Saturday, September 21, 2013

Curveballs

Until recently I have been working a 12 hour graveyard shift 4 nights a week, with 4 nights off a week.  Because I also have two young kids and the Pretty Lady in My Life also works a full time job that means on my off nights my schedule was flip flopping from sleeping in the day time to sleeping at night.  I have been doing this since before my diagnosis was changed from Type 2 to Type 1 and the entire time I have been using insulin.  I had things tuned in pretty well.  About three weeks ago I moved to working the day shift, 3 12 hour shifts followed by 3 days off.  I was expecting a change in the way I managed my diabetes but I got more than I bargained for.

My first day on my new schedule I was fighting off lows all day. I adjusted my insulin to carb ratio each day and each day fought the same battle.  I had an epiphany a few days ago and realized I probably needed to adjust my basal insulin and tried that.  Still not much of a change.  Somewhere in there I started encountering highs in the early morning.  I tried to treat these which led to more daytime lows.  I discovered that as soon as I got out of bed my numbers immediately started to plummet.  Then I started splitting my dose between morning and night.  No change.  Now I am taking the whole dose at bedtime.  It's too early to tell if this is really helping.  I miscalculated a high card dinner two nights ago and went scary low that night. Last night I went to the movies which means lots of popcorn, things peaked a little bit at night but stayed within reasonable ranges.

I think diabetes time is different than real time.  It feels like I have been counting carbs and calculating insulin for a decade. Sometimes I have to stop and remind myself that I'm still young in my diabetes life, only having been on insulin for about 8 months and counting carbs for a couple of years.  Even tiny changes can make big impacts on blood sugar management and I have to be patient as learn what adjustments I need to make (and I need to avoid pints of Ben and Jerry's Half Baked while I'm making those adjustments).  I'm still taking things in stride and learning as I go.  And usually resisting the urge to chuck my Dexcom across the bedroom when it wakes me up 3 times a night