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GTFO.

“Normally, I can roll with the punches. But today diabetes caused me to miss a conference call because I was sitting in a parking lot for a full hour waiting for my blood sugar to come up. Dizziness and the unwelcome low-crying jags dominated while I tried to entertain my son as he sat in the car wondering why we weren’t going anywhere and why mom kept saying, “It’s okay, it’s okay” somewhat to him but mostly to herself. Diabetes can GTFO today.”  @sixuntilme

A week or two ago, my endo suggested I move my active insulin time from 3 hours to 2 hours to help with some stubborn highs.  I forgot to implement his change for a few days, but remembered last week to update my pump.

“You might notice that you’re going low.  If that happens, change it back to 3 hours.  Just be careful,” he said.

I promised to pay close attention.  I meant to.

But the lows hit hard and fast and my brain immediately went empty.  It took me three full days of severe hypoglycemic episodes before I realized that I was low constantly.  Honestly, it was the brain fog of all those lows that kept me from changing my active insulin time back.  It wasn’t until a friend suggested I look at that number that my low-addled brain let some logic leak through; “Hey … Kerri.  Stop being low for five seconds and update that active insulin time.  Do it right now.  Or else you’ll consume your own weight in raisins and juice boxes.”

Yes, brain.  Will do, brain.

Changing that number (from 2 hours back to 3 hours, but I ultimately ended up going to 3.5 hours because the lows were persistent) helped so much, but experiencing so many back-to-back extended low blood sugars knocked me for a total loop that took several days to recover.  I’m older and more worn out than I was a few years ago (thank you, natural aging process and also hey there, new little baby person), making the hangover from hypoglycemia more pronounced these days.  So much so that I wasn’t good at processing normal thoughts, like, “Hey, when did the baby last eat?” and “Hmmm, what was I going to write in this open email draft?”

But after a solid day without a low blood sugar, my brain reclaimed “active” status.  And I’m no longer leaving post it notes stuck to the cupboard that say, “Pants:  Put some on.”  Clearly my brain is not any good without proper sugar content on board.

I have a new respect for low blood sugars and their ability to sneak up on me and tie my mental shoelaces together.

14 Comments Post a comment
  1. Ugh, the worst!! And I agree, the older I get, the harder it seems to be to bounce back from lows. And highs too. Sigh……

    09/25/17; 2:09 pm
  2. Matthias Granberry #

    2h is a completely unrealistic time for DIA. Even 3-4h is unrealistic given a good insulin activity curve, which no pump really has. Look for the root cause here, probably a basal rate that is off or missed carbs in carb counting.

    Advice like this from doctors who should know better really irks me.

    09/25/17; 2:22 pm
    • Leah M #

      I don’t disagree, although I wonder if that advice came from the MD’s recent experiences with the Medtronic 670. My active insulin time is now (on 670) 2 hours and my insulin to carb ratios went from 1:10 to 1:7. I wonder if that MD thought that change might translate to tighter control…or not in Kerri’s case.

      I don’t work for Medtronic, but my low fogs have nearly disappeared since being on the 670. It has a lot of annoying trade offs (lots and lots of alarms, more BG testing), so it’s not for everyone, but the sticky highs and lows are much improved.

      09/25/17; 8:49 pm
      • I may have ended up with a lower A1C, for sure, with the lows running rampant. But my quality of life was taking a nosedive!

        09/25/17; 9:07 pm
    • I think he does know quite a bit, and he did give a proper caveat (also there was more to our overall discussion than just “update your insulin profile” sort of stuff). I don’t want to make it seem like he issued a directive without considering lots of factors. I’m getting to know him but he seems like he understands enough for me to want to see it through.

      09/25/17; 9:05 pm
      • Vera #

        Still, Matthias is correct – 2h are unrealistic, unless your doses are really small.
        A dose of about 7 units takes ~3.5 hours to be gone and 2.5 hours to be mostly gone (90%). Triple dose –> double absorption time. (One third of dose –> half of absorption time.) With this rule of thumb your average dosage has to be as low as 2.5 units for a 2 h dai.

        As the curve calculations in the pumps are always linear (as far as i know), they are never correct. Therefore there is ALWAYS a high risk for lows when correcting a high in the first two or three hours after a bolus. (Which… you seem to do often, if that really is the reason for so much lows… which I doubt, I’m with Matthias here again. Basal rate ist much more probable. Or a change in insulin sensitivity, e.g. due to little daily doses over the last few days.)

        09/27/17; 5:18 am
        • I do take very small doses of insulin (TDD around 25u) and my average meal or snack bolus is 2 – 3u. But I’m seeing a new doctor and am learning his ways as he’s learning mine. I really appreciate your feedback. It always amazes me, how after 31 years I’m still learning so much about this disease.

          09/27/17; 9:44 am
  3. Ria #

    notes to myself are downright ridiculous sometimes
    Like ” bring water, food, meter, glucose tabs did you take lantus yet?” taped to my purse
    Glad you’re ok
    Glad you remembered to wear your pants, too

    09/25/17; 4:29 pm
  4. Tavia Vital #

    Hey at least your low brain has the concept of preventing extreme embarrassment by prompting you to wear pants! Yay for that!
    Tell that Endo I said “not cool.”
    Tell them to come train with me!

    09/25/17; 5:03 pm
  5. A series of lows definitely makes it harder to fully recover. I’m very glad you waited until you knew you were capable of driving safely. Also happy you remembered to wear pants!

    09/25/17; 9:29 pm
  6. Abbott Smith #

    Be thankful the post it didn’t say ‘Crochet pants’. Because that would have required an intervention.

    09/25/17; 10:57 pm
    • OMG crocheted pants!!

      09/26/17; 10:13 am
  7. Pam Spicer #

    This is really scary!! I’d much rather see a high than a low BS. The A1c is what it is. We have to survive day to day and do the best we can. Take good care of yourself. I enjoy your blog stories. Pam

    09/26/17; 8:07 am
  8. Toni #

    I can so relate! Yesterday was my first day being on the Medtronic 670, and my body didn’t waste time putting it to test. It turned my basal off during my run, and thankfully never hit the low!

    09/26/17; 9:36 am

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