Monday, November 21, 2005

Slow Monday, Long Night

Hi everyone, sorry I've been scarce lately. Believe it or not I've been *gasp* working! Things have been running pretty smoothly lately. Although there's a ton of work ahead of me, I'm feeling great about where the book is going and the topics I'm tackling!

And speaking of~

We had such a tough night last night. Last night I was sooo tired I wanted myself and the kids to go to bed at 8:30. When I gave my son his blood sugar test, he was at 100 with 1.20 units of insulin on board. 1 unit drops him 100 points, so 100-120=not good! That would have been a sure recipe for a seizure, or worse.

I fed him ~40 grams of slower acting carbs. That should have brought him up ~100 points and I figured if I tested him at midnight (I always test at midnight and plan further testings on whatever that number is...) that if I had glucose tabs and juice/crackers at the ready, we would be fine.

When I tested him at midnight (on the calf~I do alternative site testing at night so as not to wake him up), he was 370. 370! I asked him if he had eaten anything other than the crackers, and he said no. He awoke and tested again, this time on his finger, and he was 362... still unbelievable! "Well," he sighed, bleary eyed, "may as well test for ketones." He shuffled down the hall to the bathroom as I sat on his bedroom floor, so angry that not just my sleep, but his, would be interrupted this way. He returned and reported: "No ketones." I bolused a correction down to 155.

I would have tested him again at 3 am, but I slept through the alarm (told you I was tired). My eyes popped open again at 4:20 am. His must have too, because he sat up and tested himself: 245. I bolused him down to 150 and he awoke at 7:00 at 134.

Why on earth would he have gone so high between 8:30 and midnight? My fear is that I didn't feed him enough carbs and he went severely low, then his liver stores kicked in. That's scary because it means it could have been a seizure and it also means his liver stores are depleted for the next few days and we have to be REALLY careful for the next few days. (By the way, he'd had two lows earlier in the afternoon and evening.)

The other theory is he ate a whole bunch of pistachios with his dad and maybe there were some lagging protein molecules that brought up his bgs? I know protein has a minimal effect on blood glucose, but it does have an impact.

FYI to any of my O.C. advisers (cuz if you have advice, please tell me~I don't want this to happen again!), dinner was a whole wheat pasta which we weighed and bolused for and have not had trouble with in the past. He also had crackers after dinner which he bolused for. (hence the insulin onboard)

Also... his cartridge was LOW but not empty in the morning... it alarmed for being low just before bedtime and I didn't think we would need much insulin overnight, so I didn't refill it. This morning it was down to 0.20 units left in the cartridge, some of which were bubbles... I am thinking that's why the midnight bolus didn't fully bring him down to the 155 where I targeted him.

As for my writing today... I wonder if there's a way to write in my sleep?

One of those I HATE DIABETES mornings.