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October 26, 2016
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Ketones in the Night

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Lindsey Guerin

After the picnic last night, I was extremely tired. It'd been an incredibly long week, we'd just played all kinds of games, and to top it off my blood sugar was low. So I ate some fruit and mixed nuts hoping I wouldn't have to eat anything heavier right before crashing into my bed. But my blood sugar wouldn't come up, it seemed to only be dropping. I drank juice and ate crackers, intently watching the CGMS to tell me when it was rising.


Finally about 1am, I saw the 78 and 80 start to come up. With that peace of mind, I settled into bed watching late night sitcoms. At some point I must have fallen asleep because the next thing I knew my cat was nudging me and crying. I checked the clock: 5am. I checked myself: I felt okay, but a little off. I got up to use the bathroom half-asleep, but when the cat kept following me and rubbing on me, I felt like something was seriouslyoff. I checked my blood sugar and was shocked to see the 314 beep onto the screen. At once, the nausea, itchy skin and overall icky feeling in my body made sense.


The CGMS confirmed that I'd been flying high since about 2am...guess all that food finally caught up with me (not the first time that a troubled low caused a terrible high afterwards). Then I remembered that I'd fallen asleep before doing my nightly Lantus injection. I immediately bolused for the high (a normal 4 units) and my Lantus (a "lowered" dose of 12 units). I drank some water and ate sugar-free Jell-O since my stomach was so upset. As I layed back in bed, I wondered about my cat waking me up. He kept smelling me, tickling me with his wet nose and whiskers. Did he smell the ketones? Did I reek of high blood sugars?


After I'd taken all the necessary steps to get the high down, the cat wasn't amused anymore. So I drifted back to sleep, hoping that the morning would bring me into range without any trouble. At 9am I woke to the sound of the CGMS vibrating to tell me something was wrong with my blood sugar...I was afraid the correction made me low. But the CGMS claimed a 264. Frustration washed over me as the meter confirmed 263. It'd been too long for the other correction bolus to still be working, so I bolused another 4 units (this time accounting for more ketones than I did the first time).


Since I was taking today to sleep in after the long week, I went back to sleep. And around 11am, I woke up feeling only slightly better than the night before and with a blood sugar of 151. In the past week, I've gotten up almost every night with a blood sugar issue. As much as I love the CGMS alarms (and my cat), I'm tired of being alarmed so often about everything. Of course, there is the other end of the spectrum where without the CGMS (and my cat), I could be dead. On more than one occasion, I've woken to a blood sugar of 55 or lower. And the high last night was tearing my body apart.


But I'm still tired, exhausted, and frustrated. I wish I could get the mix right between food, exercise, and insulin. I keep bouncing around, from one end of the spectrum to the other. Today, I'm trying a 10 unit morning Lantus and a 12 unit evening Lantus dose. I'm also throwing in a 2-3 mile run so I'm lowering my food boluses by 1 unit. I've kept the evening dose at 12 for a few days now, not seeing many lows. But I'm still struggling with afternoon and evening lows, so I'm hoping 10 units will push me back into range without causing me to soar high again. Or if I do, I hope my cat catches it sooner this time!

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