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Constant Lows

Maryam Elarbi

May 24, 2012

For as long as I’ve had diabetes, it’s been a constant battle of trying to work against spikes or uncontrollable highs. However, for the past few weeks it’s been the exact opposite.

Thanks to metformin and my regular workout regimen, I’ve cut down my average daily dose of insulin by around 15–20 units! It’s a huge decrease for me, but it seems like I can’t cut it down enough. I’m decreasing my basal rates all the time and eating extra snacks. Even on days where I forget to pre-bolus for breakfast, I’m not getting spikes nearly as high as before. I used to think that having lows would be a better struggle than the one against highs, but I’ve learned the hard way that my wishful thinking was just that — wishful.

Being low frequently can be so much worse than being high. You literally have to stop what you’re doing and just wait until your blood sugar comes up after a snack. I used to think of lows as a convenient excuse to eat whatever junk food I could get my hands on. But the truth is, it’s much less fun when you’re low after a meal and can’t fathom stuffing yourself any more but have to because your body has decided it’s time to be 67. Thankfully, recently my blood sugar levels have gotten back in range. I’ve been changing up the time that I take my metformin and the amount I take per meal, and I finally seem to have figured out a system.

On a separate note, I still can’t seem to lock down my 5 AM blood sugar levels, especially after days where I work out. It’s so frustrating, because I continue to wake up high in the middle of the night and end up low at 5 AM, even when I don’t fully correct…or give a correction at all for that matter. I know that something needs to change, because I can’t be high through the night to combat the low in the morning. But by the same token, being stable all night long only to yield a 5 AM low isn’t going to work either.

I was ready to put in a continuous glucose monitoring (CGM) sensor last week, only to find that I had run out of them. Since the semester is finally coming to a close, I’m hoping that my first full week off will consist of me doing some basal tests — fasting for certain periods of the day over the course of a few days to find out where the real problem spots are. Additionally, by then I’ll have my sensors shipped and I’ll get to see what’s really going on at night.

I love wearing my CGM when it works and always feel like I couldn’t imagine not using it. The only real issue I have is how invasive it is. I usually get a solid two-and-a-half weeks out of my sensors, but by that time my skin becomes so irritated that I get extremely apprehensive about putting another one in and thus end up spending extended periods of time not wearing my CGM.

I’m hoping that they’ll develop better inserters that are less painful and sensors that irritate the skin less. (Though truthfully, I feel bad complaining, considering how amazing the technology is, and how well it’s worked for me in the past!) Hopefully by the next time I post a blog entry, I’ll have gone through my basal tests and worn my sensor for at least a week.



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