Thursday, October 26, 2006

On Missing Those Cues

Thanks to everyone who responded to my previous post.

I understand what you're saying, but this is a real tough one for me.

Quite a while ago, I accepted the fact that we can't beat this thing-- perfection just doesn't exist. All we can do is work hard to peacefully co-exist with this disease -- highs and lows are inevitable.


But recognizing those low blood sugars-- the ones that Joseph can't feel himself -- has been something I could do well for a while now.

Sure, Joseph can be wacky when he gets around friends-- it's that whole adolescent-boy-humor thing -- but honestly, I can usually tell the difference.

It's in his eyes, the way his smile lingers a little too long, the hint of a slur in his speech, how his body moves just slightly off-kilter...

Missing this kind of low scares me-- because the ones he can't feel are usually those with the most potential to become dangerous (i.e., he's falling fast and/or the low doesn't come up after the usual treatment).

And, I'm afraid we haven't yet figured out the reason for these lows. Same thing happened yesterday and last night-- and we went way conservative on his lunch and dinner boluses.

He was 82 just two hours after eating lunch (?!), ate a pile of popcorn at school with no bolus, and was 60 just 30 minutes later.

Three hours later-- right before dinner -- he was 59.

The only thing that comes to mind is that we changed his set on Tuesday morning, and he's got some kind of uber infusion site going...

Which would be okay, but how do we explain the lack of any rebound highs? He's had multiple lows over the last two days, and yet none of the usual later rebounds.

I know it's only two days, but it's got me wondering this morning about what his liver is doing... where's that sugar it's supposed to spit out in response to these low blood sugars?

It's also got me a bit mad that we have to wonder at all about what our son's liver is doing.


Kerri. said...

I wasn't as active in my diabetes care when I was going through puberty, but could it be the insanity of the hormones? I know once I started developing and achieving maturity milestones, my hormones were in high gear and my bloodsugars were all over the map. (Borderline Too Much Information coming up here:) Even now, during menstruation, my bloodsugars plummet and I have a number of unexplained lows and lack of rebounds. Maybe hormones plus insulin sensitivity are tossing Joseph all over the place?

Can you guys trot through a basal test or two? Maybe it would help shed some light on a few things.

Sandra Miller said...

You might be on to something, Kerri.

Hormones. Those buggers have messed us up before-- usually during a growth spurt, and usually prompting some ungodly highs.

Now that puberty seems to be here in earnest, we might be seeing the other side of that hormonal coin.


As far basal testing-- as of last week, his rates have really been working well (low-carb early dinners, sleeping in on weekends, and "brunches" have helped us confirm this).

So, I don't know. If overnight he's dropping, we run temp basals to help prevent lows. Beyond that, I hesitate to change his rates yet.

He's coming up on another set change-- if he's still running low after that, I think we'll have to test those rates.

Though I really hate making him fast when he's trending low.

Kerri. said...

I know what you mean. I'm actually testing basals this week due to some dodgy lows that cropped up lately. I've already had to toss two whole attempts because I trended out and had to eat. I keep lowering my basal by little eensy bits in hopes that I'll hit my stride and stop keeping a stock of juice at my desk here. (Good thing dLife has a unlimited supply of reaction treaters. Bonus for working for the diabetes media company. :) )

It's tough to test basals to eliminate the lows. I'm with you on that.

Scratch said...

If he's had a number of low blood sugars, as well as being active, then his body will have already been making use of the glycogen reserves. So even though his body is getting signals to release those, if there is less there it'll take longer, and there won't be as much rebound.

Jess Riley said...

I'm sorry, Sandra; sending hugs your way.

Penny said...

I have nothing profound to add. Just know you're in my thoughts. I understand exactly how you feel.



Anonymous said...

Hormones do crazy things. I’m not sure how the hormones that run through boys affect blood sugars, but I know that estrogen can make you resistant to insulin, so at varying times of the month women will need more or less insulin depending on the amount of estrogen running through them. I’d chalk it up to hormones and test when you can. I do basal testing without actually doing the basal testing if I’m trending low, meaning I’ll lower basals by .05u in the hours I’m having the lows to trend the lows a bit higher and THEN basal test. My doctors office is crazy though, they don’t believe in traditional basal testing.

Anonymous said...

I am sorry.

Chrissie in Belgium said...

Sorry you are having a rough period! The somogyl response is not consistent, this all depends on how much sugar is stored up primarily in the liver and to some extent also in the muscles.