With my ramp up in workouts over the past couple of weeks my episodes of night time hypoglycemia has increased. Hypoglycemia during periods of sleep is one of the most dangerous conditions a diabetic can face. Hypoglycemia occurs when blood sugar goes too low, this can result in seizure, coma or death – things that are not fun! From my discussions with Dr. Kirk her research has indicated two spikes in metabolic activity after exercise, one immediately after strenuous exercise and one 4 to 6 hours later. Therefore, if I finish a hard swim or trainer ride at 8 or 9 pm, my metabolic rates are going to spike at 2 or 3 in the morning. During sleep periods one's metabolic rate decreases, therefore my basal rates are a lot higher from 1 am to 6am than they are at other points during the day – a slight increase in metabolic rate will cause a hypoglycemic episode.
So as my episodes of waking up in a cold sweat or from a bizarre dream have increased, I've been able to track a few of the symptoms. One constant theme of the bizarre dreams I have noticed is that they often involve an evil villain, a gun and my younger sister. In each dream I have tried to create a strategy with Lynn to defeat the man with the gun – normally I wake up before the showdown but it's uncanny how similar all the dreams are. So I guess this means that my mind views diabetes as Lex Luger with a gun!
Not surprisingly, my basal rate has dropped a full 2 units of insulin per day over the past several weeks. Right now my basal rate is just above 13 units of insulin per day – I assume that by the end of February I'll be down to 11 units of insulin per day. Interestingly, I've realized that as my work outs become more focused my diet becomes more refined. I've switched back to mainly drinking wine if I'm out with friends, making sure I'm home by 1am and eliminating anything on my plate that I "can't recognize." The combination of the increased exercise and refocused diet has contributed to having just two highs over the past 8 days. Although all that has also increased the episodes of hypoglycemia – the system continues to be a delicate balance.