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 seriously off. 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!
Lindsey, I know you do not want to go back to the pump...but you are doing so much work with the injections, and it is so easy to forget a dosage when you are tired....At least on a pump, you will always get your insulin, unsless the resevoir is empty or the infusion set is clogged.
I just find the pump so much easier than injections.. And honey, the nature of Type one management as you full know, is sometimes not based on anything resembling predictability. I am not surprised you ended up with a high after repeatedly feeding the low. I know how you are afraid of nightime lows..but can you just wait 15 minutes, then feed the low if needed?: And I know that the glucose tabs are chalky, even the flavored kind, but they work quickly, as well as orange or grape juice boxes:I keep such things by my bed in a little basket and in my kitchen.
Just a little advice from an old-timer ( 41 years type one). It just causes more stress when you feel you have to chase blood sugars....I am not telling you to test less, just STRESS LESS.
God Bless,
Brunetta
Hi Brunetta~ Thanks for the tidbits! I desperately feel like the pump is more work for me than the injections. But I am waiting for my next A1c to confirm whether injections or the pump are better for my A1c. I also waited about 30 minutes between the first two lows and an hour to see if the second would come up. Glucose tabs don't seem to work that quickly for me, I don't know...maybe I'm just a fluke? :) Thanks again!
Lindsey, I have to agree with Brunetta above. Have you looked into the different types of pumps available now? I know of 3-Minimed (which I am on, love, lost weight and have a 7.2 A1C with), Animas, and Omnipod (which has no tube). There are others, but I don't know the names.
I am 32, have had Type 1 since I was 1 1/2 yrs old, and have to also agree about the 15 minute rule--although, I have to use 1% milk to treat my lows. Juice makes my sugar too high, then it plummets, and the tablets are ok for in the car, but I don't use them at home. Skim or 1% milk has enough sugar in it to treat myself and not go sky-high afterwards.
I have a suggestion for evenings-I find that this works really well for me so my sugar isn't low or high, its just perfect, in the morning. I eat about 1 cup of plain yogurt with about 1/4 cup of granola around 9 pm. The granola is Bear Naked-which is not loaded with corn syrup or sugar, it's all natural found in the Organic section. Another idea is if you have an alarm on your cell phone, or in your cell phone's calendar, set it for the time you usually take your evening shot so that you can keep on track.
We've all had times like yours, and I'll be praying for you!
God Bless,
Karla
Hi Karla~ I was actually on the pump for over a year and a half...and it made my A1c jump and never would come down below 7.3%. So now I'm giving injections another try. I also have alarms set for the Lantus doses, both of them, because I kept forgetting when I first switched back. But this night was just a total mess...my body wanted sleep more than insulin...until 5am of course! Thanks for the prayers and advice!
Lindsey, this story is not uncommon. I've had type 1 for 33 years. I also have days that no matter what I eat, it stays low, even if physical activities are low. However, for the most part, activities play a big role in my life. I have found that walking around shopping, swimming in the pool, painting and going up and down ladders, running around outside in the garden with bags of mulch or whatever, make my insulin work in high gear, making my BS drop. On those days, I cut my insulin in half or sometimes to nothing. If not, then I will be stuffing my face with OJs and food and then later on when I'm just laying around it catches up to me and bam, 250 to 330.
Your picnic and activities sorrounding that may have played a role in the lows. The method that works for me is if I have extensive activities, low meds and fair amounts of carbs.
Thanks for the encouragement! It's tough to get the exercise/insulin mix right, at least at this point. I've been lowering and still experiencing issues. I'm hoping it works out soon though!