From Abby: Standards of Care.
Note From Kerri: Lows suck. Larry Bird blood sugars shouldn't be making appearances in the wee hours of the morning. And not waking up right away for these kinds of lows can be terrifying. Abby (the Person) writes about a low that left her reeling and the superhuman strength of her wonderful mom.
8:00pm – 276 mg/dL (no idea why)
10:30pm – 288 mg/dL (negative ketones, and the correction bolus that ruined everything - give me a minute to explain)
12:00am – 120 mg/dL (3/4 bolus for a snack, and to bed I went)
1:45am – 33mg/dL (awesome)
I know why this happened. When I took that second correction at 10:30 pm, I thought to myself, “I might go low from this, but I feel like crud, and I’ll just eat a snack before I go to bed.” And so I did: a very small bowl of Raisin Bran cereal, only bolusing for 3/4 of it, and off to bed I went with a blood sugar of 120 mg/dL, feeling like I avoided that low.
Feeling pretty dia-successful.
When I woke up at 1:45 am feeling a little warmer than usual, but with no other symptoms, I decided I should probably check.
33mg/dL. (Editor's note: Whoa, Larry Bird)
Defeated. You win tonight, diabetes. A 6oz juice and a 19g granola bar later, I lay back in bed. And that’s when things got scary: seeing stars, extreme sweating, nausea, crying (which is new to me, and frankly I’m not a fan). I grabbed the glucose tab bottle, and obviously it was brand new and had that cannot-open-without-a-chain-saw plastic thing under the lid.
By this point I was freaking out. I stumbled into my mom's room (yes, I’m 23 and I live with my mom; times are tough, people and I’m a full time college student with two jobs, don’t judge me) where she saw the tears and the shaking hands and presumably my face sans any sort of color. She grabbed the bottle and ripped the plastic off with that “my daughter is in danger” sort of strength that I still don’t understand. All I could manage to eat were three glucose tabs.
I really thought I was going to die, like straight up fall on the floor (only with a blood sugar probably in a safe range at this point) and just die. The re-check showed me a 66mg/dL. Then I got really frustrated because I was almost back in range but I had EVERY low blood sugar symptom on the face of the earth, only on steroids. (For some reason updating my Facebook status and texting a few friends at this point seemed like a grand idea.) This is not the first time I haven’t woken up until I was under 40mg/dL. I’m sure it won’t be the last, thanks to my lack of a continuous glucose monitor. Actually, I take that back … I have a CGM, but I hate it. I try it at least once a month, I do everything by the books, and if I get one or two readings that are within 20 points of my finger stick, it’s a miracle. I’ll be starting a 7-day-trial of the Dexcom soon, and I already have an email into my endocrinologist asking her for one of my own.
The point of my story is to ask this question: Why aren’t CGMs a standard of care for diabetes? I bet if I asked my friends who have diabetes for similar stories, I’d get a boatful. (Then I would send that full boat to insurance companies and ask them if they’d rather dish out a few hundred dollars every month for their patients to have sensors and stay safe, or keep refusing us, keep making it a huge hassle to achieve safety, and instead keep sending me 87 million boxes of test strips that expire before I even think about opening them.)
The technology is here, but there is clearly nobody working for those insurance companies that knows the first thing about the fear I’ll have when trying to fall asleep tonight.
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What makes me nuts is that people who want and need a continuous glucose monitoring system still can't find coverage through their insurance companies. We've come such a long way, technologically-speaking, and it's frustrating when a fellow PWD can't readily access that technology. What insurance battles are you fighting?