Diabetes Self-Management Blog

Oh my. What’s this week’s blog entry about? A titillating tale of diabetes and sex? Sorry, folks. Check out the first word in this next sentence for the big letdown. Orthodontics…

…were an ever-present part of my childhood. A pretty common occurrence was the morning of the lost retainer. I’d estimate that 25% of those nights with retainer, whether asleep or half-asleep—because of course I’d never do it consciously—I took the little pink appliance out of my mouth and let it fall where it may. Quite often, this was in some clandestine spot, such as on the floor between the bed and the wall, or between the box spring and the bed frame, or inside a pillow case. Or, most hidden of all, in that vertical space between sheet and mattress where the sheet’s tucked under; the retainer gets kicked over the edge during the night, wedging itself into the tight tuck.

The searches could be exasperating.

Skip forward a quarter of a century now, and the times seem to not have changed. While I no longer wear a retainer, this morning after getting out of bed I noticed the surgical tubing for my insulin pump dangling along the outside of my thigh, the infusion set connector swinging a small pendulum as I made my way downstairs.

My first question: Did I forget to attach the connector to my infusion site after the shower last night?

My next question: Did I take it off at some point during the middle of the night?

My third question: Could I have accidentally popped the connector off by rolling over in bed?

I didn’t have a clear answer to any of these questions. My first order of business was to check my blood glucose. I didn’t feel like I was high, and after click stick finger-prick blood-to-strip and wait, I found I was just fine. 108 mg/dl.

Hmm. This evidence points to my taking the insulin pump off in the middle of the night, not forgetting to attach it eight hours earlier as I initially thought. But can I conclude that from a normal blood glucose reading? I’m only on 0.15 to 0.20 units of insulin per hour for my basal rate right now, and after two beers the night before, my body without insulin may not have gone much higher.

I’ll never know, however. I’m not willing to recreate a nonbasal night. Sure, I’d be happy if this were the case rather than my removing the connector in the middle of the night. If I’m sleep-removing during the middle of the night, what do I do? Duct tape? If I’m doing the unclicking, what behavioral modification therapy should I undertake to keep my somnambulant hands from wandering?

Such a dilemma. At least this latest permutation of the retainer is on a string.

It’s funny, but not really, that the several times I’ve posited worst-case scenarios to Kathryn (much to her unamusement) about sleeping with the pump, they’re usually about sleep-bolusing. Could it happen? Is it possible? You know, half-in and half-out of the waking world and for some reason I think I’m eating a 150-grams-of-carb meal and all of a sudden I’ve overbolused by 10 units at 3 AM, nary a carb in my system to meet the insulin. The horror indeed!

Am I heading down a path where the insulin pump becomes a nighttime liability? I hope not. I don’t really think so. Considering the sleep-bolus possibility, I can live with the occasional mysterious sleep-disconnect, if that’s as far as it goes.

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