Sunday, August 6, 2017

I Had a Day

A little before 8:00 on Friday night after a low glucose alarm on my CGM, I texted my friend “I am having a day” and she immediately responded “yes you are.”  Friday was one of those maddening T1 days where it felt like I couldn’t win. 

The fun started around 1 AM when I got my first low alarm of the night.  Low alarms happen when my continuous glucose monitor, the CGM, thinks my blood sugar is 55 or less.  When the alarm jolts me out of bed I head straight to the bathroom and check with a finger poke to confirm and decide what I need to do next, if anything.  The early hours of Friday morning were no fun at all, as you can see here:
  • 1:07 alarm, finger poke 75 and recalibrate the CGM to correct the reading.  Back to bed.
  • 1:26 alarm, finger poke 67 and eat 6 peanut butter M&Ms.  Recalibrate and go back to sleep.
  • 2:36 alarm, finger poke 71 and recalibrate before going back to bed.
  • 2:47 alarm, finger poke 67 and eat a glucose tab before recalibrating and heading back to bed.
After the fourth alarm my body and technology let me sleep through the rest of the night and I woke up at a perfectly healthy and reasonable 81.  Hooray!  Why was I dropping?  I don’t know.  Why was the CGM overreacting?  I don’t know that either, but if I was lying on top of it that could be a factor.  “Compression lows” are an actual thing and a major opportunity for improvement at Dexcom!

Unfortunately the overnight sleep disruptions weren’t the end of my adventures for the day.  You see, schedules and timing are a big part of keeping things level and my schedule changed on Friday afternoon.  Mid-afternoon I had some blueberries and blackberries along with a little insulin to cover the sugar in the berries.  No problem.  And then…my boss very generously sent us home early to get a head start on the weekend.  I happily headed out around 3:30 and went to the gym.  Why was that a problem?  I hit the gym with 2 units of insulin in my body and cardio makes your body more responsive to insulin.  Normally I would have left work at 5:00 or later, putting that insulin farther in my rear view window.  I was at 70 in the locker room and took a glucose tab before my workout – I’d also had half a protein bar in the car, so figured all would be good.  Wrong!

The low alarm went off while I was on the stationary bike, shortly after I’d thrown back another glucose tab.  I added a third tablet and then a fourth because although I didn’t feel low, I wanted to be safe.  I’m fighting shin splints and have been doing my cardio time on a bike instead of a treadmill this week – I’m learning, not quickly enough, that cycling impacts my sugar much faster than walking does.  I cut my time on the bike short and walked on a treadmill for a bit before calling it a day.  My finger poke in the locker room after 40 minutes of activity and 4 glucose tabs (16 carbs) was 130 at 5 PM.  What?  That’s higher than I like to be and I figured I was climbing, so I took 2 more units to cover where I was and where I suspected I was heading.

And…a little before 7:00 my low alarm went off again.  Ugh.  Another glucose tab, another “I’m not dead” text to my friend and I moved on with making a “fat head pizza” for dinner.  An hour later we got another low alarm and I sent my “I am having a day” text.  Another hour later, I ate a 5 carb tiny Milky Way for my final correction of the night.  Fortunately, that was the end of the madness.

I went to bed with my blood sugar at 127.  I took 1 unit to get that closer to 100, but didn’t go any further because I wanted to sleep through the night!  It was a day.  I never overcompensated and wound up crazy high, but I was a little too tight about avoiding the high and wound up spending much of my evening low as a result.  It’s a balancing act, and while things like random overnight madness and schedule changes are out of my control, being a touch too aggressive on keeping my numbers down is within my control.  Does knowing that mean I’ll never have that kind of day again?  Not a chance.  But every T1 “day” gives me a better shot next time.