Middle of the night BG Spikes 50 -100 points

For the last year I have been getting major blood glucose spikes. Starting around 2 AM - 4 AM. My BG will go up 50 - 100 points just about every night. I can have a BG around 100 - 125 at 12:30 AM and then when I get up at 6 AM it is 190 - 235. If I wasn’t wearing a Dexcom G6 I would not be aware of this trend. I have an alarm set to go off so I can take some insulin when it reaches 200. I have a couple of instances that it has gone up as high as 150 points. I don’t know how high it would go if I didn’t take a shot. And no I am not eating anything in the middle of the night. Last food is usually a 8:30 PM if any.
Anyone else have this problem. If so how do you handle it.??

hi @LMNrancher. in treating T1, they call 3AM the “witching hour” for a reason. I find that my basal insulin requirement is almost 2x higher between 1-8 AM than any other time of day.

I handle it by programming more basal insulin during those hours.

This is very difficult to fix if you are on long acting shots because you can’t have a higher rate for a set number of hours.

You might do better if your overnight sugar is higher, for example adding a long acting carb in the late evening so that your blood sugar runs about 140mg/dl may actually help. I don’t know exactly why.but I suspect both liver sugar and insulin resistance.

if you are on shots, you could try a little more insulin - but you have to be careful and you have to be comfortable with making your own insulin decisions.

in the 4 hours from ~3AM until you wake up, blood sugar a little higher is not so horrible, so if it’s 200 or just under, you could always “do nothing”.

I suggest you talk it over with a doc, and good luck!

A dietitian recommended that as well, I tired it for about a two weeks. BG ran about 150 - 200 by midnight then 300 by morning on average. I have found if my G6 sound a high alarm, that a shot will be put me right where I should be in time for breakfast at 0630 hrs. Just didn’t know if there were any little secrets out there. A1C is averaging about 5.7, so Doc says keep doing what I am doing.

I think it sounds like you have the best deal going then. Keep up the great work!

Hi @LMNrancher , you may be able to place much of “the blame” for your glucose spikes on Mother Nature who gave you your circadian clock - that biochemical thingy in-bedded in almost everything. People without diabetes also experience a glucose spile to help the body awaken. Enough of that.

It appears, that either the dose-amount of insulin, or the timing of when you take your insulin is in need of adjustment. You didn’t mention what type of insulin you are using, or your method - infusion or injection - so I won’t offer ‘solutions’. For me, using a pump, my solution was simple - my basal rates of insulin increases in steps beginning at 3:30 AM, and by the time I awaken my pump is infusing at greater than three times the rate it infused at midnight.

I suggest that you provide your doctor with detailed data from your Clarity reports [the expanded HOURLY data report] and discuss with her methods you might adopt. Or, if you understand insulin, and your body, try to develop an insulin strategy on your own and provide data to your medical team.