Diabetes Self-Management Blog

The other night, I woke up at 1:20 AM, 10 minutes before my alarm was scheduled to go off. I’d set the alarm for 1:30 because, as I got ready for bed two hours earlier, I checked my blood glucose and got a reading of 79 mg/dl. Not too low and not dangerous. At least, not really.

You see, earlier that night I had a pretty intense workout at the gym, and as I mentioned in last week’s entry (“What Causes Stress and Relieves It at the Same Time?”), I’m still not certain about when my “second lows” happen. I do know that I continue to burn more sugar than usual for several hours after I work out, and I knew that I needed to do something to bring my blood glucose up around 120 mg/dl, especially since, even on a nonexercise night, I wouldn’t intentionally fall asleep with a reading in the 70’s or 80’s. In fact, I fear any reading lower than the century mark at bedtime.

So after drinking a glass of skim milk (12 grams of carbohydrate) mixed with a scoop of some powdered Slim-Fast (18 g/c), I regained confidence in my ability to avoid “nocturnal hypoglycemia.” But, just in case, I set my alarm for 1:30 so that I could wake up and check again, to make sure I wouldn’t go low.

And, as I said, I woke up at 1:20, which is when I should have checked my blood glucose. Instead, I rolled over, turned off the alarm, and then pretty quickly the warm comforter overpowered my good intentions and sucked me back in. I did that thing, that stupid thing, where, half-awake, I lay in bed but could’ve sworn I was down in the kitchen going through the motions with the test kit. Ahh, the dream-imagined blood glucose reading!

I can’t remember the numbers I created for that reading, but what I did—going back to sleep without checking—was stupid. When I know I need to check my blood glucose in the middle of the night, when I know there’s a risk that I could go low, I ought wake up and get out of bed and do it. I’ve yet to experience anything but mild hypoglycemia, but my inability to walk down 15 steps and across a hallway because I’m too tired to check my blood sugar isn’t like oversleeping for a class or showing up to work 15 minutes later than normal. There’s a real chance that some night I might roll over, turn off the alarm, fall back asleep, and not wake up without help from a glucagon injection. (Or—and although it’s highly and really very very unlikely—I might not wake up at all.)

But I was lucky. I didn’t go low that night (or at least not too low).

Skip forward a few days and land on right now. It’s around 3:30 AM, a Wednesday morning. I’m awake because something roused me from sleep. An unsettling dream. My T-shirt was a bit clammy when I woke up. I hadn’t set an alarm, and before bed I wasn’t preoccupied by any diabetes-related worries.

Thirty minutes ago, some primitive bodily defense—at least that’s what I’m calling it—helped pull me from sleep. There was no lying in bed agonizing over whether to get up and go down to check my blood glucose. I simply went down and did it.

My initial reading of 74 mg/dl has only gone up to 85 mg/dl, even after 25 grams of carbohydrate. So here’s to one more yogurt and at least another 30 to 60 minutes of keeping myself awake in the hopes of seeing my blood glucose come closer to three digits. I’ll be tired today, sure. But as much as I want to trust my experience thus far with diabetes, there are always “what ifs” that poke and prod and keep me, at this hour of the night (or morning), tapping away at my laptop. To sleep, perchance to go low.

So, hey…I’m raising a spoonful of vanilla yogurt: To being a responsible enough Type 1 to get my butt out of bed in the middle of the night and check my blood glucose from now on when I have foresight enough before bed to set an alarm.

Cheers!

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Comments
  1. I find that I’m more likely to check in the middle of the night if I have a meter on my nightstand. I also have glucose tablets and a tube of glucose gel on my nightstand. (Of course, if my blood glucose is low, I forget that I have remedies close at hand.)
    Jan

    Posted by Jan Chait |
  2. I’ve got the perfect solution for you. I live 7 hours ahead of you. I’ll call you via Skype and make sure you get your butt out of bed. Just don’t call the next day.

    Posted by markr |
  3. I’m so new to all of this, as I only found out 2 weeks ago that it was confirmed that I had Diabetes Type 2. I need to understand why I get bizarre readings that I make me re-test and retest again, for example: I eat the same basic things each morning, 1 hard boiled egg, 1 Weight Watchers toast (9 carbs total)..and ususally get a 2 hour reading of 123 or 134, and if I heavily excersise I can drop it to 111. But today after eating the same exact thing, I had a two hour reaing of 228..and I thought, “that’s crazy” so I retested and it was then 197, and still thinking that was high, I retested it again, and lo, it was 188..so which is it? HOw can I flucuate like today’s Dow Jones? I have tested my meter with the solution, and it registers the same number on the strip box, so the monitor is working fine (and the meter matches the number on the outside of the strips vial). Does this commonly happen?

    Thanks Debb in MA

    Posted by DebbWithD1960 |
  4. The reading will change from time to time, it takes time to adjust. Police

    Posted by police |
  5. Hi Debb,
    Rest assured that your glucose readings will fluctuate, even on those days when you’re doing or eating the exact same thing as the previous day. This is part of having diabetes. However, the key is to not focus on just one number; instead, look for patterns in your readings. So, if for three or more days you’re running on the high side two hours after breakfast, ask yourself if your food, activity, or medication has changed. Maybe you’re coming down with a cold or are very stressed over something in your life. These things can raise glucose levels. Try not to get caught up in checking your BG repeatedly over the course of several minutes, either. Meters are designed to really provide more of an approximation of your BG (within 10-15%)at a particular time. Keep checking your BG as you’re doing and look for patterns. If you’re running consistently high and can’t explain it, talk with your healthcare team and see if anything needs to change in your treatment plan.

    Posted by acampbell |
  6. I was diagnosed with type 2 exactly a year ago today. I am on Byetta and have been experiencing some lows recently. Now I don’t really know enough about low’s to know what low really is. I was working in my yard over the weekend and started feeling really funny. I took my reading and found it was at 49. Now I am assuming that is low. But what about anything under 80. Should I be concerned if I drop below 100? I know anything below 100 makes me feel jittery, is that normal?

    Posted by Angie |
  7. Hi Angie,

    You may want to check out our articles on Low Blood Glucose, which can be found here. There you can read about how low blood glucose is defined, symptoms of low blood glucose, and how to treat it.

    Posted by Tara Dairman, Web Editor |
  8. Angie, I was told to treat anything below 70 mg/dL with 15 grams of fast-acting carbohydrate. Also, people feel jittery at different numbers. In addition to reading about low blood-glucose, you should talk to your healthcare provider. You may need a change in medications. Also ask to be referred to a certified diabetes educator if you haven’t seen one yet or if it’s been awhile. Updates are always good!

    Jan

    Posted by Jan Chait |
  9. Thanks for the information. I am only on Metformin and Byetta, both should not be causing low’s. I am going to track my food and activities a little better and see if I can adjust what I eat. Does this get any easier??

    Posted by Angie |
  10. To me, 74 doesn’t seem that low for what amounts to a fasting blood sugar. I have gestational diabetes, and I am supposed to keep mine under 90 for fasting or pre-meal. And low is considered 60 or under. My doctor, my dietician, and my nurse specialist all don’t bat an eye at fasting readings in the low 70s, though they do at a reading of 126 two hours after a meal. 49 is definitely too low, but none of the other readings on here seem to me to be of concern as too low. Or is there a significant difference between gestational and type 2 diabetes?

    Also, does anyone know if fluctuations in sugars are normal in people without diabetes? Does stress, etc. affect their sugars, as well?

    Posted by Karen |
  11. What can I do to lower my reading of 143 every morning after sleeping all night. It doesn’t matter if I have a snack or not it still always reads at 143. So when the Dr. puts me on a 12-14 hour fast to get my bloodwork done she says it’s to high in the 140’s. But, she never tells me what to do to lower it. I take glucophage between 10p.m. and Midnite (before I go to bed)but that doesn’t lower it either.Help!!??

    Posted by Lajeki |

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