It's been a heckuva day. I woke up this morning to a Dexcom reading of 46. So I ate about 12g of taffies in bed, tried to convince myself to get up. Half an hour later, I'm still in bed, Dexcom says LOW. I test on my meter, it says 42. Okay, that's not exactly "Under 40" but it's within 10%. I eat some more taffy, head to the fridge and finish up the almond milk (low carb but high glycemic index- usually shoots my blood sugar right up).
I head over to my parents' for breakfast, eat about a quarter of a large pineapple, a roll, and some mints. I take three units of Novolog. My blood sugar is trending upwards when I leave the house for work. My breakfast spike, such as it was, is over by the time I get to work, at 88 with a down arrow. I eat taffies all morning. At lunchtime, Dexcom says 48 and the meter says 66. I eat all 40 grams of carbohydrate lunch (a muffin and a cucumber) and don't take any insulin. Dexcom shows my blood sugar hitting 90 as I leave work. My meter says 110. I go hypo on the way home. Two more taffies (each 6 grams of carbohydrate) fail to get my blood sugar over 100. Once home, I eat more taffies. No dice.
So I was particularly gratified to find a message on my machine from a nurse practitioner working in the nuclear medicine department of Northwestern. She wanted to go over protocol and specifics for my gastric emptying study, which is scheduled for Monday morning. I called and left her a message and even though it was after hours, she got back to me within a few minutes.
She said that actually, I could eat until 4 AM the morning of the test, not just to midnight. She said that their new protocol, which they are transitioning to now, says that they want blood sugar under 200 at the time of the test (this is a very good thing IMHO- the test is not really meaningful at high blood sugar because many people have delayed gastric emptying with hyperglycemia but not with euglycemia), and that if the blood sugar is slightly higher they might go ahead anyway. She went over the food issues, said to bring my meter and insulins (as if I would come without them!) and was responsive to my comments.
The gastric emptying test in diabetes is actually a pretty perfect example of why logic matters in medicine. But I have to get off the computer now, so I'll type up the question tomorrow.