yogurt with no added sugar or is it one of those sweetened varieties that come in at 14 grams of carbs (or more!) for a 6 ounce serving?

What kind of fruit do you typically consume and what is your serving size? Berries are the easiest on blood sugar since they contain a high percentage of fiber which does not metabolize to glucose. A banana, however, will typically contain 35 grams of carbs.

You might experiment with just eating eggs and see what happens. If you eat meat, you could add that to the eggs.

If you eat a generally low-carb diet, you may need to dose your insulin considering the protein and fat content of your meals. I count 50% of protein grams and 10% of fat grams as “equivalent carbs,” and dose for them. Using an extended (2-5 hours) pump bolus for these equivalent carb grams has been dependably successful for me.

Unfortunately, this is not a fix it and forget it situation. Morning blood sugar management remains a challenge for many of us. We can adjust, solve the undesirable BG rise temporarily, and then face some variation of the rise in the weeks to come.

When diabetes adjusts, you must adjust, too. This was my biggest failure in my earlier years. My BG would trend higher and I wouldn’t adjust and things would trend poorly for many weeks, even months, before I took action. Your persistent efforts, even those not immediately successful, are critical to your long term health. Keep on keeping on!


Thanks to everyone for the input

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I wonder if reducing fat in my diet made the difference for me. When following the Bernstein way of eating I did have a rapid morning rise, but I don’t anymore. When I woke up this morning I was at 76 and 45 minutes later I am at 78. I have eaten my breakfast of 1/4 of a cup of cooked oats groats, a cup of blueberries, 1/2 of a banana, 1 medjool date, 1 walnut and salt, flax seed, and cinnamon. I also have 15oz of coffee a regular and decaf mix.
I took 3 1/2 units of humalog to cover my meal.

Pretty soon when my glucose level rises to about 130-140 I will jump on my bike and exercise for 1/2 hr and that will bring me back to 80-100.

I hadn’t really thought about the fact that my glucose levels are so easy to deal with now in the mornings, but I bet it has something to do with the low amount of fat I eat.

Edited to add that if I didn’t exercise after breakfast I would be in trouble, unless I added 1 1/2 - 2 units to my morning bolus. I should have given 3 units this morning instead of 3 1/2 because now I am 81 and going down after exercising.

Type 1 dx 1959

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I think you are right Marilyn. Since I have reduced my fat intake, my predawn bump is much smaller and my pump handles it anyway.
I think the fat hits later while sleeping and it makes the morning sugars high. Not sure if it is insulin resistance from the fat or not, but reducing fat has had a big effect on my insulin needs

My morning spikes seem to be inversely related to excercise. I’m an Omnipodder and when I do my 1 hr barre class at 9:45, I start spiking around 11:15, rising as high as 12 (I’m in Canada, so 216 in the US). I start bolusing of course, but it takes some time to come down so end up bolusing with a syringe. Given the class exertion, a mix of cardio and muscle work, the spiking puzzles me.

I eat almost 10 x the carbs I was eating during my 11 yrs of low carbing, while taking almost the same amount of insulin. It is pretty remarkable what lowering the fat content can do.

I tend to go too low during the night. I need to reduce my Tresiba again.

This article explains this phenomenon well.