I wake up to treat a low. I have five glucose tabs, wait until my BG is back up, then fall back asleep.

81V2VQh4DkL._SL1500_I’m low again thirty minutes later. I go downstairs and exercise great restraint by eating just one bowl of Lucky Charms (that’s hard to do even when I’m not low…). I pass the time by reading some blog posts, and once my BG is back up, I go back to bed.

An hour later, I’m up again. Low. Again.

In a fit of frustration I eat way more than I need to treat this low.

If I would have caved in to the urges to eat the house down on the first low, I would be sleeping.

My perception told me I was not being rewarded with calm and steady blood sugars from treating my lows sensibly. Just the opposite, in fact. I perceived that I was being run through the ringer that night, and that I should have just over-treated in the first place.

The reality is that my basal rates need tweaking, as do most of my other pump settings. I should have also taken into account the basketball from that afternoon and made some adjustments.  When everything is working right (pardoning those occasional diabetes-goes-crazy times), a handful of glucose tabs should do the trick.

It’s all too easy to get lured in to the trap of negative thinking when it’s 3:00 AM and you’ve been up treating lows three different times. But negative thinking usually leads me into negative behavior, and negative habits, like over-treating all of my lows.

I’m glad that I didn’t let myself fall into that trap.

At least that night.

 

27 Responses to Perception Versus Reality

  1. Jenn says:

    You showed much more restraint that I do. Those middle of the night lows scare me more than anything. If I make it to the kitchen, nothing is safe.

  2. George says:

    I wish every situation with diabetes gave us some insight to a pattern or way to make decisions about treatment easier. It never does.

  3. Alanna says:

    i am reading this while chowing on a PACKAGE of peeps bunnies and a small glass of regular 7up….ahem restraint?

  4. Nel says:

    Treating lows with restraint is difficult, especially late at night. Nighttime lows make me feel mildly paranoid, sort of like when I was 5 and afraid of the dark, so I generally don’t eat too much because I don’t want to get up. I treat the low with the sensibly portioned glucose tabs or nerds I keep by my bed, and follow up the treatment by hiding under my blankets with individual peanut butter cups I snag from my college cafeteria. Not bad in terms of carbs, but I never brush my teeth. So very bad for my teeth.

  5. Meri says:

    One of the hardest things for me to do, as a mother pancreas, is to tell my boys they ate enough after a low, and they need to wait before they eat more. My heart aches because I know their bodies are begging for more food. How do I know this? From adult T1′s such as yourself giving me the benefit of this insight. In the same vein, my heart ached for you as I read this.

  6. Jen says:

    Been there. Done that. Have the empty box of Wheat Thins to prove it. :)

  7. susan says:

    Thinking clearly at 3 a.m. is not anyone’s strong suit so don’t be too hard on yourself. As a mom of a type 1 almost 12 year old boy (with a trend of night lows), I have many nights like this. Do the best we can & start over the next day.

  8. James says:

    Yeah. I struggle with how to handle this with my daughter. If she’s low, she wants to eat LOTS of crackers, gatorade, starburst etc. And yet this mostly leads to a ‘rebound’ high – so not only has she taken in carbs, but at some point her liver decided to dump a load of glycogen into her system. Another difficult angle here is this often happens just before she goes to bed – and so we only discover the ‘super-high’ if we check in the middle of the night, or in the morning. Like Meri commented, just agonizing not knowing how best to help.

  9. Pearlsa says:

    I hate these type of low, i call them the toddler low. Because they don’t play nice and say no a lot.

  10. Betty says:

    Ditto all that Meri said. Hearing and reading from you Adult type 1s gives me better insight as a parent. It is hard finding balance treating a low. Sometimes once in a great while I will over treat. Just once in a while out of pure exhaustion just so she can sleep and I can sleep. Then correct in a few hours if necessary. I learn a lot from these D blogs and now using your insights to educate school personnel to better understand treating diabetes. Like you said, it isn’t always as simple as eating a few glucose tabs. It can take HOURS to recover. Thank you for your honesty and insights. You bloggers help more than you realize.

  11. tweak or eat…that’s a hard one and I’m not the one with the low BG!

  12. Kay Moore says:

    I’m 55 years old and have had Type 1 diabetes for 41 years. Tonight you are receiving an emotional dump from one exhausted diabetic with a rotten attitude, full of self-pity and a fair amount of anger at this disease–and my inability to deal with it.

    -My husband is also Type 1, for 47 years. He just had a heart attack 4 weeks ago, but is doing very well. We’ve been married for 9 years. I love him, but it is challenging because it is twice the diabetes we both used to have to deal with. I am astounded and in great admiration of all parents raising T1 kids, especially multiples in one family.
    -I just started pumping 3 days ago and am just plain worn out from the testing and the tedium of weighing and analyzing every morsel I put in my mouth. Not to mention the time it takes, and the loss of sleeping from testing every 2 hours overnight.
    -I used to be a very positive person but this disease has taken its toll on my emotions, my psyche, my attitude as well as my body. I don’t like who I am very often any more.
    -I had a triple bypass at age 39; followed by the onset of depression which I am still battling 17 years later. High BP. Stage 2 kidney disease just diagnosed last month.
    -I have diabetic macular edema/low vision; can still read and drive with one good eye (so far). Very, very grateful for that.
    -Cognitive/memory problems that make me embarrassed, ashamed, frustrated, and feeling just plain stupid. And like a fraud at work.
    -I participated in an islet cell transplant study about 8 years ago, for about three years. Two transplants got me off insulin for about 6 months. It was indescribable. My greatest food joy was drinking REAL hot chocolate in cold weather–I’m always cold but have never liked tea or coffee. After 6 months (and having my first A1c’s in the “6″ range) my BG’s headed back up and I was on the list waiting for my third transplant when I burned out on being a guinea pig. Extremely bad side effects from the immunosuppressants, feeling sicker than I ever had at any point in my life, and the draining blood tests, appointments, hospital stays–I finally called it quits and was back on insulin gradually over the next several months. How on earth do people with heart and kidney/pancreas transplants do it? I applaud their courage.

    -I see other people in life that have problems that make mine look trivial. And I think a lot about quality of life vs. quantity of life. And I hope the research gained from the study I participated in will help others, somehow, at some point in the future. That would be meaningful to me.

    All done–I promise I won’t be a regular contributor. My goal was not, could not be to help anyone else today, but just to unburden myself during a night of insomnia.

    God bless you all.

    kpm

    • Hi Kay,

      I really appreciate you feeling comfortable enough to vent a little bit. If my blog can help you get through another day, hour, or minute of living with diabetes, please don’t hesitate. I mean that.

      You and your husband have a lot on your plate. It’s completely understandable why you feel the way you do. This disease is so unfair.

      Some of the toughest days I’ve ever had were when I transitioned from shots to the pump. It feels like such a step backwards as you work to get all of your settings adjusted. But stick with it. Once you have a solid base to work with, I think you’ll see a lot of improvement in both your management and lifestyle flexibility.

      Thank you for participating in that study. The sacrifices you made are paving the way for new therapies.

      Hang in there, Kay. You can do this.

  13. stacey says:

    next time just eat the marshmallows for the lucky charms…All of them … :)

  14. Scully says:

    Dude… By the third one I would have been cursing up a storm. If you over-treated the first low it no doubt would have sent you into a roller coaster of highs and lows. Just to spite you.
    This post irritated me because I know. I KNOW and I could sense the wtf.
    Lower those basals! Hope you get a good nights sleep

  15. Scott S says:

    I’m glad I’m not the only one with this issue (this week!) … all of my ratios have been adjusted thanks to some freakin’ lows using the same ratios that kept me in very good shape since last summer. Maybe its the time change and the changes to daylight (I think they call that “circadian rhythm”, a term which always makes me think of the rhythm method of birth control which was used back in the 1950s and lead to the Baby Boom … no one said it was effective!) that screws things up. The reality is this never-ending change that glucose “control” (surely there’s a better term?) requires is a “perception” that medicine has, but the “reality” is control is a poor word choice. I think “guidance” is more accurate. We can try and guide things, but diabetes doesn’t always respond the way its supposed to even when you follow the rule book. Anyway, I hear you on the idea of falling into a trap, but to put things in perspective, lost sleep is a bad thing for anyone. Thanks for sharing!

  16. Reva says:

    I had a similar experience a couple nights ago. Low in the middle of the night, treated it sensibly and tried to fall back asleep only to be woken up by another low shortly after! As much as I hate seeing a high after over-treating, sometimes it seems preferable when you just want to sleep through the night. It’s frustrating!

    • Joy says:

      I understand all of you about the lows at night. I have had T1 for 19 years. Why does it make us want to eat everything in site. It’s like we haven’t eaten in a month. It ‘s so hard to stop with just a few sips of OJ or whatever. Everything taste so good like you can’t get enough.

  17. I’m sorry you went through this, but I am glad you are ok.

  18. minnesotaAnn says:

    another perspective, for those whose middle-of-the-night-lows wake you…3 times,,,granted, bad night full of fighting adrenaline, tired the next day….

    Me jealous, adrenaline no longer wakes me now that hypo-unawareness lives here…

  19. ria says:

    what I love the most about treating those lows with glucose tablets is having to sit up from my slumber so I can chew a mouthful of oversweet chalk…. =)

  20. Katy says:

    Lucky Charms, oh so delicious. You have such restraint.

  21. You have so much more restraint then I do. I feel so helpless when Im low and am constantly over-treating lows.

  22. Now I want to buy some Lucky Charms. Good attitude.

  23. NN says:

    How have you found you can control overeating? I find that is my biggest problem especially when I am sleep deprived. I just want to get back to sleep!

  24. AMG says:

    So glad to have found this blog and everyone! I’m sitting at work, trying to treat a low that won’t go away. Is it from the 2 glasses of wine last night? Did I bolus too much for breakfast? But more than trying to figure out why, I have to miss the one yoga class that I had scheduled for this week. It’s like I’m being punished for trying to take time to take care of myself. So frustrating!

    - and totally agree with the glucose tabs == chalk!

  25. Karen says:

    This is such a great point, Scott. I know I sometimes fall into the “stupid diabetes just does whatever it wants to” trap, when sometimes if I really stop and assess there probably is a reason for whatever is going wrong. Thank you for the reminder.

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