Most nights, my diabetes and I get along fairly well. I test a few hours after dinner and either eat a small snack or take a corrective bolus, depending on my blood sugar. I usually wind up going to bed without worrying too much about my overnight numbers.
But once in a blue moon, something goes awry. I was doing well with my blood sugars until a recent Monday night rolled around. I ate a fairly typical meal (salad and pita bread), so I had no trouble calculating my bolus. Between 6 and 8 o’clock, I went about my normal evening routine to prepare for work the next day. When I sat down to watch some TV before bed, I noticed a diagonal upward-facing arrow appear on my CGM screen.
I blamed it on the pita bread; after all, it tends to kick in slowly. I tested around 9, took a corrective bolus, and went to bed. I woke up above 200. This was weird for me, seeing as my nighttime blood sugars are typically good. I shrugged it off and took a bolus for my breakfast and to correct. Otherwise, it was a standard Tuesday…until the evening.
Again, I experienced a trend of my blood sugar hitting my target soon after dinner, but then rising sometime between 8 and 9. Tuesday night was especially annoying because I woke up twice throughout the night due to my CGM high alarm wailing. Both times I took a corrective bolus, and still woke up above 200.
I thought I was doing fine after I corrected and ate breakfast on Wednesday morning, seeing as I coasted down to 138. I ate lunch at noon and was simultaneously surprised and angry to see I was up to 278 three hours later. I began to wonder if something was wrong with my pump or the site, but that didn’t entirely make sense to me considering my blood sugar came down like it was supposed to Wednesday morning. I bolused again and headed into the evening pre-dinner hours at 164.
Eventually, I sat down to eat my dinner with a certain amount of trepidation that wound up being justified—AGAIN. Close to three hours after I ate, I was 233. But I didn’t want to freak out; after all, I completed a routine pod change shortly after dinner. Surely, a new pod filled with fresh insulin would prevent a high. I bolused a couple units (it was around 8:30) and decided to run a 95% more temp basal for the next hour. When the temp basal finished running, I would test again.
One hour later…I was over 300. Something was wrong. I consulted my parents, trying not to panic after testing my ketones and seemingly spilling some. By 10 o’clock, it was decided I’d change my pod for the second time that night as well as manually inject fast-acting insulin to fix my high as quickly as possible.
After all that, I had no choice but to wait it out. I didn’t want to go to sleep until I knew my blood sugar was coming down, so I fought my sleepiness and put on some mindless television while I waited. Finally, two long, drawn-out hours later, I was coming down. I woke up at 2 A.M. at 70, but my sleep-deprived mind didn’t care because I was so happy to be lower. I got up at 7 A.M. as usual to get ready for work, more tired than I wanted, but happy to wake up at 134 mg/dL.
As I reflect on this particular string of hectic hyperglycemic blood sugars, I’m feeling in a bit of a haze. I want answers to my questions: Was it a site problem or an insulin issue? Did I actually spill some ketones, or were the strips inaccurate because it wasn’t a fresh vial? Was I carb-counting correctly? Could my emotions (stress!) over the situation have affected it? Does my body just hate me? It’s frustrating that I can’t really get a complete explanation as to why my blood sugars were creeping up like that for three nights in a row; it could have been any of those factors. It’s a reminder that blood sugar can be affected by anything and everything, whether you can control it directly or not.
For now, I’m relieved that I’m back to normal and seeing a bit more clearly now that I’m coming out of the fog.