Feet to Floor Phenomenon is exactly what it sounds like. A rise in blood glucose upon physically waking and standing up. Its cause is unknown and not everyone experiences it. It’s also not clear if it is related to Dawn Phenomenon or not; however, I would surmise that it is different as it is essentially dependent on when you physically wake up and get out of bed. My most educated guess is that Feet to Floor is a result of increased cortisol levels.
Do you experience Feet to Floor Phenomenon?
I do, but not always. And that is the truly frustrating part; I can’t plan for it. I can’t set my basal rate higher, as it is dependent on when I physically get out of bed AND it doesn’t happen consistently.
I’ve noticed a few trends, but they are not consistent. For example, when I do experience this phenomenon, it’s during the week when I’m getting ready for work in the morning. Weekends I have never experienced Feet to Floor. This could have something to do with in increase in cortisol levels (Cortisol is often called the “stress hormone” because of its connection to the stress response… –Hormone Health Network)
Even during the week it is not promised. Take these two CGM graphs as an example, February 13th and 14th, respectively:
(Pictures taken upon arriving at work, after bike ride)
The first graph shows a steady glucose reading until about 7:20 (woke up at 7:00). Since I ride bike to work, I do not like to bolus until I’m physically at work in order to mitigate any lows from insulin and exercise. However, the bike ride spiked me even further. This is very rare and quite questionable. It’s also quite defeating to start the day with such an unexplained, silly, high blood sugar.
The second graph shows a steady glucose reading just like the other. A slight rise starting at 7:30, about 30 minutes after waking. However, this is the funky part; during my morning bike ride to work, my glucose levels started to drop. This is literally the complete opposite effect that I experienced the morning before. The conditions were the same. No active insulin for over 8 hours, no food, etc. Arguably, the intensity of my morning bike ride was probably the biggest influence in the different results, nevertheless, Feet to Floor is annoying.
I would love to hear your take on Feet to Floor Phenomenon. There’s not a lot of research done on it, so I rely on the expertise from my bellow diabuddies!
Just to note: I usually fast from 7pm until 12-noon the next day, so it’s safe to say that I KNOW it doesn’t happen every day. I’m not covering up a possible Feet to Floor spike with a breakfast bolus because I don’t eat breakfast (therefore no morning bolus).
theinsulintype.com 
I get dawn effect from 3am slight rise till I wake, then foot on floor boom! Since last Monday I have gone insulin resistant in morning. Last Monday 1 to 10, yesterday 3 to 10. Experimenting today, woke on 7 by time I got to syringe 9.0. I’ve gone back to novorapid I think fiasp is the problem been on it a few months. I’ve injected 16 basal and 8 novorapid, not eaten yet been an hour now and I’ve gone up to 9.9! So another 8 novorapid repeat. Upto last week I was hyper sensitive, 1/2 unit pen, 1/2 lowers bloods 2.5 as you can see in morning 8 units should kill me but does nothing against foot on floor.
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I absolutely experience this phenomenon. Every single day for breakfast I have 2 eggs, scrambled and black tea, and yet by the time I get downstairs to eat, regardless of when I wake up, I have climbed from 4-6 to 8-10. I thought it was my pills (thyroid, antidepressant, crestor) but none of these list high blood sugar as a side effect. I was starting to think my toothpaste was the culprit! I now have to lie to my pump and tell it I’m eating carbs for breakfast just to get back into range! Frustrating, but I’m grateful to have found this post and discover it’s not just me. Thanks!
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This is interesting. I have switched from Lantus Glargine to Tougeo long-acting and am now experiencing foot to floor. I never had it in 25 years of T1 – only since i switched. It is very annoying and I hope to find alternative insulin to avoid it. Has anyone else wondered if it’s their insulin type causing the problem?
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Super late reply here but I just discovered this phenomenon.
I am having a similar problem… I fast from about 4 pm to around 10 am the next day and I have found that if I wait too long before eating I will get a spike after flatlining the entire night/morning. I have heard that this is my body releasing stored glycogen, but not sure on that. If I eat at a consistent time each day the spike rarely happens.
Possibly related… exercising intensely can spike my bs dramatically, but eating a small amount of just about anything before I exercise flattens the spike. Maybe try drinking a glass of water with a little lime or salt first thing when you wake up.
Thanks for the Post!
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I have always thought I had dawn phenomenon because I was unaware there was such thing as ‘feet to the floor phenomenon’. But now I have read about this I can definitely 100% relate to this.
I will wake up with a perfect blood glucose reading of 6 (flat line throughout the night) and then by the time I have brushed my teeth it can be as high as 14! I always thought it was my tooth paste that has some sort of hidden sugar in it haha. I really struggle treating this because some days it happens and others it doesn’t. My diabetes nurse has raised my background insulin but I ended up having a hypo in the night.
I’ve currently have the Libre and the Miao Miao So when I see my bloods rising I will inject 3/5 units. But often it’s too late to prevent the spike.
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Everyday. In bed I could be 5.1 and by the time I’ve walked downstairs and put coffee on, 5 mins , I’ll be 6.1 sit on couch and wait for coffee , 5 mins, I’ll be possibly 7.0.
I inject before I put the coffee only. I’m zero carb carnivore breakfast only , unless blood sugars make me eat more
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My son has been getting this very frequently lately! We are on quarantine right now so it’s certainly not about getting up to go to school! :p
He wakes up at all different times of day and the rise almost always happens. I can tell as soon as he’s awake before he tells me. So weird!
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This happens to me as well, but not consistently. Maybe about 3-4 days a week and weekends/ weekdays, it doesn’t matter.
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I am like this about 5 days a week. I was told to increase Lantus at night and when I did my sugars were 3 when I woke u. Going to take a small correction dose before breakfast to see if it helps.
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Happens to me too but also on weekends. Very intermittent. On a possibly related note, do you shower in the morning, every morning? (Not to get personal). I learned a while back (probably later than I should have) to take a small (1 unit for me) bolus before disconnection for a shower otherwise I spike a little. I doubt if it’s just the short disconnection/loss of basal but that combined with getting up and exerting energy (I’m usually running late at that point😔) I haven’t determined if the F2F phenomenon correlates with being unplugged for that short time.
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I shower at night, almost habitually. I don’t think the small time being unplugged could cause a rise like that. A normal 5-10 minute shower wouldn’t do that. But bolusing before would help the blood circulation and help the insulin start working faster due to the hot water.
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Yes I can relate to this! I seem to suffer more on a Monday morning with it too, although again no frequent pattern.
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Maybe Monday’s have an added stress – starting the work week. I should keep track of mine to see if this also coincides with stressful days!
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