Saturday, 10 November 2007

One unit

I'm amazed at the difference one measly unit can make.
It can be the difference between a low and a high Blood sugar reading.
It can be the difference between a happy day and a grumpy one.
And just lately, it's the difference between a horrible night's sleep and a good one!

Recently I took myself off Metformin. I'd been taking it on and off for years - from the days when I was mis-diagnosed as a type two, and then as a booster when I couldn't lose weight. I'm not sure why I stayed on it - I didn't lose an ounce, it had no effect at all - and yet the docs wanted me to stay on it. What use is that?

When I went on the Met I needed to drop my basal by one unit each injection (twice a day for that lovely smooth basal...), and I dropped the Novorapid a little too. It just makes sense that I'd need to put them up again once I stopped Met, right?

Wrong, apparently!

The Lantus went up, the NR was increased just a teensy weensy bit for any meal with a decent amount of carbs involved. My BGs were looking SO good. Really really beautiful numbers (Can blood sugar readings be beautiful?!). My pre-bed numbers looked gorgeous. My post meal numbers were to die for. I could eat anything and get away with it. I could even have a very small snack without injecting. Highs were rare. It was as if my pancreas has suddenly started working just a little bit...

But DUH. Think about it, M. It was overkill, that's what it was. The Lantus was too much. I was on an all day drop. To some degree this worked for me - it was nice to have the knowledge that I was always in a good BG range, and it was nice to be able to nibble something without jabbing once in a while. I could handle the odd low - it meant I could have munchies! But what about the night time?

NOT good. I was waking up around 8 - 9 mmol a few times a week. Other days I would definitely be higher than when I went to bed. I was happy assuming that this was some form of Dawn Phenomenon that I wasn't used to, something that the Metformin had worked on for me that I now had to deal with myself.

After a few weeks of this I was actually beginning to look forward to my a1c (which I took yesterday). But I was feeling so trashed. Sleep was an issue - I wanted too much of it! I felt unrested. I never remembered any dreams which is odd for me. I'd fall asleep with the lamp on and some nights I'd even left the electric blanket on. Eep. And I was getting up far too late - a day feels so wasted when you're not ready to face it until lunch time.

It turns out that one unit makes a BIG difference. In hindsight, I can see that it was too much Lantus. I was actually going low overnight, and then my liver (all praise the wonderful liver) was rescuing me. This led to an uncomfortable nights sleep, which made me even more tired the next day, which led to me being too sleepy to wake up for the next nights low, which led to more of the same.

Which in turn makes me FREAK OUT. I was going low every night. EVERY night. How low? I'll never know. I can't help but question it. What if I hadn't woken?

I'm just glad I didn't go on like that for too long.

And as stupid as it is, I'm glad I did my a1c at a time when I'm almost guaranteed to get a good result. The result will also verify my theory of these overnight lows. I can't see that my problems could be anything else when I look at the evidence. I'll know soon... the countdown for another a1c result is on. I'll report in a few days :)

It's been two days now since I dropped the Lantus. I feel SO GOOD! I slept well last night, I woke up feeling good - I actually woke up feeling like I was going low, I was 4.2 - not low yet but heading there - so the Lantus changes still need another day to kick in, but at least it was a morning low not an overnighter. I can deal to it with breakfast - perfect.

Ah, I feel Dumb for missing this for weeks - but I feel GOOD that I've got it sorted :)
We never do stop learning, do we?


Bernard said...

It is amazing how a tiny amount (1/100th of a ml) can have such a big effect.

I'm glad you figured it out. And good look with your A1C, I hope it's a great value.

AmyT said...

Hi M,
Nice blog. Happy Dblog Day!

Cara said...

I don't think we do every stop learning. I learn something new nearly every week. I think that if we didn't, we would not be taking good care of ourselves. I'm glad you are feeling better.

Naomi said...

Hello! I'm tagging you for the random 7 meme. I guess it's just the diabetes OC's way of getting to know one another!
The rules are simple:

1. Link to the person’s blog who tagged you.
2. Post these rules on your blog.
3. List seven random and/or weird facts about yourself.
4. Tag seven random people at the end of your post.
5. Let each person know they've been tagged by leaving a comment on their blog.

Oh, and have fun!