I’ve been thinking about the topic for the DSMA July Blog Carnival — mostly thinking it is impossible:
We usually talk about how we deal with different aspects of diabetes, or things that would help us deal with those aspects. This month let’s change things up a bit. We’re going to revisit a question from the Open Chat on June 18th and come up with something about diabetes to change. That’s right, we want to know . . . .
If you could change one thing about diabetes, (besides not having it), what would you change? Why?
Every time I think of A thing to change, I think of something else that I should change instead. Prioritizing the things changes based on the situation it seems. Kind of like diabetes :) But, since I am awake – again – at 2:30 a.m., I’m going with the situation I’m in.
I would change the relentless unpredictability.
Tonight was supposed to be the last night of a pattern test before changing basal rates overnight. I have been mysteriously running high bgs starting at around midnight that then stay elevated until morning. The good news: My basal rates for the second half of the night are good — keeping me steady at whatever number I enter at. The bad news: If I enter at 280, that’s where I am at for 6 hours, waking up feeling like a large mammal has been sleeping on top of me. A temp basal to combat the midnight high has just pushed the high to 4 a.m. – so… what does that say about those later basal rates?
“supposed to be” Instead, I woke up at 2:20-ish to that very harsh dexcom alarm signaling 55 bg (or lower). A test revealed a bg of 60. Glucose tablets, wait for a while, and #CGMnow 81 and rising. True: had I changed some overnight basal rates, I probably would have been 40 at 12:30 a.m., so that makes this good, right? Tell that to my sleep-deprived brain (or maybe, wait to tell my brain until it is awake enough to make sense of what you are saying).
Of course, since I’m awake anyway, I test the Bear’s blood sugar. She was 155 at 10-ish when we went to bed so tonight would have been a night “off” from this middle-of-the-night test. The past month or so if she has been around 160 at 10 p.m. she wakes up in an awesome range of 90-120 — and with good numbers at 2:30/3:00 a.m. This time? She’s 190 and since she isn’t wearing her dex right now (another story) I don’t know which direction that is heading. Pump suggests 0.1 correction which I do but thank goodness the BHE gets up early and will test her before I have to wake up.
Overnight is important in diabetes. And, it should be easy: you aren’t eating or exercising, there’s nothing like that to mess with bg numbers. One third of the day really has an impact on averages and HbA1c. If you can get the overnight “right” you’re way ahead of that A1c game.
Are you listening diabetes?
So, if we could just set nighttime basal rates and be done with it, have 8 hours of stable, in-range bgs, it would make managing all of the other things that I wish I could change about diabetes more tolerable – more manageable.
How about it?
This post is my July entry in the DSMA Blog Carnival. If you’d like to participate too, you can get all of the information at http://diabetescaf.org/2014/06/july-dsma-blog-carnival-4/
Other good reading on this topic:
Summer Basal Changes – Meri @ Our Diabetic Life
[And that other blog post(s) I read recently that explained the 1/3 of our day and impact on HbA1c that of course I can't find now... Post in the comments if you have a link!]