Does anyone else have stagnate highs at night? From 11pm to about 5am I will hover between 200 and 250 no matter how much I bolus. I will also increase my basal rate and see very little change. Normally, I am incredibly sensitive to insulin so this type of resistance is a bit alarming. I understand what the dawn phenomenon is and have experienced that before, but this is a much longer amount of time with sustained highs. I have read that this can be caused by the liver excreting glucose, and that could likely be my issue, but the thing is my diet hasn’t changed. I am a very scrupulous low-carb, healthy eater and am very aware of everything I put in my body, so it causes me to wonder. Additionally, this has lasted for several days, and I have had normal blood sugar levels during the day.
Are you bolusing enough at dinner to cover part of your protein? I have noticed that not covering larger portions of protein (e.g., when I have some NY strip steak) sends me up and keeps me there. I find taking more insulin a couple of hours after dinner, and before my BG climbs too high, helps a lot.
I sometimes have immoveable highs like that. I inject insulin in my side. But I think there are “dead” places in my torso with too much fat, or no blood vessels, or scarring. I do not lnow what… where injecting insulin does nothing.
Hey eburt - Like you I also follow a strict LCHF diet. I agree with Catlady - If I eat a large steak too late in the evening I can count on going into the low 200’s right around midnight onwards. I always find it best to try to eat dinner well before going to bed (between 6-7PM at the latest) and keeping my portions moderate. This will usually ensure flat, in range BG readings at night. The other thing I’ve noticed that if I take a break from my exercise routine I can also experience these unexplained midnight spikes about a week later. They stop once I start exercising again.
When do you increase your basal rate? The rule of thumb seems to be to increase around 2 hours before your levels start to rise. If your BG has gone up as a result of not enough basal insulin (as opposed to too little bolus) it will tend to make you a lot more insulin-resistant.
This is a long shot, so treat it as such, but . . . if it really is liver dumping that is behind this, metformin might make a difference. Obviously that needs to be discussed with your doctor before forming any conclusions.
For something that’s a recent development, I’d tend to suspect protein more than sudden changes in liver function. However, if it were me, and I wanted to test the liver theory, I’d have a glass of wine or a serving or two of bourbon (or your booze of choice) a couple of hours before the rise starts and see if that inhibits it. Would give you info, even if it’s not what you end up doing for a longterm solution. If it is that, you could keep having a nightcap or I agree that you could try some Metformin ER, which has been helpful for me.
I like it! There’s not much a nice glass of wine or bourbon can’t help. 
Yes. I’m nocturnal but usually 4-5 hours after my last meal Bg often but not always goes up and sits there for hours. If I manage it I often crash eventually when I sleep.
Hi - I was just about to post about the same issue, so not offering a solution, just sympathy! For me, it’s been happening off and on for about a year. I’ll go through long stretches with great, flat numbers at night and then I’ll start having days or weeks when I run about 160 to 200 (Dex is set to 160 alert) after midnight, and I’ll do a correction bolus (on a pump) every 2 hours, even doubling what the pump calculates, and it won’t go down. It doesn’t go up either usually, just stubbornly stays around 180-200…
I also have great numbers in the day, eat really well and low carb, and am sensitive to insulin. This doesn’t seem to correspond to lows later in the day, exercise, stress, etc. Maybe it’s from eating higher fat meals these days, but why would the correction boluses not help?? When I get up in the am and give my breakfast bolus, including a needed correction still, then I usually fall quickly.
It seems to resolve on its own after some time, and then I go back to steady numbers at night, or even lows. I’d love any thoughts to solve this mystery, thanks!