How to stop my 9am blood sugar spike

Yep, our body kicks out...cortisol, I think? which causes the liver to kick out sugar to "help us have the energy to hunt" for our first meal of the day. The longer we fast, the higher the sugar kick can be, because "obviously" (from an evolutionary perspective) the morning hunt didn't go well. That is the phenomenon that metformin is supposed to suppress. It's also the phenomenon that going keto suppresses, theoretically. (Once you are using ketones rather than sugar, your liver should be less likely to kick out sugar as an assist.

I was having a horrible time with that and with unresponsive blood sugar for the last year or so. Low carb seemed to be suddenly counter productive. Low carb meals gave me high readings, and adding a piece of fruit kept the readings from spiking - but the general trend was up.

It took a long time - long enough to start to suffer complications for the first time in 25 years - to find my solution. I can't take metformin because it is largely corn by weight and I am very sensitive to corn, but I eventually found a combination of herbs that made my blood sugar responsive again and now my numbers are coming down again in response to what has always worked before.

Are you eating low carb? Are you sure you want to go off metformin? Can you have a protein snack before bed? That help a lot of people, I am told...?

Grandma Misti said:

It's also the phenomenon that going keto suppresses, theoretically. (Once you are using ketones rather than sugar, your liver should be less likely to kick out sugar as an assist.

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Really? I always assumed morning readings improved to a degree due to the fact your liver simply didn’t have the enormous stores of glucose it previously had, but I haven’t dug down into it much other than to know even on keto it’s not unusual for dawn phenomenon to persist for months gradually decreasing over time. Morning fasted readings are often the last to “behave” even when the rest of the day has been very good indeed for sometime. And we see that in here over and over again

You didn’t by any chance have the c virus before this difficulty started did you? Or anything else? A lot of people have reported erratic or difficult control afterwards for some time and some long covid people simply don’t seem to return to their pre infection levels for a very long time or not yet anyway. I know my control is more difficult since being hospitalised (and stuffed full of glucose drips!!) and that’s a year ago. Not all to blame probably but definitely a factor. Still I’m glad you found an answer that is working for you.

Our liver kicks out glucose to give us energy to start the day. Sometimes this happens in the early morning and sometimes it happens once we get out of bed. This is not a diabetes thing - it happens to most people but because their pancreas / insulin works properly, they don't see the BG rise.
The two things I have found that help are
- break your fast as early as possible. This stops the liver from dumping more glucose and continuing the BG rise. I don't have to eat carbs for, a handful of nuts works.
- intensive exercise the day before. I believe this empties/reduces the liver's glucose stores so it has less to dump in the morning.

To find out more, use the Search function at the top of every page and search for "Dawn Phenomenon"

HSSS said:

Really? I always assumed morning readings improved to a degree due to the fact your liver simply didn’t have the enormous stores of glucose it previously had, but I haven’t dug down into it much other than to know even on keto it’s not unusual for dawn phenomenon to persist for months gradually decreasing over time. Morning fasted readings are often the last to “behave” even when the rest of the day has been very good indeed for sometime. And we see that in here over and over again

You didn’t by any chance have the c virus before this difficulty started did you? Or anything else? A lot of people have reported erratic or difficult control afterwards for some time and some long covid people simply don’t seem to return to their pre infection levels for a very long time or not yet anyway. I know my control is more difficult since being hospitalised (and stuffed full of glucose drips!!) and that’s a year ago. Not all to blame probably but definitely a factor. Still I’m glad you found an answer that is working for you.

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Yes, sugar from the liver is released from the liver in response to stress the stress hormone cortisol. The cortisol is released as a part of the normal waking up process as well as other kinds of stress. The liver will make glycogen from protein if it doesn't have access to carbs, so to really deplete your liver's sugar stores, you'd have to be low carb *and* low protein, though as In Response says, you can partially deplete them with intensive exercise the day before, which will keep the release smaller.

I did indeed. Long COVID (post viral syndrome), which in its worst form lasted 13 months, seems to have kicked me hard in the endocrine system. In addition to my blood sugar flipping out, my thyroid replacement needed to be increased. It's now been 18 months and I am learning to work around both issues. My blood sugar had been slowly climbing in the time before I got COVID but at least it was still responsive to my efforts until I got the dreaded plague. I had post viral syndrome in the 1990s, and it lasted a LONG long time, but it did eventually, gradually go away, so I have hope that these troubles will resolve eventually, too.

As @In Response said everyone experiences the dawn phenomenon to some extent. Also exercise can spike BG as it’s putting stress on the body and cortisol rises.
Bread (doesn’t matter if it’s whole grain or white) is carbs, check the label of your peanut butter as it can contain sugar and apple, in my experience, apples are one of the worst fruits to eat. I would have a similar spike if I ate a breakfast like that. I don’t have breakfast very often, just a large mug of coffee with almond milk and double cream. If I have fruit it’s raspberries, blueberries or strawberries (as these are lower in natural sugar) and full fat yogurt. Breakfast ideas are cheese omelette, bacon, yogurt and fruit, as mentioned. Some on the forum buy low carb bread and rolls if they’re missing the bread element.
Good luck with experimenting.

Snootybutnice said:

Maybe I just need to be patient but I’d like to find a way of stopping it. This morning I’ve eaten an apple and small piece of toast with peanut butter and a handful of peanuts to see if the body thinks now it’s eaten it doesn’t need to increase glucose- then went for half hour walk. Yes just getting over Covid from 2 weeks ago.

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I do similar with a tiny breakfast but eat a lot less (especially carb wise) than you list. It does help me and quite a few others find it helps. Eg just a boiled egg or matchbox of cheese.

Theres also a thing on low carb/keto called adaptive glucose sparing (or physiological insulin resistance). https://www.dietdoctor.com/low-carb/fasting-blood-glucose-higher. It makes fasting levels look high compared to the rest of the day and is about the body adapting to low insulin demands. It’s physiologically not the same as a pathological IR in disease and there is a school of thought not to worry too much about these morning glucose dumps in this situation as a result (assuming they are not silly high) because insulin remains low unlike in disease and in type 2 it’s high insulin that drives many of the complications. The link explains fasted readings and these phenomenon better than I can.

Snootybutnice said:

Think that since porridge also didn’t work (high in carbs but made with semi skimmed milk and no sugar or sugar substitutes) I’ll need to try a 1 egg omelette tomorrow perhaps at 7am to see if that works.

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Why one egg, specifically? You could have 4... Wouldn't do anything with your blood sugars, and keep you from going hungry a lot longer than one egg would.

I have a touch of dawn phenomenon, not going quite as high or consistent as yours though that I've found (I only fingerprick test, but have done so at a range of times and intervals).

@In Response's advice is sound and what I use on mornings I notice it. I've also found that my first reading of the day has improved as I've lost weight, presumably because I have a fatty liver that's slowly becoming less of a fatty.

Snootybutnice said:

Maybe I just need to be patient but I’d like to find a way of stopping it. This morning I’ve eaten an apple and small piece of toast with peanut butter and a handful of peanuts to see if the body thinks now it’s eaten it doesn’t need to increase glucose- then went for half hour walk. Yes just getting over Covid from 2 weeks ago.

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40g of carbs roughly so not the ideal wake up for your liver at what is the most insulin resistant time of day for a lot of people.

Grandma Misti said:

Yes, sugar from the liver is released from the liver in response to stress the stress hormone cortisol. The cortisol is released as a part of the normal waking up process as well as other kinds of stress. The liver will make glycogen from protein if it doesn't have access to carbs, so to really deplete your liver's sugar stores, you'd have to be low carb *and* low protein, though as In Response says, you can partially deplete them with intensive exercise the day before, which will keep the release smaller.

I did indeed. Long COVID (post viral syndrome), which in its worst form lasted 13 months, seems to have kicked me hard in the endocrine system. In addition to my blood sugar flipping out, my thyroid replacement needed to be increased. It's now been 18 months and I am learning to work around both issues. My blood sugar had been slowly climbing in the time before I got COVID but at least it was still responsive to my efforts until I got the dreaded plague. I had post viral syndrome in the 1990s, and it lasted a LONG long time, but it did eventually, gradually go away, so I have hope that these troubles will resolve eventually, too.

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I’m familiar with dawn phenomenon and gluconeogenisis thanks. In a type 2 protein isn’t usually an issue the way it is for type 1. There is an explanation why that is but it escapes me now. I’ll try and find it. The process is demand driven not automatic and when you are habitually low carb (which the majority of type 1 don’t follow) your body is better and prefers using fat rather than protein. A huge % of the type 2 in here eating low carb have no issues with eating plenty of protein, in fact quite a number go quite heavy on it and have less fat instead of the carbs.

It does seem to have caused a lot of people issues. I hope yours resolves soon.

HSSS said:

A huge % of the type 2 in here eating low carb have no issues with eating plenty of protein, in fact quite a number go quite heavy on it and have less fat instead of the carbs.

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lovinglife said:

As a T2 I eat less than 20g carb a day and have no problems with protein whatsoever, I eat a higher protein normal fat rather than high fat lifestyle for satiety, sometimes if I just eat meat and cheese for lunch and very little to no carbs I don’t see much of a rise if any between the 2hr mark.

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For any less experienced readers when it comes to low carb diets, higher protein has been shown to help with maintaining fullness and reducing hunger (it's also used for gaining muscle mass on low carb, but this is more specialised). For general dieting, it can also help reduce loss of lean muscle mass when losing weight, which is a risk with any form of weight loss diet. There's some scientific support for this too, although quite small studies:



When doing this, fat tops up intake and promotes satiety, rather than being the outright dominant macronutrient. In practice, this means that standard keto moves from being approx 5% carbs / 20% protein / 75% fat, to anything up to 5% carbs / 40% protein / 55% fat (note: percentage macros aren't the most meaningful, but serve as an illustration). For what it's worth and for transparency, according to my tracking app, my protein intake is approx 30% and I keep carbs to 20-30g a day (generally nearer 20g).

A decent (in my opinion) medically reviewed guide to all the ins and outs, benefits, and potential risks of higher protein low carb / keto is here:


As a word of warning though, if you have kidney disease, it's often recommended protein intake is limited. From what I've read, there doesn't seem to be much scientific basis/evidence for needing to restrict protein unless final stage kidney disease is present, but I could have missed something and I'm not a qualified medical professional, so seek advice in-line with your personal situation/health if this is a potential concern.

The main takeaway, in my opinion, is that this is yet another example of just how flexible low carb diets can be. There are a lot of people, particularly medical professionals, who claim it's "too restrictive and unsustainable", yet it's anything but in my experience and can be tailored to your preferences, likes, dislikes and overall goals - particularly if those goals change as your low carb journey progresses.

Snootybutnice said:

I couldn’t keep up with keto as I’m not a huge meat eater but I do need to make smarter meal choices and possibly not skip breakfast to keep spikes lower. xx

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Keto isn't essential, there are a number of people on this forum who just low carb and can have up to 100g of carbs a day (that I've seen said) and manage their BG levels. We all have different levels of insulin resistance, so there's no one rule fits all.

Just keep testing as you go and you'll find your tolerable carb intake level per day. Mine is up to 40g, if split across 2-3 meals, but I just naturally eat between 20g and 30g a day. Low carb can be very flexible, so finding what's right for you can take some time.