One of the most absurdly frustrating things about diabetes is how much stuff happens when you’re sleeping. Or, you know, trying to.
Most of us don’t eat when we’re sleeping, or exercise, or take insulin. Mostly we just lie there and dream about cures and cupcakes and not being able to find our lockers. But those hours between 11:00 at night and 7-ish in the morning can be so damn volatile.
My Continuous Glucose Monitor, as much as I love it, can be part of the problem. Take Tuesday night — I went to bed relatively early, all nervous about a huge presentation I had the next day. It felt like a normal night’s sleep, until I woke up in the morning and checked my blood sugar. Four-fucking-hundred and 58 mg/dl. 458! The highest number I’d seen since, I don’t know, 2008?
Here’s the best part: the reason my blood sugar was so high was because I — or some naughty diabetes fairy — had suspended insulin delivery. I hit the escape button on my pump and there it was on the screen: “SUSPENDED AT 2:47 A.M.” I’d gone over 5 hours without a drop of insulin.
That's me and my diabetes, just trying to get through the night.
I scrambled through my head, trying to piece together the events that might have led to this nonsense. I didn’t remember being up at 2:47. I hadn’t gotten up to use the bathroom or anything. And my husband had been out of town, so there’s no chance he’d woken me up. Then I looked back at my CGM graph and my alarm history, and noticed that I’d been hovering around 78-82 in the hour before that mysterious suspension — right around my “low” alarm threshold. (I should mention that, at that moment, my CGM read 126 with two down arrows. Lovely.)
So here’s my theory: I’d been sleeping soundly, and my CGM had not. I must have reacted to meaningless alarm #17 by simply turning my pump off. Since I don’t even remember doing it, I’m sure it wasn’t intentional. My diabetes reptilian sleepy-time brain probably thought it was silencing the alarm, or adjusting the basal rate, or saving the world from a nuclear apocalypse.
Of course, I bolused immediately after I saw that 458. A few hours later, I was back down to 134 and feeling like someone had smacked me in the head with a duffel bag full of pig pancreases. But my big fat presentation was still looming, so I drank as much water as I could stomach and put my best “normal person” face on.
For so many of us with diabetes, sleeping is one of the scariest things we can do. And for me, the CGM serves as a security blanket. I’ve never had to consider the idea that the thing that’s supposed to help keep me alive and well could annoy me to self-destructive behavior.
As it turned out, that work presentation went swimmingly, and I’ve managed to make it through the past few nights without turning anything off or pulling anything out. I’m counting myself lucky, and sleeping in restraints for the rest of the week.