One of the biggest issues I face with Diabetes is the occasions where I become exhausted from going above and beyond what’s required for a normal day. For example, when the average person wakes up, they go to the washroom, wash their face and get breakfast going. Likely, they’re including coffee in that mix. Although if they aren’t, the light help them. But for me, my morning start with the consumption of three different medications, testing my blood sugar and depending on the day I may need to change up my insulin pump’s infusion set. THEN I get to use the washroom and potentially consume breakfast. But caffeine is a must. Obviously. Moving on…
Once in a while, I’ll succumb to this exhaustion in the sense that I’ll skip steps in the process that I likely shouldn’t. this was demonstrated last Tuesday night when my CGM sensor decided to expire at about ten o’clock at night. Now if you know anything about the process for getting one’s CGM going after a replacement, it’s a lengthy one. I’ve written about this before and in fact, I’m pretty certain I’ve thrown up a video of the CGM installation as well, but the bottom line is that it takes anywhere between 4 to 6 hours for a new sensor to be up and running.
This is because once you’ve injected the sensor and installed the transmitter, there’s a 2-hour warm-up period required. then, the pump prompts you for a blood glucose test to calibrate the sensor, followed by another one sometime in the following few hours. Starting this process at 10 o’clock at night when my head should be hitting the pillow doesn’t sound appealing. So, I did the only thing a reasonable and exhausted person in my position would do; I shut off SmartGuard, plugged the transmitter in to charge for the night and went to sleep without it.
That night wasn’t such a huge problem, although I did have a waking blood glucose reading of about 10.4 mmol/L, which is a tad higher than I’m used to. But I could live with that. Since I primarily place my CGM on my triceps, I usually recruit my wife to help install the sensor and transmitter since I can’t see the back of my arm, especially if I’m pre-coffee. Insert whatever nurse-fantasy jokes you’d like, here. But given that she was quite exhausted from dealing with my hyperactive loinfruit the day before and she was still asleep, I figured what the hell…. I’ll go a day without and install it tonight. No biggie, right?
Don’t get me wrong, I love my insulin pump. Honestly, I can’t understand how I survived as a Diabetic for as long as I have without it. It has the potential to make life SOOOO much easier…. Please note that I used the word “potential” in that sentence. I didn’t think I would ever have to admit that I could become addicted to an electronic device, but apparently I have become incapable of managing my blood sugars properly with the use of a CGM. By the time I got home from work, I had fluctuated from high to low at least three times and I was exhausted and just wanted to sleep.
Let me break down why this scenario is a problem…. When you DON’T use CGM, your pump delivers a pre-programmed base rate of insulin, referred to as a “basal rate.” But as your blood sugars fluctuate, the pump doesn’t take that into account until you test your blood sugar to discover that you’re either high and need more insulin or low and need to eat something. Meanwhile on CGM, SmartGuard will begin to trickle in an extra bit of insulin on top of your basal rate in order to stem higher blood sugars and will set off an alarm if you start going low. The result is better time in range, better overall control and less feeling like you just want to voluntarily curl up into a coffin and stay there. Still with me? Good.
Once I had the CGM installed, my evening started to go a little bit better but my blood sugars somehow managed to creep up a bit. So I corrected. This started a yo-yo effect that lasted through the night. My correction caused a low. In my sleep-induced haze, I ate a few too many jellybeans. Fell back asleep. My many jellybeans caused a high and I was woken by an alarm. I treated. Then I woke with my alarm in the early hours of the morning with a low. Bloody lovely.
Despite the fact that some of that can be attributed to human error (too many jellybeans, etc), it stands to reason that this can happen frequently depending on a number fo different factors. I’ve written about this type of this before but once in a while, it’s good to remind people that it ain’t all joy and jellybeans, even with the advantages of an insulin pump. And that complacency can start to have an effect if you get to used to the technology you’ve been given. ☯️
The Blogging Buddhist 