Another nighttime low? or no?

CrazyNight_GraphI’m stumped.

Last night, shortly after 1:00 am, I woke up to the sound of my baby son crying hysterically. (A “Low Predicted” CGM alert at 12:30 and a “Low” alert at 12:45 did not. Have I mentioned my expertise in silencing alerts in my sleep before?)

Lifting him out of his crib and laying him on the changing table were no challenge for me. Removing a wet diaper was no challenge for me.

Then the  feeling set in. I started sweating. Shaking. Becoming disoriented. Nausea was starting to set in. This wasn’t the “Regular-Low”, this was the “Oh-Crap-Really-Bad-Low” feeling.  A quick glance at my pump/CGM and I see a sensor glucose of 65 mg/dl. Oh shit, I thought. If the sensor’s reporting 65, I’m probably more like 35. I know how this thing behaves!

Flashbacks of that night a couple of weeks ago when I “sleep-bolused” came in my head.

But I had another task at hand and chose to fight through it. I had a crying half-naked baby in front of me and he needed my attention. Using every bit of concentration I could muster, I put on the diaper and — somehow — managed snapped up his onesie and his pajamas before I put him (still crying) back in the crib. All the while I was hoping, praying that he wouldn’t fall on the floor — and neither would I.

If you’ve ever tried to line up the snaps on those baby clothes – with a normal blood glucose – you know how difficult it is. I must’ve spent 10 minutes on those stupid snaps, trying so hard to line them up properly with my sweaty, trembling hands. Yes, I contemplated not fully dressing him at all, but my priority was on him, not me. Somehow, I did it. (If I’m ever involved in a plane crash, I highly doubt that I’d put my own oxygen mask before putting it on my child, as they always tell you to do. Just being honest).

Now that the baby was safe and warm (and still crying) in his crib, I stumbled back to my bedroom, still sweaty and disoriented, and checked my blood sugar with the meter on my nightstand.

82 mg/dl.

Huh? This sure didn’t feel like an 82! I didn’t believe it. Let me check again.

CrazyNight_TableThis time, meter says 95.  CGM says 65.

(A quick note on the images: at this point it’s now 1:40 am, and you can follow along with the events in the table to the right, courtesy of Medtronic CareLink Personal. The graph at the top is also from there: blue line is my sensor glucose, the black dots are my fingerstick glucose readings, and the little siren icons indicate each time an alert was sounded. But the image from Personal is condensed and not too useful. Oh how I wish I had CareLink Pro).

What the hell is going on here? Noticing the trend of sensor glucose, and feeling the way I did, I downed a handful of glucose tabs despite the no-need-to-panic fingerstick readings.

They always say the sensor LAGS the meter. But is it possible, at times, for the sensor to LEAD the meter? Maybe the meter would catch up with the “Oh-Crap-Really-Bad-Low” I was feeling, eventually. After all, the CGM sensor towards the top of my arm (fairly close to the heart) and the fingertips are, obviously, at the bottom of my arm. So the sensor would, in theory, get a fresh supply of blood first. (This is another one of my unscientific non-credible theories that I should add to my list. Remember “I am, therefore I think” from back in December? That list.)

It’s not the first time I’ve felt my sensor is leading the meter. Sure, most of the time it works as expected and the CGM is constantly playing catch-up, but not this time.

So anyway, I treated the low that didn’t really happen, eventually regained my composure, got some numbers on my CGM and meter that didn’t scare me (with some calibrations to nudge it in the right direction), and later dealt with the inevitable post-overtreatment high.

And my wife, who had just arrived home, exhausted from a business trip in Dallas a few hours earlier, took over with the baby. Happy Valentines Day, honey. I’m sorry.

But I still, for the life of me, can’t figure out what happened.

Can anyone explain it to me?

Anyone?

Posted on February 15, 2013, in Continuous Glucose Monitor (CGM), Diabetes, Personal, Type 1 and tagged , . Bookmark the permalink. 3 Comments.

  1. All I can say is that I’ve had the sensor “lead” the meter. Not all the time, but I know it happens. So, that could have been in play here. You could have also felt lower because of anxiety. Sometimes if I’m in the middle of something important (in your case, attending to your baby) and I think I’m going low, but am not in a position to treat it, I will become very anxious. This anxiety, of course, has all the same symptoms of a low blood sugar, so it can be very deceiving. Either way, glad you were at home and had all your normal supplies with you.

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  2. I don’t wear a sensor full time but diabetes is messed up and sometimes never follows any sort of rules or guidelines. Its unusual but it has happened to me before. Either way this is one of those cases where it doesn’t matter what the technology says, the body says LOW.

    I just wanted to make a comment on the Carelink, WHY the hell don’t WE as the PATIENTS have access to that PRO version? I mean is it just me or does it seem odd that we get less information than our docs? I dunno… a disease that is 90% patient driven and managed..?

    I think you did with your baby what most of us would have done.

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    • Tell me about it. I suspect it has to do with the level of information in there, and perhaps FDA approval as well. Medtronic is in the business of giving the data but not explaining it (or having a whole division devoted to software tech support) and don’t want to have to educate patients regarding what certain plots/graphs MEAN.

      Also, I’ve seen the Pro printouts from my doc, and there are recommendations to the doctors to “consider discussing…” things like hypoglycemia with patients if such a trend is spotted. To give that information directly to the patients could be a liability for them. I’d be happy with the data presentation without the recommendations, though. That’s for sure.

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