Timing is Everything
I’ve had very similar experiences twice in the last few nights, so hopefully I’ve learned my lesson. Here’s what happened: on both occasions, I tested my blood right before getting the kids to bed (a bit late now that it’s summer and light out so long!) around 8:30 p.m. My blood sugar was on the higher end: 198 mg/dl and 179 mg/dl, respectively. Those numbers shouldn’t have been correction worthy as I was less than 2 hours postprandial from dinner. But, for some reason, I gave myself a correction dose of about 1 unit.
Then, after my kids were in dreamland, I got ready for bed myself and tested my blood (a little over an hour after the correction bolus). My blood sugar, expectedly, had started to come down a bit. Then, my mind starting calculating and pondering, “How much lower will it go?” “Did my dinner have enough fat/protein/fiber to keep it from dropping too low?” and the big question, “Should I have a snack? Perhaps a glucose tablet or two?”
Instead of consuming any carbohydrates, I got in bed to read for awhile and then turned off the light to go to sleep. Since I’m waking at 5:15 a.m. daily to exercise and going, going, going all day long, I usually fall asleep right away. However, in both of these instances, I found myself awake for 10-15 minutes, until it occurred to me that my blood sugar was probably dropping, thus providing energy and keeping me awake.
Sure enough, when I tested, my suspicions were confirmed by blood sugars at least 50 points lower than the bedtime test.
As I trudged off to the kitchen, I thought about how diabetes means that sometimes I can’t eat when I want to (because my blood sugar is high) or I have to eat when I don’t want to (for a low). Very frustrating! I had a date stuffed with a couple almonds and a small handful of dried blueberries.
As with all blood sugar management actions, there’s a consequence. In the middle of the night, I woke up to blood sugars in the mid 200s. Lovely.
The morale of the story? Timing is everything! I do typically need a little extra fast acting insulin after dinner to get me through the night. But, by giving that dose so close to my dinner bolus, it worked more efficiently (that stacking insulin issue!) and dropped my blood sugar too much, too soon. When I bolus right as I’m turning in for the night, the timing is much better as the insulin gets into my system just as my blood sugar is slowly rising from dinner and the lack of activity while sleeping.
Lesson learned? I hope so.