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Need Some Adjustments.

The last few days have been nothing short of annoying - and I have the blood sugar logs to prove it.  In this past week alone, I've had six low blood sugar episodes ringing in under 50 mg/dl.  The lows are intense, sneaky, and have me fumbling with my meter, my hands, my words. 

Hypoglycemic unawareness is very, very scary to me.  It's this weird mix of being proud that I can still function at a blood sugar of 31 mg/dl, but also frightening because I'm not feeling the symptoms of a low until my body has almost crashed.  Last night, as I was getting dressed to go to Chris's film event in the city, I felt the teeniest twinge of a headache, but nothing that stopped me from doing my hair or brushing my teeth.  It wasn't until Chris asked me, nicely, if I was able to pull up HopStop on my Blackberry from the train.

My snippy response:  "Yeah.  I can, okay?"  Pause, realizing I was being enormously bitchy.  "I'm going to test.  I think I'm low."

A few seconds later, I'm looking at that officially scary number of 31 mg/dl staring back at me.  Still, no real symptoms.  I drank some juice, finished getting ready, and put on my coat and scarf.  It wasn't until I was all buttoned up and ready to go that my legs gave out and my brain went on hiatus.  It took about 30 minutes to fully recover.

Later on, during the screening, I tested at random and saw a blood sugar of 48 mg/dl.  More juice.  More nervousness, because that one came without any warning whatsoever.

I'm not sure what's been going on these past few days, but the lows have been unpredictable, yet daily.  I can't explain them with an "Oh, I over-bolused," or "I did a more intense workout than usual," or "Whoops, I forgot to eat!"  I even (TMI) took a pregnancy test to rule out any possible biscuit building.  Negative - no biscuit.  So now what?

Thank goodness for Dexcom.

My Dexcom sensors arrived via FedEx yesterday and I put one on this morning (after charging the receiver - I always forget to do that in advance).  Actually, Chris put it on for me because the sensor is on the back of my right arm today.

"I'm glad this is back on," he said, expertly pulling out the needle and attaching the black sensor to the housing on my arm.  Since I wear my sensors mostly on my arm or my lower back, Chris is the one who knows how to put them on best.  His hands move quickly and surely, talking to me as he attaches this device to my body.

"Me, too.  Yesterday sort of sucked.  The gym on Monday sucked, too."  The sensor clicked into place and he kissed me on the cheek.

"All set."

Now that I can watch the numbers trend and burn, I'm going to run a basal test for the next few afternoons, so I can see what the hell is going on with my body.  Am I suddenly more sensitive in the afternoons?  Is there something going on in the morning that is affecting my afternoon numbers?  Are the glucose gremlins on vacation?  I'm counting on my meter, the Dexcom, and a little old-fashioned freaking vigilance to help me find the source of these lows.

Either way, I'm still on this diabetes trapeze.  But at least I have a bit of a safety net now.

Comments

I have been having the opposite where all of my basal rates seem to low now. I guess it is time for some fasting tests. yuck.

Good luck Kerri.

It's so frustrating, isn't it? I've been there too lately. A 27 with no warning except a bit of queasiness. A 43 with no symptoms at all. But then, a 55 where I felt SO LOW. It just doesn't make any sense. I even called my endos office to see about starting the process on a CGMS now, before my appointment in 3 weeks. For the first time ever, I got an answer from their office that I didn't like - "don't do anything until you come in and talk to Dr. F". Grrr, sometimes three weeks seems like such a long time.

Here's hoping your Dex has all the answers on what is going on. I'm sure the basal testing will help shed some light.

Ross puts my sensors on too. I always fumble with them and the sticky stuff gets messed royally.

It was nice to see you on Friday! Sorry we didn't get a chance to chat more.

I'm so glad you got your sensors! I hate lows and that unawareness is so scary.
Maybe things will straighten out now.

I swear sometimes I feel cured. With barely a drip of insulin, I can drop to 28 and then have to fight like hell to get the bloodsugar above 75. It's frustrating. Maddening.

And I feel that same mix of pride and fear when I realize I'm totally functioning at 30 or below. As if it's a badge of courage - but one that's totally ugly and that no one really wants. Not that I want to be passed out at 30 - but you know, a flicker of a symptom would be stellar.

Do you think that the insulin sensitive among us are simply much more susceptible to these kinds of sneaky tricky lows? I give between 20-28 units on insulin on average in a day - the 28 is usually on a day when I've eaten like a piggy... And I have these periods where time after time I'll have the kind of lows you describe. I know you're insulin sensitive too - could that have something to do with it? And I'd love to have a doc's insight on what correlation there is between insulin sensitivity and hypo-unawareness - there's got to be something to that too. 99% of the people I know who are hypo unaware are also on mini-doses.

Hoping that the Dex helps you out some. I am still uber-jealous that you've got one!

Hi Kerri

I have had the same problem lately - maybe it's something with the position of the moon or the planets, or whatever universally annoying facts that affect our D management ;-)

Last week, and especially the weekend, was really bad in terms of the number and intensity of lows for me. Saturday I woke up 2.5 hours AFTER my alarm clock was set to wake me, I had turned it off without even remembering so, and when I tested, I was rewarded with a 1.8 mmol/l (that should be 32 in your units). That wasted the better part of the day for me because I felt really sick afterwards. Then on Sunday numbers had been more stable so I thought I would go for a run. I managed to run a few miles before feeling tired. I stopped and tested, seeing 2.4 (43) glaring back at me. Popped 5 glucose tabs and continued my route walking. A mile or so later I realized that I had missed the turn I had planned to make, and that the world was starting to look just a bit foggy through my eyes (it was bright sunshine!). I grabbed the glucose tabs again, ate a few more and continued walking, but not for long as I felt my legs starting to give up on me. I stopped and tried to keep standing, but couldn't control the jerking of all 4 limbs in their own directions. I stumbled on a few more steps before I fell to the ground. Sitting on the pavement I was trying to get hold of myself and the glucose tabs still in my hand, when a nice local came running to ask if I was okay. He stayed with me, talking to me - which I think helped me not entering this semi-conscious state that I sometimes experience, when extremely low - and after maybe 5 minutes or so helped me to my feet again to make sure I was okay. I was actually feeling a lot better, but when I tested, all I got was a "LO" on my meter, meaning that I was at or below 1.1 (20). I still cannot believe that I was still able to function - although not optimally - at that level. I ate 8 more glucose tabs, and finally, after a full pack of glucose tabs + approximately 20 g of hard candy, my numbers went back up. Just in time to calibrate the Medisense sensor that I had inserted a couple of hours earlier – what cruel irony is that?

I hope that the arrival of the new Dexcom sensors will scare those pesky lows away from you now – take care!

Heidi

I had some issues with odd numbers after my breakfast meals. If my BGs were low before meal then 2 hrs after they would be in the 200 range. If my BGs were higher (170+) before meals then they would plummit within two hours.

And I would have the same exact meals, and the same Bolus ratio and test 2 hours after my meal before my work out. That would be the frustrating part. Not knowing what my numbers would be before working out. Seemed like a crap shoot.

I even tried changing up the bolus ratio and it did not help. So the only thing I had not changed was the insulin sensitivity. Just by 2 point from 20 to 22. And magic. It seems to have worked. Cross our fingers now.

The insulin sensitivity was the only thing I have not changed this year since I have lost 35 pounds. So I will take this up with my doc next month.

Thanks for your posts. I really enjoy reading them.

Kerri, thanks for sharing. Be careful with those lows. I had a sudden on-set of lows in the evenings, down into the 30s, and have no idea of the source (nothing had changed). About 2 mos. ago, I passed out and gave myself a concussion. I've cut my evening carbs and night-time long-acting insulin intake and have pretty much beat the lows. If I do go low, I eat an apple and then test about 15 min. after. Just stay ahead of those lows...they can be scary!

Jeannie
http://www.youtube.com/diabetesmiracle

Kerri, seriously I think we are the same person or something the same exact thing is happening to me too! Get off my body wave. aka brain wave lol sensor wave? Ok having too much fun with that.

Noah's been having the weird lows, too. Followed by insane highs.(overcorrect much?) I think it IS the moon, tides, change of seasons...who knows!

maybe it's the change in weather (at least out here in SF-- summer hanging on for as long as possible, and turning straight into winter). i'm noticing lately that my post-prandial afternoon BGs are ~50mg/dl lower than normal. if i didn't regularly check at this time, i'd be crashing before dinnertime every day this week.

I was going to recommend a pregnancy test. You read my mind tho! I hit these times where blood sugars either skyrocket or they drop terribly low for an extended amount of time. Sometimes you just never know what caused them.

Chris is totally amazing! I want to marry a guy that will insert my sensors for me (I'm oddly afraid of those things)!

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