The View from 2:30 a.m. – DSMA July Blog Carnival

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?

ONE thing?

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!]

Advertisements
This entry was posted in Getting it Wrong, Living with Diabetes, Pump Management. Bookmark the permalink.

19 Responses to The View from 2:30 a.m. – DSMA July Blog Carnival

  1. Oh I completely understand where you’re coming from. My overnight basal rates, I have no idea what’s going on…some days I’ll wake up with a perfect blood sugar of 80, other days I’ll wake up in the 190 range. Such a pain. 😦

  2. Laddie says:

    My overnights have been a mess lately but I think that my problems are related to evening snacking that I need to eliminate. It’s always something…. #dblogcheck

  3. kelly2k says:

    CHECK & overnights – as of late have been good – Except for last night!

  4. Karen says:

    Yup, picking one thing is nearly impossible. But the unpredictability is definitely high on my list!!

    #dblogcheck

  5. Kelley says:

    Bless your heart! I think it’s tough just trying to figure out my overnight rates, let alone mine AND someone else’s! You are right, the relentless unpredictability would be amazing to eradicate! I hate days when I do the exact same thing but my blood sugars react in completely opposite directions-so annoying! I hope you get a chance to nap a little today!

  6. Michelle says:

    Check!

  7. Yep, overnight IS vital to our diabetes control, and yet it seems somewhat unpredictable because of all the things we did (or didn’t do) the rest of the day. My blood sugars are affected (down or up) for more than 24 hours after exercise, and when I exercise more than once in a 24-hour period, that adds to the unpredictability. But the more I stay on top of this, the more I understand how my body reacts to stuff … that is, until my body changes, which of course happens over time. I’ve had t1d for 42 years. It’s certainly an ADVENTURE!

  8. StephenS says:

    You are exactly right! And it’s extra hard because often, people who don’t know think it should be easy to manage everything, like it’s exactly the same thing every day. Great post. Love the blog!

    • Thanks! And thanks so much for your post today 🙂 I have been very encouraged by your words in the past – you have a real gift for expressing important, complex things in a gentle and simple way.

  9. You nailed it – that uncertainty, especially overnight, is one of the most stressful and fear-creating aspects of diabetes for me. I feel so reassured by the safety net my G4 overnight, but it still never completely goes away. Thanks for writing this, especially when it’s on such a tough topic with so many possibilities!

  10. Briley says:

    Absolutely agreed!

  11. Christopher says:

    I would change the burden of diabetes. If I could bare the weight of living with this disease to the point that no one else I cared for would be impacted or hurt – sign me up. #check

    • Wow – yes! I wish my husband didn’t worry about me going low and I wish I wasn’t always worried about our daughter’s bg excursions… it’s funny how this disease is so personal and individual but still seeps out to touch those who live with us and love us.

  12. Oh, it would be amazing to get rid of the unpredictability and get diabetes to behave more like an exact science. But there are so many variables to control: hormones, stress, weather, weight loss or gain, emotions, it goes way deeper than carbs and insulin and exercise. Thanks for your insight.
    #dblogcheck

    • I wish some of the doctors in my life understood that “it goes way deeper than carbs and insulin and exercise.” Still looking for an endo who really “gets” it like my first one did. Thanks for your comment – will be checking out your blog!

  13. Ilana Lucas says:

    Check! The unpredictability is exactly what I would change, as well! It’s like playing Whack-A-Mole, if the unpredictably-surfacing moles also got mallets (and possibly missiles).

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s