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Dealing with Overnight Low Blood Sugars.

Quick confirmation:  Yes, you are reading this on the Internet.  No, this website is not written by a doctor.  Or a medical professional of any kind.  (Or a professional of any kind.) This is not medical advice.  I have been living with type 1 diabetes for over 30 years and this is just how I do it.

Such a good song.

Anyway, overnight low blood sugars are gross.  During the day, am I struck by the urge – need? – to consume 10 times more carbohydrates than I need to correct a low blood sugar?  Nope. I don’t eat glucose tabs by the fistful at 11 am.  But in the middle of the night I am able to consume 1400 calories without blinking twice thanks to the panic and chaos of middle of the night low blood sugars.

Over-treating lows has been a tricky trap for the last three decades, but there are a few strategies I use to hit back against hypos.

No IOB before BED.  
I try to keep my snacks very low-carb after 8 pm in order to keep my boluses at bay.  While I’d love to dive head first into a bowl of rotini before bed, I feel safest going to bed without insulin on board.  Sometimes it’s hard to avoid a bolus here and there, but on the whole, a big fat zero on my IOB brings better sleep for me.

Timing Exercise.  
This is a tricky one because my schedule changes every day, but I do my best to exercise before 4 pm on most days to mitigate midnight lows.  If I exercise in the evening, the chances of bottoming out overnight are high, so if I’m able to get things done before dinner, I feel safer.  (This does not always work out for my workouts because of kid 1, kid 2, work stuff, family schedule, etc. but I try.)

Pre-Counted Carbs.  
What do you mean, eating two nutella and peanut butter sandwiches to treat a 54 mg/dL at 3 am isn’t a good idea?  If I wake up low, I want to inhale the fridge.  Sometimes I over do it so hard that I’m bolusing while low to compensate for the carb overload.  This usually results in a high blood sugar.  And also bigger pants.  Keeping my low blood sugar treatments pre-carb counted helps a lot.  This means using glucose tabs or a juice box instead of a bag of candy that I can take too much of or a bottle of juice that I can drink too much of.

Bedside Snack Table.  
I need to keep snacks on the bedside table instead of daring my low legs to make it down the stairs.  My bedside table is almost always armed with a jar of glucose tabs or a juice box.  This is easiest because it keeps me from taking field trips while low.

Continuous Glucose Monitor.  
THIS.  This thing is the best battle tool against nighttime hypos because I can set my threshold to 80 mg/dL which, in turn, alarms and wakes me before I actually end up low.  In the last ten years, since starting on a CGM, my overnight hypos have decreased significantly simply because I catch them before they become disasters.  Of course lows sneak in here and there, but they are fewer in number thanks to this technology.

My next goal is to figure out how to stop the cleaning fits while low … although they are terribly productive …

The One About the Gym.

UUUUUUUGGGGGGHHHHH the one about the gym.

Dude, I wanted to start this post with a story about how hard it’s been to regain traction with losing the baby weight and then end with a BAM I NO LONGER WANT TO BURN MY SHAPEWEAR IN A BONFIRE.  But no.  That is sadly not the case.

The road to my last pregnancy was paved with fertility drugs, miscarriage, depression, and other terrible crap.  Ends eventually justified the means and I was beyond grateful to find out I was pregnant after such a journey.  (The little Guy is my favorite guy.)  My son was born eight months ago and he is exactly who we had been waiting for.

Table all the parental happies for a minute, though, because this post is not about infertility.  Or the little Guy.  It’s about the tarnish that’s settled onto the word “just” in the sentence, “I’ve just had a baby.”

No.  I did not just have a baby.  I had a baby eight months ago.  And I still feel like I’m trapped in the postpartum schlubby chub club.

So I joined a gym.

I used to go to the gym a lot.  It was kind of a family thing and while I never sculpted a physique that would stop traffic (unless a vehicle actually hit me), I was stronger and healthier and slimmer than I am now.  I didn’t feel ashamed of my shape and I wasn’t avoiding my closet in favor of athleisure wear.

Oh yeah.  “Doing absolutely nothing in my active wear” has been a theme these last eight months.

Postpartum anxiety didn’t help (better now, though) and neither did the c-section recovery.  I didn’t feel great after my first c-section and, despite rumors I’d heard that the second one is easier, I did not find that to be true.  Add in some wrist and hand issues (I ended up with breastfeeding injuries, which feels silly as eff to type but is actually a thing) and my body felt like something I was renting out instead of taking ownership of.

That did not feel good.  I want change.  Can’t wait around for change, though.  Have to chase change.  Change is exhausting.  So is this paragraph.

So about a month ago, I joined a gym.  It wasn’t a cheap decision, but the gym feels low pressure, has great hours, and also provides childcare for small baby people, so I have no excuse NOT to go.  Also, something about paying for it makes me less likely to NOT go because I hate throwing money away.  So I’ve been going.  Despite feeling shy (is exercise timidity a thing?) and despite feeling flumpy, I’ve been going.  I use the treadmill and the free weights and I’m debating a class or two if I can find some glasses and a fake mustache to wear while participating.  I’m trying not to weigh myself but instead using a particular pair of pants as my barometer for progress.

I hope to see some progress soon but I’m trying to find small victories in the steadier blood sugars and increase of energy.  And also in the “hey, I left my house and didn’t spend the entire day juggling kid requirements only.”

Hopefully, in time, I’ll schedule my shapewear bonfire, but in the meantime, I’ll try and find some pride in taking small steps now.  Especially wearing these mad cool glasses and this fake mustache.

What I Did On My Bloggy Vacation.

Whoa – this was the longest unintentional blog break I’ve taken in ages. Maybe ever. And it’s not like I didn’t have diabetes-related things to say or conversations I wanted to contribute to.

I just didn’t feel like writing. Which is weird. I usually feel like writing.

After the Target low, I was on break with my family for a while, and then in Dallas for a TypeOneNation event.  I took a short pump break. I saw some PWD in the wild while traveling and the urge to hug them was unrelenting. I read a bunch of crap about “diabetes in a cup” and had that desire to climb on a soapbox clutching a unicorn frappuccino in one hand (but not taking a drink of it ever because my insulin has better things to unpack and also I keep picturing a liquified unicorn, which grossed me out further). I read a blog post and watched our community react to it. And I saw a bunch of angry Tweets and uncomfortable people and hurt feelings and just so much stress.

Oh, never mind the fact that I open the CNN homepage whilst looking through my fingers because there’s always some new yick storm.

I needed a breather.

Random street art ❤. @spacegirlw, thought of you.

A post shared by Kerri Sparling (@sixuntilme) on

So I guess I pulled back for a while. We celebrated Birdy’s seventh birthday as she crossed that threshold into an age that I remember (I totally remember second grade and my friends back then and riding my bike in the neighborhood and reading books and all that stuff – I have some clear and vivid memories of seven. I was also diagnosed with diabetes that year, so I keep looking at her through that lens, wondering if I appeared simultaneously so big and so little to my own mother.) We traveled without the Guy for the first time and it was kind of stressful for me, being away from my smallest little, but made me grateful for my mom and stepfather once again, how they are always willing and thankfully able to mind my kid(s).

… oh, and I am the last person on the planet to learn that if you are typing a text message on an iPhone and you turn the phone sideways, you can create a handwritten text message. THIS IS MY NEW FAVORITE THING and I am madly in love with this feature. I have sent several ragtag cats, two ten gallon hats, a pair of jeans, a plane that looked more like a shark, a bunch of grapes, and boobs to unfortunate recipients. Anyone in my contact list is at risk of receiving nonsense and I AM NOT SORRY.

After a few days, I felt a little clearer. I cracked open my email and confirmed calls for the coming week, met deadlines that were looming, and created a document titled “Shit to Write About” with bulleted ideas of shit to write about. We paid our taxes. The tulips bursted up in the front lawn and they look like an army of happy. I felt a little bit productive, not so drowning in diabetes, and kind of ready to open a “New Post” tab on my blog platform.

So I did. And here I am. And here it is.

It was nice to work a little bit on a non-diabetes writing project I’ve been tooling around with. I liked sending the plane shark. I really enjoyed dealing with diabetes as a stand alone thing instead of repeatedly documenting it. Diabetes is all day and sometimes it needs to be tabled as a content source, with “shit to write about” waiting until I feel ready.

Which now I do.

Target Lows.

“Can you scan these so I can open them now?”

“Sure thing,” as she reached her arm over the conveyor belt to scan the package of Skittles in my sweaty palm.

BEEP.

I ripped open the package clumsily, my phone screaming out the Dexcom urgent low alarm tones.  Jammed a handful of Skittles into my mouth – way too many to be chewed at once – while simultaneously and awkwardly unloading the carriage.

“Do you have a Target red card that you’ll be using  today?”

” … mmmfff …”

My jaw was busy processing a dozen Skittles at a time.  I took a second to hang on (hopefully casually but most likely looking like a drowning man clutching the edge of a raft) and concentrated on chewing.  When I remembered, I would retrieve another item from the cart and place it on the moving track.

The lady behind me switched lanes, properly assuming I was a hot mess.

“Are you okay?”  The cashier was about 20 years old and probably accustomed to a flurry of weirdos coming through her cashier line.

I finally mashed the Skittles into something I could swallow.  “I’m fine.  Sorry – I have diabetes and my blood sugar is really low.  It happens here a lot.  Target makes me low.”  I was rambling and couldn’t stop.  “It always makes me low.”

She nodded slowly, putting my items into a bag as I loaded them onto the conveyor belt, one every fifteen seconds or so.

“I bet.”

She was kind.  I was probably drooling colorful drool.

“You can keep eating those,” she added.

So I shoved the rest of the package into my mouth, a hypoglycemic cow chewing on taste-the-rainbow cud.

BG 56 mg/dL. Eff off, Target. You always make me tank. (But I ❤ you anyway, you sassy store, you.) #diabetes

A post shared by Kerri Sparling (@sixuntilme) on

Signs of Distractabetes.

My endo appointment is coming up fast, and I’ve just realized that I don’t give much of a shit.  Not good.  I’m deep into distractabetes.  Signs?

Your fasting blood sugar is taken at 10 am.

You think coffee is breakfast.  And is also lunch.

You carb count by glancing at the food and going “meh.”

You accidentally end up on a raw food diet only because you don’t want to cook anything anymore.

You changed your lancet last week and you’re still all proud, despite it needing to be changed again.

You wonder if it’s finally time to look under the bed and retrieve the many juice box straw plastic sleeves that have taken up residence there.

You go to dump out the dead test strips from your meter bag and there are only a few instead of a giant pile.

You notice a week long trend of overnight highs and instead of gently tweaking the overnight basal rate, you ratchet it up and hope for the best.

You deleted the Dexcom Clarity app off your phone … because the idea of looking at that estimated A1C thing is stressing you out.

Your CGM high alarm goes off and aside from humming the tune back in response, you don’t take any other action.

You go to write a blog post but end up writing a list about distractabetes from the third person POV.

(Also, by “you” I mean me.  Entirely  me.  I’m a little burnt out after 3 years of either pre-pregnancy-then-actual-pregnancy-then-breastfeeding.  The years of obsessively tracking blood sugars have given way to something I can’t entirely call diabetes burnout but instead feels like wicked distraction.  I’m maybe a teeny bit looking forward to my A1C draw next week so I can at least know what data point I’m working from.)

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