Dear CDE,

I am a Type 1 diabetic, diagnosed at age 18 in 1972.  Have been using a pump since 1982, staying good control ever since (A1C around 6.7%).  So this is what happened this morning:

·         Woke up at 4:00 am with a reading of 41.  I just didn’t feel like getting a juice, laid down and went back to sleep for 90 minutes (that in itself is very unusual for me—I always treat my lows immediately).

·         Got up at 5:30 am, removed my pump, and took a 10 minute shower, reconnecting my pump immediately. 

·         Tested at 6:00 am and was 93.

·         Tested again before breakfast at 6:45 am and was 195!!!!  Felt like crud!  Bolused 1.6 u – didn’t eat breakfast.

·         At 7:10, I was 218!

·         At 7:34, was 208, bolused 1.0 unit

·         Blood sugar returned to normal about 10:30 am, then I finally ate some yogurt and bolused normally.  Everything has been normal rest of the day.

Was this a matter of my body taking care of that 41 BG by shooting my own glucagon into my system from my liver?  I was ready to change out my infusion set, but since the BG’s were coming down once I started bolusing (albeit VERY slowly), I decided to wait, which worked out OK.  Certainly not a fun way to start the day!

Thanks for any insight you can provide. 

Best regards, 

Molly

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Hi Molly,

I believe that probably your liver did kick in some glucose to help you out. But there could also be some other variables at work to cause it to go up so high and it may be coincidence that you happened to have a low as well.

A few things to consider would be your basal rate at that time of day. Have you done any basal testing at that time of day lately? Perhaps you BG rises during that time and comes back down by lunchtime and so you have not been aware on a regular day because you check at breakfast and then again at lunch but not in between.

Other things to consider are pump variables as well such as was there an air bubble in your tubing? Was your cartridge low? How old was your site? Also some pump folks think you should bolus a bit even after you take a shower and have been off your pump for just a few minutes. I also assume from your age that you are through with menopause? As you may well already know, menopause can cause blood sugar variability. And the other thing may be "the nature of the beast" Good Luck!

Dear CDE: 

I've been hearing a lot about Diabetic Neuropathy lately.  What is it? and how do I know if I have it? 

Celiac disease, also called celiac sprue, nontropical sprue, or gluten-sensitive enteropathy, is an autoimmune disorder that damages the small intestine and interferes with absorption of nutrients from food.  People with celiac disease cannot tolerate gluten, a protein in wheat, rye, and barley.  It can also be found in medicines, vitamins, and lip balm.  When people with celiac disease eat these foods or use these other items, their immune system responds by damaging or destroying the villi lining the small intestine.  Villi are normally responsible for allowing nutrients from food to be absorbed through the walls of the small intestine into the bloodstream.  If villi are not working correctly, one can become malnourished. 

Dear CDE,

I have been going through menopause for about a year now and my blood sugar control has suffered.  I want to know: Can menopause cause fluctuations in my blood sugars? and can you tell me what should I expect during menopause as a woman with diabetes?

Dear CDE,

With the holiday season soon approaching, do you have any tips or suggestions on how to mantain my good diet?  I know that pretty soon work parties, family gatherings and other social events full of sweets and high fat goodies will be around.  It's tempting to forget about my diabetes and splurge at these types of events.  What would you advise I do so that I can enjoy these functions without being overly concerned about what I'm eating?

Thank you!