It is Fage Yogurt 2%, so totally unsweetened. A cup has 9 grams. He ate a little less than that; the remaining carbs were from blueberries and some from walnuts, and a half-teaspoon of honey. He likes it sour!
I don’t think this is related to dawn phenomenon in any way, which he actually doesn’t have (and apparently many young toddlers don’t have.) The thing is the rise only occurs after he starts eating. In this instance I even inadvertently pre-bolused because I bolused, he fell out of his chair and bumped his neck and was hysterically crying for like 10 minutes, then he wanted 10 minutes of “mommy lie down” time before he decided he was in good enough spirits to eat. This is way more of a prebolus than we did yesterday, for instance, when I bolused for a meal with matzo (which I imagine must be a very fast-acting carb) in quarters over the course of him eating.
Some other factors: If he waits till 9am to eat (on the weekends) he won’t drop low or high; he’ll be totally fine. It’s not like his liver pumps out the glycogen the moment he wakes up. It really is totally dependent on the food he eats. Also, what’s not totally clear here because his phone signal dropped out for a while is that he was rising very steadily over the course of more than an hour, but there is no pronounced “spike”–he probably didn’t rise by more than +5/5 minutes for most of the morning. It’s just that the insulin we kept pumping in was having much less effect than it usually does, which i see as a sign of classic insulin resistance.
And if we were to give him, say, an English muffin with some avocado on top or a bowl of oatmeal with a glass of milk or a bagel or french toast, he’d be fine with almost the same amount of insulin for more carbs, not prebolused by more than a minute. It really does seem to be an issue solely with the low-carb breakfast.
There may be some way to keep him from spiking when he eats a low carb breakfast, but I suspect that no matter how low the carb count is, I’d wind up having to bolus at least 1.5 units…which sort of defeats the purpose as he’s growing and needs (and likes) carbs.