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It’s 3 AM. Do You Know What Your Blood Glucose Is?

Eric Lagergren

January 17, 2008

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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