My efforts to manage my blood sugar and be a good parent collided last night. Here's what happened:
First of all, some background information. Yesterday Sienna received her six month immunizations. The check-up went well; she's growing perfectly and developing normally. Getting shots always puts her in a little bit of a funk. So, by around 7:00 p.m. she was getting fussy and tired. I'd just enjoyed a delicious bran muffin after going for a walk with my mom and Sienna.
I knew my blood sugar was on the high side, so I tested in anticipation of dinner. My blood sugar was 233 mg/dl. Oops! I bolused 2 ½ units of insulin as we were planning a low carb dinner of homemade cheeseburgers. Dennis and I attempted to feed Sienna some milk and then some oatmeal, both of which she mostly refused. She was getting more tired and fussy by the minute.
"Okay," I announced. "Let's just get her in bed and then make our dinner."
The memory of the recent bolus hit me, but then I figured, since I was high previously I shouldn't drop too low before we got dinner made.
You can see where this is going...
As we finally sat down to eat dinner, I started to feel low. Testing confirmed that my blood sugar was 48 mg/dl. Darn! The cheeseburger on half a slice of whole wheat bread wasn't going to raise my blood sugar very efficiently. So, I had an appetizer of Honey Nut Cheerios and milk (I take the opportunity to eat cereal when I can!)
After my cereal and cheeseburger dinner, I started to feel really low. The turnaround time of trending blood sugars can be so frustrating. When I tested at 48 mg/dl, I didn't feel that low. Even though I'd eaten sufficiently to raise my blood sugar, I still had to sit with that low feeling for several more minutes. To pass the time, I had a couple graham crackers and several mini brownie cookies with milk.
The regret soon followed. I bolused for my overcorrection and tested a couple more times before bed. My blood sugar didn't crest 150 mg/dl for several hours. Those in-range blood glucose results lured me into thinking that I'd bolused appropriately. When Sienna woke us at 4:45 a.m. this morning, I tested at 306 mg/dl. Agh!
There are many places where I could have changed my behavior and thus avoided these rollercoaster blood sugars. However, I think the most critical place to focus is on the catalyst: the severe low blood sugar before dinner. By bolusing for dinner in addition to giving myself a correction bolus for my high blood sugar at 7:00 p.m., I set myself up for failure. Since my eating schedule is now dependent on the activities of my growing family, I can't always predict when and what I'll be eating.
The moral of the story is to bolus independently for corrections and meals, rather than attempting to "superbolus" my way out of a high blood sugar. Sure, I may have slightly higher postprandial spikes if I avoid bolusing ahead of time for meals. However, that's a small price to pay for the piece of mind knowing I'm not going to have very low lows when my eating schedule goes awry.