Bubbly High Sugars…the REAL Culprit??

A few days ago, I was waxing poetic about how I had these really odd overnight highs that seemed to be for no good reason. I sort of (but not really) thought they could be connected to bubbles in my insulin pump cartridge reservoir. Or they could have been because of any number of extraneous causes. With blood sugars and diabetes, just when you think you’ve figured something out, something else comes out of left field and wrecks your theory.

Well, now I have a NEW theory….a couple of months ago (around the time the night-time highs started), I decided to give my hips and upper butt pump site areas a break, and went back to using my stomach. I really hadn’t used my stomach for infusion set sites much since I was pregnant – the past 3 years have FLOWN by! – but it always worked fine before, so I didn’t even think twice about it.

Now, remember: the crazy unexplained highs I was getting were mainly while I slept. I sleep *on my stomach.* After I wrote that post the other day, I did a site change-out and moved back to using ye olde trusty hip zone. Voila!! My first night in a long time where I had no crazy high readings. The next night, the same. And the next. Seriously folks, we are on a roll now!

So…..could that be it? Could the weight I put on an infusion site overnight (because I sleep on it on my stomach)  have caused all those high sugars? Or maybe, uptake of the insulin was somehow lessened because I was sleeping on my stomach, right on top of the infusion set site? How many licks does it take to get to the Tootsie Roll center of a Tootsie Pop? For all of these questions, and more,  the world may never know….

I wish EVERY overnight and morning looked like this!

Since I moved my infusion set back to my hip, here’s what my overnights and mornings have looked like, for the most part.
I WILL TAKE IT, HAPPILY, regardless of what the reason may be!!

 

 

The Devil is in the Bubbles?

I really must not have been paying attention when I filled this one. I’ve been fighting some really weird blood sugar highs recently – occurring at times when I normally see a level line on the CGM or am otherwise crashing (like 3am, all the freaking time) – and before my last pump site change, it was just getting ridiculous, so I took out the set early. And found this monstrous bubble (as seen above) in the reservoir.

Sitting here now with my new set for the past couple of days….the highs are still hanging around. (And that 1 bubble doesn’t explain the “bubble” I’ve seen in my blood sugar numbers being steadily higher for several months now.) The time I notice it most is the overnight sugars as seen on my Dexcom CGM. I’ll go to bed at a comfortable and steady 110 or so. Fall asleep. Rudely awakened by a blaring high in the 200s for several hours overnight. Wake up. Drink water. Take correction bolus. Sometimes eat a cheese stick if I think it’s dawn phenomenon-related. And most times, it goes down and I’m good by breakfast-time.

I keep wracking my brain….what am I doing differently from the past year+ that is making this happen??  It’s not *always* the last week of my cycle, I haven’t changed any medications or vitamins recently, I don’t think I’m sick (or getting sick), my exercise regimen is better than it’s been in years, I haven’t changed my basal rates (this will be the next thing I do to try to counteract it)….my checklist of “what it could be” goes on and on. MAYBE I’m not drinking enough water lately and I’m slightly dehydrated? I have been downing a lot of coffee over the past few weeks of cold-weather spells we’ve had. (But I’ve moved to half-caf and decaf, shouldn’t that be OK?) And sure, some nights the highs will happen after I’ve had a couple glasses of wine and some snacks with my girl friends, but even taking those out of the equation, it’s still a LOT of unexplained overnight highs for me. And it shows in my A1c – up 0.4 from my last A1c of 3 months ago (which was up 0.2 from the A1c before that.) It seems like a small enough gain, but feels really big. I’ve got to shut that sucker down, and stop the upwards “bubble” trend I keep seeing. Now, if I can just figure out how to do that…..

Sleep Study Update, and More

As you may recall, I was required to complete a sleep study as a pre-requisite for becoming approved for any type of weight loss/Bariatric surgery.

I got a call with my results from the sleep study clinic, and the gist of the conversation went like this:

Sleep Clinic Lady (SCL): “Hi, we got your results from your sleep study, and you tested positive for mild OSA.”
Me: “Not *severe* sleep apnea, like I was diagnosed with before? What exactly does ‘mild’ mean?”
SCL: “Well, below 5 is normal, and you had 12.1 during most sleep. During REM sleep you had 34.3.”
Me: “OK.” (insert a look of deer-in-headlights here….those numbers meant nothing to me since I had no point of reference. Was “severe” something like 500 during some allotment of time? Is this during one hour? During 5 minutes? Who knows.)
SCL: “Next, we need you to come in for a CPAP titration study and get you setup to use a CPAP machine.”
Me: “Oh, no you don’t. My whole reason for having this done was because I don’t want a CPAP machine, I would rather use a dental device to help correct it, and my surgeon just wanted this study done to see what level of OSA I had.” (I think that is why, anyway.)
SCL: “Hmmm, well, OK, I’ll put a note in here for the sleep center Doctor and forward your results onto your surgeon. I will contact you after you’ve met with your surgeon to go over the results.”

CPAP machines equal PANICAnd I’m thinking: Yeah, you do that, lady. Remember, I have NO desire to use a CPAP machine, and was worried that my refusal to do so would hinder my chances of getting the bariatric surgery done. I was stressing out just a little about this. I’m not kidding when I say, using a CPAP machine feels like you’re being forced to drown in air, all night long. It made me too panicky, and also irritated my sinuses so much I ended up with sinus infections every time I had tried to use it in the past.

Fast forward a week to my next followup appointment with my surgeon. He reviewed my chart and brought up the sleep study results.

Surgeon: “It looks like you did your sleep study, is the sleep clinic putting you on a CPAP machine?”
Me: “They said it was only mild OSA….do I really need one? If I have to use something, I’d rather find out more about using an oral appliance/dental device instead.”
Surgeon: “Well, if it’s only mild OSA, it is really your choice as to whether or not you wish to treat it in whatever way. You’ll just be taking on the risks of poor sleep, etc, that OSA causes.”
Me: “I’m fine with that.” (….since I really don’t feel OSA wrecks my sleep as much as the stupid sleep study people say it does. I also recently got a FitBit Flex, and over the past few weeks, it is solidifying my conclusion that my sleep is not as bad as the sleep lab people lead you to believe.)

The surgeon said all my blood work looked great, advised me to up my exercise each week (always a struggle), and went over some of the upcoming things I needed to have done:  psych eval, nutrition counseling, gallbladder ultrasound (oops, didn’t have this on the first list – one more thing to do!!), and an endoscopy to check out my upper GI tract. With the sleep study hurdle overcome, I am hoping for smooth sailing from here on out as I work towards final approval to have the surgery!