The Dawn Phenomenon

First weekend with my new pump went really well. I spent a good part of Saturday in the pool and checked my sensor at least once an hour. Sunday was tough. I never suffer from migraines, but I had the closest thing to one all day combined with a throbbing twinge in my neck. I ate well, tried to relax, went for a swim, watched t.v., drank water, drank coffee, took a bubble bath and a nap. Nothing worked, but at the same time, my blood sugar was very steady all day. Fortunately, after dinner and a backrub from my sweet husband, I started feeling better.

Then, the weirdest thing happened. I went to sleep with a blood sugar reading of 207 which I don’t mind because I find that my sugar goes down while I sleep. However, early this morning, my sensor started yelling at me and I woke up at 317. I assumed that my sensor was just way off but when I calibrated it was right on the money- finger stick was 318. I ate dinner around 6 the night before, went to sleep at 11, and had a small snack  about 45 min. before bed (no bake peanut butter balls— I use 1 tbsp. agave instead of brown sugar and add a handful of dark chocolate chips). They don’t usually bring my blood sugar up too high and I always give myself a bolus when I have one. The other weird thing is that I didn’t feel like my blood sugar was high at all. I never woke up to use the bathroom, didn’t run to the kitchen for a glass of water and didn’t have dry mouth when my alarm woke me up. I was convinced my sensor was just way off like it’s been before, but it wasn’t. I must have had a peanut butter ball loaded with dark chocolate chips in addition to experiencing the ‘Dawn Phenomenon’.

I did a little digging and found that there are a bunch of people who experience the Dawn Phenomenon. Between 4 and 8 am (which was exactly when my sensor started yelling at me) people with both type 1 and type 2 diabetes find that their blood sugars will spike. Sometimes it’s a lot, and sometimes it’s not very much at all. This happens because the body increases hormones like growth hormone, Cortisol, Catecholamines, Glucagon, and Adrenaline. That triggers the liver to release glucose to give the body energy to wake up. Although it took my sensor beeping at me and my alarm ringing in my ear to really get me awake.

I find that my blood sugar goes down more often than up while I’m sleeping, so I’m sure my high blood sugar had more to do with my snack. I was also due to change my pump and should have done it before bed, although I don’t like changing it and then going to sleep in case I have a site failure. Maybe I’ll skip the dark chocolate chips in my peanut butter balls next time!


Chugging Along

It’s been 3 days with my new insulin pump/sensor combo and low GI diet, and I can honestly say, my blood sugar hasn’t gone over 230 once (baby steps). I know myself, and I know that just having a new gadget to learn and practice using is a big reason why my blood sugars are stabilized. But at the same time having everything in the same place, at my fingertips, and keeping all my supplies on hand make it way easy to keep me checking and calibrating and stable.

Exercise is even easier because I only have one medical device with me when I work out now. I also bought glucose tablets the other day, so I don’t have to worry about lows. Yesterday I spent all day at a theater near my house working as an extra for a movie coming out next year (I love Los Angeles!). I was pretty much standing and dancing for 8 hours with a few breaks in between. I came prepared. I had my cute diabetic bag with me the whole time, stayed hydrated and snacked throughout the day. Overall, I had an amazing day with some amazing friends and my diabetes didn’t get in the way of that at all.

Eating low GI foods has been easier, and more delicious, than I ever thought possible. Grilled fish or chicken with salad and veggies doesn’t change my blood sugar at all. No spikes, just chugs along. I feel better after eating low GI foods. I’m not stuffed right before I go to sleep. My stomach doesn’t hurt and I sleep peacefully all night long. I can’t describe how wonderful it is to not have to wake up 4 or 5 times during the night to pee, or get a drink and then try and fall back asleep again.

I see my endo in a week and a half. I’m going to try and keep up this momentum. I’m also going to meet with my doc’s nurse practitioner and see if she has any tips to staying on track. I’m afraid I’ll lose interest (which is a stupid this to say especially when it concerns my diabetes) but it happens far too often. Even in other aspects of my life, I’ll get organized and develop a great plan and follow it for a couple weeks. And then I’ll get lazy. I don’t want to get lazy. I can’t get lazy. I need to get to <7.

Let’s try this again

Step 1 towards <7 a1c:

Today is the first day with my new sensor. Applying it definitely didn’t hurt as much as it used to. I just remember how awkward it was and scared that I didn’t have it set at the right angle. Now, the inserter is much more user friendly, like a bigger version of the minimed insulin pump inserter. I know I’ll get used to it. For the first day, I carried my meter around with me so I can check the accuracy. I’m used to Dexcom’s readings being so precise and in the past, every time I calibrated my minimed sensor before, it was always at least 20 units off.

A couple things I’ve discovered, first, working out right after calibrating isn’t a good idea. My sensor read 170 and dropping right after my run and 150 after my shower (I probably should have checked the accuracy with my meter right after my workout- forgot), and when I checked it, my reading was actually 65. Frustrating, but I ate a snack and calibrated again. I figured my blood sugar was falling fast and my sensor couldn’t keep up. Then a few hours later, my sensor just fell off. It didn’t rip out or get caught on anything, it just unstuck from my site. I’m thinking the heat had something to do with it and the Nexcare bandage I used to keep it in place wasn’t completely centered. All learning experiences.

Step 2: Organize my diabetes bag. I’m ordering extra infusion set and reservoir inserters, but for now I’ll keep the ones I have on me at all times. I also included alcohol wipes, test strips, glucose tabs, lancets (15), syringes (2), insulin, a battery, my meter, a large nexcare bandage, extra infusion set and reservoir, an extra sensor and keytones strips. No excuses now.

Tomorrow I’m going grocery shopping 🙂

Five Things

2015 has had a bit of a rocky start, and high stress situations don’t really bode well for diabetes management. I feel like I have hit a diabetes plateau. I have some really good days, and still some, what I like to call, see-saw days. While I’ve become an expert on what I need to do to regulate my blood sugars, I ‘forget’ in the moment (aka, decide that whatever else I’m doing is more important), and end up cutting corners. So I try to eat better, healthier, more quality foods. I set reminders to check my blood and set aside at least 30 minutes to exercise everyday. And that lasts for about a week. And then I buy greasy, salty, delicious, handmade pita chips and convince myself that cleaning my apartment is the same thing as exercising.

I went through some of my old notes with the amazing nutritionist I was seeing last year. I revisited some great recipes and decided to try and eat mostly foods that are low on the Glycemic Index. These foods do have carbohydrates, but they take a long time to digest and therefore don’t spike blood sugars like other foods can. I got the GI list months ago, but didn’t utilize it. At the grocery store, I tried to remember which foods were lower than others, and for the most part, I succeeded, but it was always a half-assed attempt.

I’m tired of my a1c hovering around 8.5.  It’s been the same since November/December. So I made a new promise to myself, a mid-year resolution. I’m going to bring my a1c to < 7 by the end of the year.

I’m going to bring focus back to the foods I eat, are they quality foods; and regular exercise, for at least 30 min. each day.

I’m going to start using the 530 G minimed pump with the sensor feature included. I tried this about 6 years ago and hated it, but I’ve been assured that updates and changes since then have made it much more reliable and easier to use.

In addition to seeing Doc. Peters monthly, I’m going to start seeing Donna Miller, her nurse practitioner, and hopefully bring my a1c down safely.

I’m going to organize a diabetes bag so that I never run out of supplies ever again. I’m embarrassed to say that this happens more than I’d like to admit.

I’m going to qualify for pump studies, approved by my doctor, so that I can get free testing/pump/sensor supplies or better yet, money!

I’m going to bring down my a1c to <7.