I Hate the Nightlife

It would make sense that low blood sugar and sleep deprivation share some of the same symptoms: confusion, a vague sense of instability, lethargy, hunger, uncontrollable rage unfairly aimed at the family dog. Sleep and sugar are both things our bodies and brains run on, and when they’re in short supply, everything feels . . . wrong.

The difference between sleep deprivation and low blood sugar? One of these problems is easily fixable.

I know it sounds trite and ungrateful and cliché to complain about the lack of sleep that comes with a new baby. But I’ve got diabetes, too, and between those two factors, I honestly don’t believe I’ll get a solid night of sleep any time before 2024.

As much as people assure me that, at six months, little Magpie should be sleeping through the night, she’s just not. Old girl will go three to four hours, tops, but then she’s up for a midnight — or early morning — snack. And during those three to four hours, when I should be clinging desperately to every minute of sleep I can possibly get, I can often be found in the kitchen, draining a juice box or filling my face with Easter candy. Or I’m in the bathroom, rage-bolusing a high blood sugar from a low I overtreated earlier in the night, or changing my infusion set because the rage boluses aren’t working.

Somewhere along the line, my record of almost-perfect overnight blood sugars went off the rails. Now, it seems, I’m either climbing, or crashing, or it’s time to calibrate the sensor, or there’s a weak signal that needs my attention, or my CGM beeps and wails and screams just for its own amusement. Last Thursday I awoke to find that, in my sleep, I’d given myself a 5-hour square bolus of 10 units of insulin. I can’t be sure, but I’m guessing it happened while I was trying to silence an alarm. Thankfully, I caught it a couple of hours in — only 3.5 units had been delivered.

It’s a cycle. The breastfeeding affects my blood sugars, which keeps me from sleeping, which (I swear) affects my blood sugars, which causes me to overtreat a high or low, which sends me in the opposite direction, which wakes me up or makes me more tired . . . you get the idea.

The most tragic part of all of this is that sleeping has always been one of my favorite hobbies. Even when it seemed there was nothing else to look forward to, there was always a nap to be had. I collected pajamas and sheets and pillows the way cyclists hoard bike accessories.

Now I look at the smiling people on mattress commercials and want to throw things at the TV. I’ve got this weird perma-bag that hangs out under my right eye, fluctuating in puffiness according to how much salt and caffeine I’ve consumed in the form of microwave popcorn and Diet Coke.

I’m losing my damn mind, and even if there was something I could do about it, I’m too tired to try.

No insight to this blog post — nothing to learn or appreciate. Just me, complaining about the same stuff millions of other people soldier through every day.  And really, I don’t expect anyone to feel sorry for me, and that’s okay. I’ve got enough self-pity to last a thousand sleepless nights.

The Bigger Diabetes Picture

After months of struggling with my Minimed Continuous Glucose Monitor Carelink settings, I’ve finally done it. I’ve figured out how to upload all of my CGM information to the big Carelink cloud in the sky. And I’m uploading that information every few weeks, so that I, and my Certified Diabetes Educator, can look over all the pie charts and line graphs and color-coded calendar icons and make changes to my basal rates and carbohydrate ratios on a more frequent basis.

I should be proud of myself, and I am — to an extent. This whole baby-growing-in-my-diabetic-body thing kind of forced the issue, so I finally committed myself to spending an hour and a half on the line with Minimed’s technical service team. Some poor soul named Aaron patiently walked me through the wonky process of tricking Java into working on my home computer’s operating system (it’s a long, nerdy story), and for the first time since I’ve had the CGM, I felt like a full-fledged diabetes robot.

The first few uploads were thrilling, as ridiculous as that sounds. Here was my entire diabetic life, recorded in detail and illustrated in full color, ready to share with the world. Unfortunately, it only took me a few weeks of uploading and reviewing to realize: here was my entire diabetic life, recorded in detail and illustrated in full color, ready to share with the world — and that picture isn’t always a pretty one.

Skiing, anyone?

I call it “Still Life with Dead Pancreas.”

During my first pre-natal visit to my CDE, she brought out several weeks’ worth of printed records. The lines on the graphs peaked and plummeted, jerking up and down according to those diabetes variables we all know and love: food, stress, exercise, baby-building hormones. A devastatingly narrow green rectangle ran the length of the chart, representing the range that those lines should have been confined to. Instead, they were dancing all over the place.

“What do we think’s going on here?,” my CDE asked, gesturing to a mountain range that spanned the 6 p.m. to 10 p.m. landscape of the chart.

“I’ve been low a lot in the late afternoon,” I guessed. “I think some of this may be me over-treating the lows right before dinner. And I had pizza a couple of those nights.”

She pointed out a few other trouble areas, and we made some small changes to my afternoon and overnight basal rates — no big deal. But ever since then, I can’t look at my 3-hour or 24-hour CGM display on my pump and not imagine how it will look when it’s printed out in a few weeks at the Mayo Clinic.

It’s not particularly healthy, but I’d gotten used to viewing my blood sugar fluctuations in tidy little easy-to-swallow snapshots.

This never happens, by the way — which is why I took a picture of it.

The ridiculous thing is that this is why I signed up for this CGM adventure in the first place — to get this vulture’s-eye view of how diabetes behaves on a day-to-day basis. It’s just that now that I have it, I miss my days of relative ignorance.

Diabetes is just one of those things that’s infinitely easier to deal with when you take it one niblet at a time. If I woke up every day thinking about all the blood sugar checks it’ll take to keep me on track for the rest of my life, I would never get out of bed. It’s the same thing with these graphs, even though they’re retroactive. I look at those lines and that little green rectangle and, even though I’ve been doing this for 21 years, I think, “Wait — this is my job? I’m supposed to control this shit? Every day?”

Yes, the graphs are useful — even the Pac-Man pie charts that show you how much your management sucks or succeeds on any given day — but each one challenges the “A1c is just a number!” mentality of self-forgiveness I’ve worked so hard to cultivate.

The perfect response here, I understand, is to view this information as motivating. After all, it’s there to help, right? I need to remember, especially now, that even though everything’s not completely within my control, I’m lucky to have the technology it takes to kick diabetes’ ass, no matter how unattractive the big picture is.