Glucose spikes in the afternoon

Hi! My 5 year old’s sugars are managed very well on school days (breakfast 645, lunch 1035, dinner 5pm) however on weekends even when following the same schedule he has at school for some reason he has huge unexplained sugar spikes between 230-3pm. The only difference is he takes a nap at home around 130-330. We still have a camera on him so I am positive he is sleeping and does not have the ability to sneak snacks. His sugar will be in large and suddenly spike to 275-300 around 230-3pm and stay there regardless of exercising or drinking water.

Any suggestions? He takes Humalog with meals and Lantus at dinner and breakfast for long acting

Hi Heather welcome to the forum. I guess I go through the same issue except my high’s hit in the morning after waking up. After talking with others on here it was brought to my attention that there is a condition called “dawn phenomenon”. You mentioned that your son is experiencing his high BGL’s on days he is not in school and takes a nap in the afternoon. This condition from all discussions happens as he is waking up and his body secretes a boost of glucose from it’s stores in his liver which is a natural response to becoming awake. He sounds like his school schedule is very good for him. There are two things that may help to keep his BGL’s at acceptable levels. The first is to consider keeping him on his school schedule eliminating his naps. Second is something you may need to discuss with his doctor and it may be determined he needs a bolus of Humalog to counteract the sudden boost of glucose he maybe encountering while waking up. You may want to consider the first method first and see how he does without a nap and if it works it may be a better fit plus staying on a successful routine may make it easier to get used to his school schedule when back in school. Who knew that waking up would cause such an issue for some people, but it does for me and certain others. Please remember that all of my ideas come from my similar personal issues and others may have totally different ideas to consider also. This is my opinion and I hope it helps. Also you may want to check out my topic on the forum “BGL’s climbing” where this condition was brought to my attention.

@hnvilcek Hi Heather, and welcome to the JDRF TypeOneNation Forum! I’m not here as a medical advisor so, my comments will be based on what I’ve encountered and learned during 64 years living with MY diabetes - each of us can have different results.

My first thought is to let your son be a real boy, live fully everything in life and stay active - you and he will learn how to make adjustments in the three basic elements - food, and activity, balanced with insulin. In other words, design diabetes management to fit HIS life; not always as simple as the words I wrote.

If you want his BG readings to be the same every day, send him to school 7 days a week - NO. What I can see as a possible pattern is his activity level, including nap.

Sleep is the time period when our bodies work hard to “fix” our bodies. It has been noted by people who have lived a while with diabetes and use insulin pump along with CGM for Automatic Insulin Delivery systems [AIDs] that more insulin is required during good sleep than at other times of the day - your son’s nap may be a contributor. BUT, let him nap, and then consider giving him a “little extra” insulin [Humalog] at dinner. Be careful that this correction bolus is not too much insulin.

Another thought is to compare his school activity level with his Saturday / Sunday level. Considerably higher weekend morning activity could possibly cause an afternoon BG spike. An example, if he is running hard, those tired leg muscles may be “healing” themselves during nap and causing the BG rise. As Bill @rs3880 pointed out, upon awakening his body may by producing the steroid adrenalin which almost always causes a rise in BG.

Enjoy your life with your son, and celebrate Mother’s Day.

Hi @hnvilce. I can’t come up with any reasons for his different readings but wanted to suggest that if he’s on a pump you could set separate profiles for school days and weekends.
Another possibility is type of exercise. I was diagnosed in '63 (1963😊) and back in those days I was taught exercise would bring the numbers down. However some people find that certain types of exercise will let there numbers - while others send them up😖.
Wishing you the best in solving your mystery!