Thursday, January 27, 2011

First Totally New D-Experience In A While

Over the past few days my blood sugar has been reacting pretty weirdly.  Since Sunday I have frequently had blood sugars in the 300s but have had symptoms of lows, not highs.  I received my new order of Dexcom sensors yesterday so should be able to zero in on any basal rate adjustments; but my big worry is that my body is not processing insulin as quickly as it should be around lunch time.  Since my diagnosis I have struggled with my blood sugars between 2pm and 5pm.  Historically my blood sugars have spiked about an hour and 1/2 after lunch, causing me to perform a correction bolus.  That correction normally leads to a nasty low sometime between 4:30 pm and 6 pm - this only happens during the work week, not on the weekends. 

Originally I had thought that the correction was necessary so began letting the blood sugar come down naturally, much to my dismay I was still encountering lows.  In fact it has seemed that no matter the meal (salad, sandwich, or whatever) and regardless the level of meal time bolus my blood sugar will still raise north of 250 and come crashing down sometime later.  I've been trying to figure out this pattern for nearly 4 years but still haven't had any success.

Yesterday I attended a conference for work in San Francisco and decided to go swimming after it.  Much like many other days my blood sugar was almost 300 around 3:30 pm but I felt like I was trending very low.  I reduced my basal rate and by 4:25 pm was walking to the pool.  After about a mile walk my blood sugar was 89 even though I hadn't given a bolus correction and had eaten a 35 gram nutrition bar while I started my walk.  I downed a Gatorade and hopped into the pool - probably not the best idea.

I swam well enough but then experienced severe leg cramps after 45ish minutes of swimming (about 1500 meters) and decided that was enough for the day and hopped out of the pool.  In the shower I had near debilitating leg cramps and came close to falling to a heap on the floor. After some time at my locker the cramps loosened and I was able to make it to the subway feeling pretty "weird".  I tested my blood sugar and was at 65 so I just reduced my basal rate in an attempt to naturally bring my blood sugars back up.

As I commuted home I began to feel even more weird and eventually felt my heart racing a bit.  I checked my blood sugar again and was at 31 - yikes!  I downed a clif bar as quickly as I could, made it to my apartment and held onto my bed until the world stopped spinning.  My blood sugar climbed to 109 by the time I had dinner and I felt much more like myself again.  Then this morning even though I had been waking up with a blood sugar of 220ish (its been off in the morning for whatever reason) I woke up with a bs of 77.  So either a ton of insulin decided to hang out in my butt cheek instead of going through my system or there was a complete 180 of environmental factors.  Hoping not to experience anything like those cramps or a racing heart anytime in the near future though - that was a new one that I'd rather not repeat.


Anne said...

I'm sorry, Ed. Those sorts of days are frustrating.

a few thoughts...

I can't use an infusion set in my butt/hip. I've tried many times and every time, I will have a huge building high BG and then crash. I have given up on using that area.

Also if you are having a consistent high after lunch that doesn't seem correlated to the meal, you could try increasing your late morning/early afternoon basal. Perhaps you could set a weekday basal profile and different weekend profile, although that can make life complicated.

I am typically most insulin sensitive in late afternoon, and reduce my basals 1 PM - 5 PM. When I first started doing triathlon, it was such a big change for me that I actually had to turn my pump off completely in the afternoon at first. (That didn't last too long but my basals were still quite low in the afternoon.)

I have had that disconcerting low feeling when I'm high or normal before. It can be a prelude to dropping BGs but sometimes not.

Anonymous said...

do you do morning workouts during the week? I reliably get delayed lows 8 hours after I workout, even with my basal off and an afternoon snack...have you tried a protein snack?--t1 pumper