A Picture's Worth ... a Bunch of Carbs!
I have a fairly active imagination.
There are times when I can lose myself in mental adventures. My wife would say it happens most when she's trying to talk to me about something important.
But there is something that I wish my brain was better at. Graphing my blood sugar. I think that in terms of blood sugars, a graph is very powerful. You can see what's happening (or has happened). You can usually get a pretty good picture of where things are going, and whether you need to do something about it.
Many of us are using Kevin's awesome excel spreadsheet. I love it, and use it all the time. I would be lost without it. In fact, if I could have done in my head what Kevin's logbook does for me on the computer, I could have avoided this particular low and subsequent kitchen destruction. Let's take a look:
Overall, a pretty wild day. I have had to make a few changes to my basketball routine, and as you can see here that it hit me pretty hard. Took me until much later in the day to get back down to normal.
Do you see what happened that night?
9:45 pm - 112 mg/dl
11:30 pm - 90 mg/dl
A slow and gradual drop. No single number was cause for alarm, or even alert. I felt fine. Then at 1:15 am - 46 mg/dl. Ouch. Awaken from my slumber, ravenous, shaky, ready to eat whatever I can get my hands on. And I do. A bunch of cereal. A bunch. Which, of course I paid for shortly after with a 216 mg/dl, and the next morning with a 268 mg/dl - even though I tried to bolus for an unknown number of carbs I ate.
As I looked at this graph the next day, I really wished I had been able to see that graph last night when I tested at 11:30 pm, I might have paid more attention to the downward trend of the graph, especially so close to the bottom of the target range. I might have had a little snack to fend off that sneaky low that hit a couple hours later.
But, instead, I just went on to sleep feeling pretty good after seeing such a nice number on my meter.
If I would have known, I could have acted.
Likewise, I would have been on the alert if the numbers had been a little more different. For example, dropping from 190 mg/dl to 90 mg/dl (100 points) in two hours is much, much different than dropping from 112 mg/dl to 90 mg/dl (22 points) in two hours.
It's the slow and sneaky ones that catch us.
I think that things like this will get easier as new CGMS devices are made more affordable, reliable, accessible, and comfortable.
But for now, I'll just have to practice making charts in my head.
There are times when I can lose myself in mental adventures. My wife would say it happens most when she's trying to talk to me about something important.
But there is something that I wish my brain was better at. Graphing my blood sugar. I think that in terms of blood sugars, a graph is very powerful. You can see what's happening (or has happened). You can usually get a pretty good picture of where things are going, and whether you need to do something about it.
Many of us are using Kevin's awesome excel spreadsheet. I love it, and use it all the time. I would be lost without it. In fact, if I could have done in my head what Kevin's logbook does for me on the computer, I could have avoided this particular low and subsequent kitchen destruction. Let's take a look:
Overall, a pretty wild day. I have had to make a few changes to my basketball routine, and as you can see here that it hit me pretty hard. Took me until much later in the day to get back down to normal. Do you see what happened that night?
9:45 pm - 112 mg/dl
11:30 pm - 90 mg/dl
A slow and gradual drop. No single number was cause for alarm, or even alert. I felt fine. Then at 1:15 am - 46 mg/dl. Ouch. Awaken from my slumber, ravenous, shaky, ready to eat whatever I can get my hands on. And I do. A bunch of cereal. A bunch. Which, of course I paid for shortly after with a 216 mg/dl, and the next morning with a 268 mg/dl - even though I tried to bolus for an unknown number of carbs I ate.
As I looked at this graph the next day, I really wished I had been able to see that graph last night when I tested at 11:30 pm, I might have paid more attention to the downward trend of the graph, especially so close to the bottom of the target range. I might have had a little snack to fend off that sneaky low that hit a couple hours later.
But, instead, I just went on to sleep feeling pretty good after seeing such a nice number on my meter.
If I would have known, I could have acted.
Likewise, I would have been on the alert if the numbers had been a little more different. For example, dropping from 190 mg/dl to 90 mg/dl (100 points) in two hours is much, much different than dropping from 112 mg/dl to 90 mg/dl (22 points) in two hours.
It's the slow and sneaky ones that catch us.
I think that things like this will get easier as new CGMS devices are made more affordable, reliable, accessible, and comfortable.
But for now, I'll just have to practice making charts in my head.
posted by Scott K. Johnson | 6:00 PM
6 Comments:
Yuck, that looks like a bouncing, uncomfortable day! Damn those slow and sneaky lows!! (I think I uttered that exact phrase on Friday)
Hopefully CGMS units will be insurance-worthy sometime soon!
Brother, I am still playing the lottery so if I win, you will have your CGMS.
I hate that up and down and up and down. bleh it sucks man.
and Kevin's spreadsheet is awesome!
You wake up hungry with a low? I tend to go low at odd times in the afternoon (if I do at all) so maybe it just feels different then.
Kevin's spreadsheet is totally awesome if you actually put the numbers into it.
Love the spreadsheet...and yeah, definitely a lo-fi CGMS there. That's all the CGMS is really good for, that trendline. Helps you to head off going in either direction at too steep a pace...I avoided many lows and staved off high high highs that way on my one week w/ a Dexcom :)
Like you said, the graph is pretty useful, but only if you have it in front of you. I feel like I've averted several lows by checking the slope on my blood sugar graph during the day at work.
But it also sounds like something Gary Scheiner has called Delayed Onset Hypoglycemia (or more amusingly: DOH!). I've also had some luck guessing that I could *really* use an afternoon snack based on how my blood sugars are doing and how sore by body feels from a workout (or most likely just laboring around the house).
Like Jill said, though, hopefully CGMS will put all this graphing business behind us.
Do you think if you kept juice or tabs right next to your bed you might not wolf down so many carbs next time? I've had a couple of low blood sugars when I was pregnant and I know that urge to hoover up the kitchen is almost irresistible. I'm just thinking if you have a set amount of carbs, like in a juice box or a baggie of your cereal of choice, you might be less inclined to just eat and eat and eat.
With O, I pre-package things like goldfish crackers or Kix into 15 - 20 g baggies. That way, she's not as tempted to over treat.
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