Many people who live with diabetes will tell you that having this disease doesn’t keep them from doing the things they love. And for the most part, that’s true. There are people with diabetes who race cars, who complete triathlons, who swim in the Olympic Games. There’s even a PWD on the Supreme Court.
Usually, I agree with the superstars mentioned above. But not this week. This week, diabetes is having a deleterious effect on my favorite pastime of all: sleeping.
I know it’s not as impressive as rock climbing or cycling or other forms of weekend-warrior-ing, but sleeping is one thing that I am really, really good at. And of course, it’s not without its benefits. Without the 9-ish solid hours I aim for every night, I’m noticeably worse at paying attention to things at work, making decisions, being nice to people, and getting my general life stuff done for the day. The events of the last two nights have helped solidify this theory. Each night, I’ve been awakened no fewer than six times for some diabetes-related event.
My pre-bedtime check on Sunday night showed me at 180. A little on the high side, but perfectly safe for sleeping. My blood sugar levels tend to drift a little low in the middle of the night, anyway, so I snuggled into bed and fell blissfully asleep — for an hour and a half. Shortly after midnight, I was awakened by the familiar vibration of my pump. “HIGH,” it said. “201 mg/dl.” I was one mg/dl above the high blood sugar threshold I’d set for my Continuous Glucose Monitor, and I was being buzzed awake with the same urgency as if my blood sugar had dipped to, say, 45.
I decided to dismiss the alarm and continue sleeping, but that pattern continued for the next five hours, even after I turned on the light, bolused, and buried my head under the pillow. My blood sugar just kept tap-dancing around the 200 mark. Not high enough to kill me — just enough to trick my CGM into ruining my life.
Last night was the same way, except I saw it coming. Faced with an inexplicable 330 just before bed, I changed my set and bolused to bring the number down. My attempts were mostly in vain, though — I stayed over 200 (alarms and all!) until about 4:30 — at which point all the insulin I’d given myself all night seemed to attack at once. I stumbled out to the living room couch to enjoy a feast of Jelly Bellies and saltines with a side of cold sweats and the shakes. When I flipped the TV on, the local morning news was just starting, and I thought, “I can’t fucking believe it’s already Tuesday, and I still haven’t slept.”
Situations like these are perfect examples of why we can’t — and don’t — leave the decision-making parts of diabetes management up to the pump and its robot friends. After all, my CGM has no idea that I only have 3 hours left to sleep before the workweek begins, and that a blood sugar of 201 isn’t worrying enough to warrant an alarm every 30 minutes. It doesn’t understand that I know my blood sugar is over 250, but it’s dropping, so I’d like to just go to sleep and let ol’ Humalog do its thing. And I’m sure it doesn’t understand how grating that 4-pulse vibration is when it interrupts REM sleep, because it would have known just how close it was to being shoved down the garbage disposal.
As grateful as I am for my CGM, I’m taking the thing off tonight. If there’s anything I need more than minute-to-minute knowledge of my blood sugar trends, it’s one good night of uninterrupted shut-eye.