I recently had an “aha!” moment.
I was recovering from an overnight high (472 mg/dl for the record) because I over treated a low the night before.
The “aha!” moment? I realized (again) that all of my highs (and I mean my really high highs, like 300+) were from over treating lows. This is something that I’ve talked about before, but apparently keep losing focus of.
I do go high for other reasons, but they are usually “moderate” highs. Low to mid 200’s, or even high 200’s if I goof up my carb count enough. But my really high highs, those are almost always explained by a low blood sugar that I over treated.
The crazy thing about those lows is that I’ll take a bunch of insulin along with that food I’m cramming down! Just think of how many grams of carbs I’m eating if a massive meal bolus isn’t enough to offset them? And how scary is it to take insulin while treating a low (when I may not be thinking clearly)?
So, once again, I am trying my best to avoid lows in order to avoid highs. It’s the ones that happen during the night that get me because 1) I’m not awake to catch them before they get out of hand, and 2) I’m not awake to monitor for the crazy BG spike afterwards.
A topic for another post maybe, but why is it we have to keep “re-focusing” on things like this? If I realized this way back when, why is it still causing me problems?
Another topic for another post is trying to avoid those lows – especially when we have so much less “fudge room” on that end of the blood sugar spectrum…
Scott,
When treating lows you should always assume or take into consideration when you took your last shot or insulin intake, if its past the two hour mark, then you need to realize your insulin is now tapering off and any bounce back food digested will not be controlled with any insulin; causing high blood sugars. When combating low blood sugar always eat a small amount of carbs with some protein to help stabilize your body again. The roller coaster effect is not the objective.
I have found through 19 years of experience that its best to eliminate large amounts of carbs in the evening. They’re essentially carbs/energy that are not needed. The tough thing about carbs is understanding how and when they will break down into sugars in your body. Some carbs have a glycemic index that can last or break down several hours after a meal, when your insulin is no longer working for you any longer.
I currently only eat my carbs in the morning and at lunch time when I need the energy. Giving me the stability and consistency with my blood sugars and diet.
Good luck and let me know if I can be of any assistance.
Ryan Coelho
http://www.olade.com
Yeah I definitely have those bounce-back 300s and 400s too sometimes (especially after bedtime or overnight lows)… I wish I could say that all my 300-400s were from that, but they aren’t.
It’s so hard not to overtreat because a) our bodies are screaming at us to EATEATEAT b)i am usually tired/half asleep and have no self control or just don’t care that i’m overtreating because i want food and c) i also heard that when low, sometimes it makes you bounce back high even if you don’t overtreat too bad because the body is in this mode of trying to get higher – even though we have less, we probably have some hormones that work to raise blood sugar also. I have taken to giving myself some insulin too to cover the big snack. Also, for nighttime lows, sometimes if I just leave out a decent snack (enough glucose tabs /andor some fruit) by my bed, if I can avoid going to the kitchen I usually do better at avoiding it.
Truly sucks, don’t it?? I have a tendency to over-treat my lows. It’s a never ending cycle. Just hang in there and hopefully, we both can conquer the demon that is over-treating.
The bad part is that I go into “panic eating” and I, like you, end up paying for it hours later. Most of the time (about 99%) my super highs are from overtreating lows too.
It’s crazy. I can even be sitting there, in all my “low-ness” telling myself not to drink anymore than the 1 juice box. And I still do it. I eat until I feel better. And even after giving insulin, I still spike out.
It’s awful. Sigh. I dealt with this the other day. It’s so frustrating.
Scott-
I can relate to your dilemma completely. There have been plenty of times where I’ve had a low and I felt that I needed to eat a ton– I think it was Amylia who said “survival instinct” and I think that’s exactly what it is. You’re low and you need to bring your blood sugar up so you do what you need to. I once ate a half a box of Special K with strawberries to treat a low and woke up in the high 400’s and beat myself up when it happened. To remedy it, I only drink one 4oz Juicy Juice box now when I have a low and if I’m not up in 15 minutes, I’ll drink another one. It’s easy because I know how it works and that I won’t go overboard with it. The waiting time is the worst with lows, though, so good luck!
Oh, Scott. This just happened to me last night too. I am so there with you. Hang in there 🙂
Scott,
Thank you for your honesty. I have had type I diabetes for 23 years and this still happens to me. I consider myself pretty smart, but when I over treat a low and get a sky high number, I feel so upset.
I am sorry that you have to experience this too, but your sharing has helped me tremendously. Next time it happens to me, maybe I remember this post and not beat myself up.
Thanks again,
Erica
Scott,
BTDT, of course…so one thing I TRY, TRY, TRY to live by is the old 15/15 rule of treating and testing for lows.
When the survival instinct is just too overpowering to follow the standard, I will do my best to estimate how much I had over and beyond what I needed for the low, and then do an extended bolus to cover the excess. The extended part makes sure that I bolus immediately (so I don’t lose count of the carb gram intake), but slowly/safely doses the insulin so that I minimize the risk of hypoing again. And if the readings do not come up, I can always cancel the extended bolus or modify it later.
Just a couple of thoughts there. Of course, it’s always best if we can avoid lows and highs in the first place, right? But, whoever is perfect enough to figure that one out, please let ME know. 🙂
One thing we tend to overlook is the effect from our liver dumps. Not only do they help bring us out of hypos by releasing sugar, but they also increase our insulin resistance from the hormone releases. Sometimes this can be very dramatic, and it can last for many hours. I’ve had early morning hypos that kept me high all day. Getting a handle on the resistance is not easy. It is also easy to overcorrect these dumps and get sucked right into that spiral.
As others have said, it’s best to identify the reasons for going low and prevent them as much as possible.
I wanted to leave one more comment, I had to condition myself, I when I get some low’s that are horrid, I have to keep telling myself, now just how much insulin is actually getting pumped in you….these are not shots, this is not that bad, if this does not work, and all, then I know I need more food….
I have extreme anxiety issue’s, but I overcame over doing it eventually….because I never wanted to see 300, and I don’t from overdoing it, I only see it if a set fails, I have not seen a 400 since 2006, refuse to see that number I would fall over dead with such an extreme pannic attack, because to me, I feel with pumping I am playing with fire, being over 250, because of the little amounts of insulin in me, and what if set fails at the same time as I am overdoing a low….akkkkkk to much on the brain….
So I retrained myself, hard at first….but if I have overtreated a low here recently we are dealing with 170’s 180’s now….which I can handle….I know how you feel it is a fight though…
Cheryl
It helps me to have pre-measured low snacks in a basket under my night table. But I am so guilty of overtreating. You’re not alone, Scott.
Scott,
I totally relate to this cycle, though since pumping it’s been tempered quite a bit. I don’t get the highs or lows like I did on shots unless my pump isn’t working and then I get REALLY high highs!
I’m sure a ton of us can relate to this post and thank you for being so honest about your goofs. Like George commented, when you’re bloodsugar is low you can’t think straight even if you think you are. It’s like being drunk, but without the fun. You may not know how drunk you are and so make stupid choices from a place of altered consciousness.
Severe hypoglycemia can be a near-death experience. Who, when faced with the all to real prospect of dying, is going to worry about a little high blood sugar later on? The focus is on the PRESENT MOMENT, on SURVIVAL. Like I said in an earlier post, I want to get out of survial mode and start THRIVING instead of surviving, but when faced with a roller-coaster of highs/lows/high/low and especially wicked lows, it’s hard to focus on thriving. You just want to survive.
Don’t be too hard on yourself, man. We love you, and we understand.
We have to keep re-focusing because we’re human 🙂 Because real life gets in the way! And because the beast keeps changing…
I’m normally pretty good with not over-treating lows… but I stuffed it last night. I woke up with a 2.4 (43), munched, made a cuppa and read a few blogs – fully intending to stay awake long enough to test again and take a jab… and then went to bed. Woke up over 13 (234). That’s the kind of number I just don’t see… ever… since I got into micro-managing my diabetes. And boy did I feel it!
But sh*t happens, right?
My issue is not berating myself for those occasions when sh*t happens. Gotta accept it, learn from it, and move on. But I still feel guilt and pressure to do better – which makes me more likely to binge or screw up in some other fashion. Bah.
Wonder if we’ll still have the same issues in 20 years? Will we still be kicking ourselves for the same things, or will we eventually learn to relax and accept it? Even better – a CURE so that we can kick ourselves over something else and completely forget about our diets & jabs!
A few years ago I bought the book “Stop the Rollercoaster” by Lois Jovanovic and John Walsh. I distinctly remember that their first rule was “deal with the lows first – what’s causing them and how you treat them”. Some things never change……
You bring up a good point about bolusing for the massive carbs we tend to consume in the process of treating the really bad lows, Scott. Some hypos are like those old “Film Noir” movies, with a flashing neon sign in the foggy distance telling us to EAT, EAT, EAT, EAT . . .
Why don’t you see how much you can bolus for a meal, that won’t make you low, so if you eat a higher carb meal that requires more insulin you can dual wave the carb amount, I have to this for thankgiving and x-mas, though not perfect bg’s I never get low, and the highest I see is a 230, at x-mas I only went to 190, but if i bolus for more then 50 or so carbs I do go low, or what not, So that is my limit….and then if it is high fat, I have to dual wave regardless…
Also keep those 4oz juicy juice boxes by your bed, only one bring ya right up, I need less then that when I get low in the middle of the night, but even if you did, atleast you won’t see a 400…
Just suggestions, but I know how you feel…
Cheryl
I am not sure why we do not learn or at least I don’t. It is like you always tell me, when you are low you can’t think straight. That is why overtreating lows is a constant battle I think. It is hard to remember anything when you are low.