Sunday, May 07, 2006

Insomnia

Diabetes affects my sleep patterns. A lot.

Right now, it's 3am and I'm awake. Why? Because my blood sugar rose to 375 and I went to bed with 3 units in my reservoir. I thought that would get me through the night, but clearly I was wrong.

I also went to bed after treating a low of 58 two hours after a big meal.

Dinner is my trickiest meal of the day. I often eat a large meal, and I often take my biggest bolus at night to cover the meal. But many times I'll go to bed at a low or normal number OR I'll treat, say, a 221 with insulin to bring me down to 100, and I'll wake up in the middle of the night because my blood sugar is very high.

I usually find my neck and back of my head are sweaty, too.

I don't know if I'm crashing in the middle of the night and then rebounding, or if I go to bed high, I'm just going higher.

I know basal testing might uncover something here, but I really think it's due to what I eat for dinner, going low, and then rebounding.

I'm not sure how to fix it, either. But I know that when I eat a meal and stay steady through the night, I wake up so much more refreshed and well-rested. That happens all too rarely, though.

I already eat the same thing for breakfast and lunch; do I have to eat the same thing for dinner too to be able to get a good night's rest?

This is probably one of the things I dislike the most: rarely getting a great night's sleep because of disruptive highs in the middle of the night.

Any suggestions for a solution?

6 comments:

Caro said...

I hate to say it, but it sounds like a job for a basal rate evaluation! I guess rather than a formal basal test, you could try eating normally and bolusing as you would, but then test every 60-90 minutes through the night Granted, you won't get great nights sleep doing this, but it might at least tell you if your hunch of crash and rebound is correct. If it is, maybe a lowering your basal in the couple of hours before the drop will work.

I tend to find that if I have less than ten units in my cartridge, my control goes out the window. I used to think maybe that was due to air in those few units, but often I can't see any. Maybe that was a factor in the high you describe here.

Good luck with finding a solution!

kevin said...

I too have the most difficulty with dinner. And I too eat basically the same meal for breakfast and lunch. I find that how large and how late my dinner meal is what drives how high my sugars go over night.

Some things I've found are that high fat meals really suck at dinner -- the usual suspects: pizza, chinese, mexican with lots of guacamole. Also the later I eat, and the more full I feel going to bed the worse it is. I've started giving square boluses overnight if I still feel full when laying down to go to sleep even if my blood sugar is in range.

Honestly, though, this hasn't helped much. Up the dosage! I guess, huh?

And I also have a crazy hypothesis about how you don't get the most out of your bolus when you're sleeping because the inactivity doesn't really get all the insulin into your system. Perhaps it just pools subcutaneously and waits to strike you low when you're least expecting it. The beauty of this theory is that it explains two of the most frustrating things at the same time! (obstinate high blood sugars overnight and random low blood sugars during the day).

Hope my random thoughts on the matter help in some small way. But I too have to agree that a basal test is probably the first line of action.

bethany said...

i have to use a combo bolus no matter what i eat at dinner time ... even if it's not fatty ... that way i don't get the lows and then i don't get the highs ... good luck! (oh and i'm delurking :-D ... so hi!)

Kassie said...

Bethany beat me to it :)

I'm starting to use my combo bolus more and more for just this reason. For the obvious culprits - like pizza and pasta - I take 50% up front and spread the rest out for 4-6 hours. For other stuff, I've been taking 70-75% up front and spreading the rest out until about midnight. So far, so good.

Good luck!

Lyrehca said...

Thanks all, but I'm already doing dual boluses (at every meal, even for oatmeal and peanut butter for breakfast). I've had some success with lengthening the square basal to eight hours (typically I do four), so I'll keep an eye on that.

julia said...

What abou a CGMS trial for a few days, to see where you're spiking?

Do you log all the fat/carb info? Have you tried testing every hour all night? A pain in the ass, I know, but if a CGMS is out of the question, it might catch things. It's really hard to tell what's causing this unless you're able to check all night.

Having the same thing for every single meal would be boring in the extreme. Maybe it would make it easier to manage your diabetes, but jeez. Dull city. It's hard to figure out, but seeing how different foods react in your body could be beneficial.

 

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