Wow, talking about a trifecta of ugliness that causes a bad blood sugar day…..this particular morning, it was a combination of:
- Dawn Phenomenon – no matter what the linked Wikipedia article says, I *do* have to change my insulin intake to manage the spike in sugars that happens in early morning. Over the years, my endo and I have tweaked my morning basal rates to account for it in some part. And I *do* eat a small snack before bed that has about 10g-15g of carbs and some protein and fiber in it so that my stomach isn’t so absolutely empty by the morning that the dawn phenomenon cranks up my sugar to exponential heights. For me, if I don’t eat breakfast by around 8am, my sugar just starts climbing and climbing no matter what I’m doing or how much insulin I take. Thank you, Mr. Liver for that input of yours. Sigh. This particular morning, I was so busy doing other things, it was close to 9am before I could eat.
- Infusion set site change – My pump ran out of insulin at 7am, so I had to put more liquid life into my pump (in the form of Novolog) and change out the infusion set. It never fails – no matter if it’s a new or old bottle of insulin,
no matter if I’m putting the site on my stomach, my hip, etc, it seems to take a few hours for the insulin from a new site to really start absorbing and working. I sometimes supplement with shots, but that brings on it’s own level of danger since who knows when the pump insulin will start absorbing.
- Post-Breakfast blood sugar spike – I have fought this battle for many years, and Metformin has helped immensely with this, but with the dawn phenomenon and infusion set change already hard at work at wrecking my sugar, it was inevitable that breakfast would send me over the edge. (I took the picture of my Dexcom at 9:17am right after breakfast, and then it got all confused at the rapid rise and gave me the ???, but trust me, it stayed up in the 200s for several hours of the morning.)
The good news? By lunch time, the new infusion site had settled in and started working, and my sugars only mildly tanked because I had so much insulin on board from taking a couple of shots in an attempt to avoid the 300s. The rest of the day was thankfully uneventful, sugar-wise. Note to self: in the future, try to think ahead and change out the infusion set at ANY other time than the morning. Of course, we always have the best intentions that don’t always pan out…thinking of and remembering to do every-single-thing-every-day-to-counter-bad-blood-sugars? Good luck!