Something very scary happened to me the other night. I was woken up by my baby to discover that my bloodsugar was 1.8 mmol/l (32 mg/dl)!
Oh, you thought that was the scary part? Not so. Just wait…
Lately I’ve been very tired, due to an unusually restless baby sleeping in a bed about two feet away from me and waking me multiple times every night. (She was such a good night sleeper, but not lately. I digress…) So I’ve been wearing earplugs to sleep. They let me hear her when she really needs me and tune her out when she doesn’t. I’ve also been using my short stints of good sleep to sleep extremely soundly.
One drawback to the earplugs and the sound sleep is that I haven’t been noticing my CGM alarms. My pump is set to vibrate for alarms, and I have it on the waistband of my pajamas up against my belly so I’ll feel it. (NOT between my boobs!!) Normally the vibration wakes me. But lately, between my exhaustion and my earplugs, my husband has been waking me quite often to tell me I’m sleeping through my CGM alarm.
This hasn’t been ideal because it’s meant that my pump has tried to wake me with vibration, then with an alarm, then resorted to waking my husband, who then wakes me. It gives my bloodsugar time to drop further before I notice a problem – and the CGM already has the (approximately) 15 min. delay, so timeliness leaves something to be desired. In the past, I actually used to wake up to nypos quite easily, but this has changed with the aforementioned exhaustion. All in all, timely bloodsugar-related wake-ups are sketchy at best these days.
So when my baby girl woke me up, I realized I was pretty darn low. My CGM said 2.3 mmol/l (41 mg/dl), and must have been alarming – which is probably what woke the baby. I wobbled, bleary-eyed, into the bathroom to test and could barely stand up. When the 1.8 appeared on my meter, I cursed, inhaled seven dextrose tabs (3g carb each) summoned all my energy and dragged myself back to bed . In a case of bad timing, the baby wanted to eat at this very moment (she’s breastfed). So I lay in bed and fed her (thank goodness for the side-lying breastfeeding position!), while my husband kept a watchful eye on us.
By the time she was finished, my BG was going up at a reasonable pace (quite quickly, actually), but I tacked on a few crackers with peanut butter for good measure. (Am I the only one who craves peanut butter when I’m low?) It was another 10g of carbs at most. I was pretty impressed with myself for managing a wicked nypo like that with only 30g of carbs, since I’m just as prone to face-feeding during a nypo as the next PWD.
By breakfast time, I was in the 8s (that’s about 150 mg/dl), which was too high, but really not too bad considering what had happened overnight. I had my breakfast of high fibre oatmeal/flax/etc. and proceeded to feel hungover. By mid-morning, though, I was a whopping 17.8 mmol/l (320 mg/dl) – WAY higher than I usually see.
It was at that point (or, rather, after my BG came down to a more reasonable level) that I decided to start logging again to figure out what the hell needed to change in my diabetes management to keep this from ever happening again.
I sat down at my spreadsheet template (because I’m a geek).
I entered in my bloodsugar readings from my meter memory.
I started to enter in my boluses from my pump’s bolus history.
That’s when I saw this:
Something important to know at this point is that I was 8.7 mmol/l (157 mg/dl) when I took this correction bolus during the night.
Something else important to know at this point is that my regular correction for an 8.7 mmol/l should have been about 1 unit. I would only ever take 7.4 units of insulin at night if I were eating a second supper of about 40g-50g of carbs.
Something else important to know is that I don’t remember taking this bolus. I do remember fiddling around with my pump – trying to take a smaller bolus or calibrate my sensor or something – but the details are fuzzy. Thankfully I do have a recollection of doing something or I’d be likely to blame my new pump and would be very afraid to continue wearing it. But I’m quite sure this was human error. My error.
I’ve never, in all my 30 years of having diabetes, done something like that before.
Presumably my liver kicked in to bring my bloodsugar up, because I don’t know how 30g of carbs, plus a bowl of oatmeal (with breakfast bolus), would have brought my bloodsugar up to 17.8 otherwise. So it’s good to know that something was working – since I couldn’t feel the low, feel the vibrating pump, hear the alarming pump, or even think clearly enough to bolus properly.
This mistake has me very freaked out. Lows like that are so dangerous, and I can only imagine the speed at which I must have been dropping after that whopper of a bolus. I don’t want to think about what could have happened if the baby didn’t wake me. Do I owe my life to her already…?
The question is, how do I keep from repeating this mistake? My pump’s Max Bolus had been set to 12 units, and since this mistake it has been changed to 6 units. If I ever want a bigger bolus than that, I’ll do it in two parts. Also, I no longer wear earplugs to sleep. I’d rather have a restless sleep than continue to sleep through my CGM alarm. And I’ll be wearing a CGM 24/7 for the foreseeable future – at least until I’m less exhausted and easier to wake. (Funny how even an unusual breath from my baby can wake me, yet a beeping pump won’t.)
Beyond that, I’m not sure what to do. Will I do it again…? I’m crossing my fingers that this was both the first and last time, because that was just way too scary.