Sunday, October 09, 2011

I got ready for a rough Yom Kippur fast because all of my fasts in the previous year had been rough. There was Yom Kippur 2010, in which I developed very large urine ketones and wasn't sure what I should do because it had never happened before. There was T'isha B'Av, where my blood sugar behaved itself but my stomach didn't and the nausea persisted for two weeks post-fast. There was the nonreligious personal fast of June 2nd in which I drank water but developed large ketones anyways. There was Ta'anis Ester, on which really high blood sugar forced me to correct and the correction brought me low and ended my fast in under six hours. And on the fast just the week before Yom Kippur, my stomach cramped badly enough that I gave it up and ate before it could get worse.

So, the night of Yom Kippur, I dropped the Lantus dose from 10 units to 6 units. I stayed home to minimize exertion the day of the fast. I corrected conservatively for highs but nonetheless ended up taking four correction shots before I went to sleep for the night. I woke up with a blood sugar of roughly 170 in the morning. I bounced a little bit after waking up, and then spent the next six hours with Dexcom readings in an almost perfect straight line at 160. Because I was feeling so well with only an hour and a half left of the fast, I checked my blood sugar; the meter said 148 to the Dexcom's 161. I walked to the synagogue (about 1 and 3/4 miles) with no discernible change in the line.
Yom Kippur was the easiest fast I've had in the past thirteen months.

Unfortunately, I forgot to prebolus before breaking the fast (I mean, I injected just as I started eating) and I spike to the 290s before coming down. I took nine units that night, which kept me right on the edge of low, and spiked very dramatically when I ate a small roll for breakfast this morning. In fact, you can see me coming down from that spike (keep in mind I was 70 half an hour before the beginning of this 24 hour graph) and having a roller coaster-y day.

I am posting this Dexcom graph because, on diabetes art day a month ago, somebody put a picture entitled glucoaster, a word that I assume means to have blood sugars very high and very low in close proximity, so that he graph looks like a roller coaster. But the graph in the picture was a dream! Yeah, it went up and down- but not very high or very low. I would like to show you something a little closer to a real coaster (though not my most dramatic works, I'm afraid). I'm also posting this sort of as a response to Reyna's comment on my last post, about how stable my blood sugar looked. My blood sugar is a lot more stable in the past year than I've been accustomed to. But I don't have a typical day. And there was a day last week in which I spent more than 10 hours below 60, a lot of that time below 50- stable, yes, but not the good kind. My A1cs in the last five years have ranged from 6.1 to 7.2 and they are not accomplished by any small amount of effort or tweaking.
I do not experience some of the challenges that other D folks do- I don't really have dramatic exercise drops, for instance, and I usually escape mealtime spikes. But I very rarely spend a night in range (in range meaning 60 to 180) and I see both 30s and 300s on a regular basis. Anyways, here's today:
Picture of Dexcom on top of a box of syringes- Dexcom graph shows three spikes and valleys, ranging from three hundred to sixty

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