Long Term Lows.
Last night, just before bed, I did what I do every night before turning off the bedside lamp: checked the IOB (insulin on board) on my pump and looked at the Dexcom graph. IOB was okay (0.21u from a small snack bolus two and a half hours earlier), but the Dexcom was showing 146 mg/dL and heading in a southwesterly sort of way.
It was midnight-thirty, and I had to wake up at 5 am to catch a flight to California, so I knew I wasn’t going to be asleep long anyway. Since my blood sugar was in the 140′s and not the 40′s, I decided to run a -90% basal rate for an hour and hoped that would stave off the low.
(This shit never happens on a night when I am able to sleep in and I don’t have any responsibilities the next day. It ALWAYS happens when I’m scheduled to catch an early flight and have a full agenda for several days straight.)
Fifteen minutes later (close to 1 am), I saw double-down arrows and my meter confirmed me at 70 mg/dL. A jar of glucose tabs on the bedside table showed I had four left in there, so I chomped them all down in an abundance of caution, pretty sure I’d end up in the 150′s when I woke up at 5 am.
Twenty minutes later (close to 1.30 am), I was 52 mg/dL. And I stayed in the 50 mg/dL range for three hours. THREE stupid hours. For three hours, the Dexcom wailed, I checked my blood sugar, and steadily consumed carbs made out of dreams and air, apparently, because they didn’t touch the low. This low wasn’t symptom-free, either; it was one that made my shirt damp between the shoulder blades, and had me flipping the pillow over repeatedly in search of something cold. And once it was starting to taper off and the Dexcom arrows were pointing back up, the adrenaline from waiting out the low for hours had my muscles tense, like a cat who had been stalking the same dangling ribbons for hours.
Only instead of rolling over and taking a cat nap, I was wide, wide, wide awake.
“Are you awake?” I asked Chris at 4 am, who had been awake for part of the night, when the low dipped into a tough range.
“No. Unless you need juice, and then yes.”
Just past 4 am, I fell asleep, and the alarm set to get me to the airport on time went off an hour later. Pity party time? No, but it will explain why most of this post is rambly and might smell like glucose tab dust. So far, today has been a hazy, confusing shuffle of airplanes, connecting flights, and awkward naps on the shoulders of strangers (but we know each other better now, don’t we, Tom?). And the low hangover is impressive, making me actually want to put on sunglasses and have a glass of that Naked Mighty Mango drink (which seems to cure every hangover I’ve ever had – shit is magical).
But I’m glad that today’s destination is somewhere warm (Los Angeles) and I’ll be seeing some of my favorite people from the diabetes community at the Medtronic diabetes forum taking place this weekend. (Hashtag to follow is #MedtronicDAF, and by way of disclosure, Medtronic is covering my travel, lodging, and expenses, although my opinions and poorly-timed jokes remain, as always, mine.) Other people posted that they were attending and asked for discussion points from the DOC, so I’m doing the same. If there’s anything you’d like me to be sure to bring up to the Medtronic team, please let me know.
… only I’ll be wearing my Animas Ping and my Dexcom G4 and a host of dark circles under my eyes and hopefully clutching a Mighty Mango drink. We’ll see how that goes.