As Markie says, the dawn phenomenon is a likely culprit. I'm not a physician, but as a long time diabetic, that'd be the first thing I'd check, too.
Many of us need a different ratio in the morning than at other times of day and it's an easy thing to check. In addition to considering how many carbos are in our meals, we need to consider our beginning blood sugar.
FOr example, if his meal has 60gm of carbos and his blood sugar is within his target, he would take XX amount of insulin. If his blood sugar is, say 50 points higher than his target, he needs to know how to include a correction for that in his dosing.
A person whose ratio is 1:10 "all day long," might begin to adjust the morning Humalog by using a ratio like 1:8 for a few days (and make adjustments for too high/too low starting point).
Hope this helps. Good luck.
The most likely reason for your grandson to be high 9:30 am is the dawn phenomenon. Raised levels of hormones cause glucose to be released into the blood stream and simultaneous insulin resistance. The results is that blood sugar levels increase, in spite of higher levels of circulating insulin. The effect starts at about 3am and continues until around 11am.
You can try increasing the pre-breakfast Humalog dosage. The drawback of this is that Humalog is very short-acting. And getting the timing right is hard. You could also try injecting NPH before going to be instead of in the morning. It's action would peak in the early hours of the morning and waer of before lunch. And a Humalog injection before lunch would be required.
Cheers,
Mark
I am not a physician, but the mom of a type one diabetic, and a volunteer.
When our daughter was on NPH and Humolog we had the same problems at first, but we discussed the numbers with our daughter endocrinologist and adjusted her dosage at the time. The reason for this is that each person reacts differently to the different types of insulin