Monday, April 4, 2011

The Roller Coaster

We rode the diabetes roller coaster this weekend.
If you’ve never had the pleasure, let me explain.  It starts with a significantly low blood sugar. Sometimes these, if caught quickly and treated appropriately, resolve with no lingering effects.  Other times, however, people experience what is technically called the Somogyi effect (named after the doctor who discovered it), also known as a rebound.  To summarize the definition on the Children With Diabetes website, this is high blood sugar which occurs after an extreme low blood sugar from an untreated insulin reaction.  The body releases hormones to counter low glucose levels and blood sugar suddenly skyrockets.
The trick, for us, is to figure out how much (if any) of a post-low high is from hormones and how much is from over-treating the low, or from some other cause altogether.   Otherwise, we board the roller coaster. 
While others’ experience certainly may vary, we find that if we treat highs which occasionally come from a rebound with what would ordinarily be an effective amount of insulin, my daughter is back to the 40’s again in no time, and we’re starting all over.  They're somehow not the same as a highs caused by bad carbohydrate counting, or illness, or sitting around.
Our current ride started with an out-of-nowhere 48 on Friday morning.  She was perfect at lunchtime and then 280 when she got home from school.  She had a friend over, but it was raining, so it would be a sedentary playdate.   I gave about half of the suggested insulin for snack/correction.  By the time the friend left at  5:30, my daughter's blood sugar was 52.  Juice, supper, a friend’s theater class play, and by 8:00, she was 250.  And so it went, trying to be patient, but eventually assuming the high was there to stay and needed to be knocked down only to have her end up low again.  Saturday saw a wide range of imperfect numbers.
Oddly enough, things seemed to resolve during Sunday afternoon’s softball game and have been pretty steady since then.  Maybe it was the temporary basal rate during the game?  Or the under-bolused lunch?  Maybe we'd just been patient enough overnight that she never bottomed out again?  If only we knew...
There’s no doubt that living with diabetes is like an amusement park ride in many ways, but I wish it would take note that we prefer the kiddie rides that go around in a perfectly straight circle. 

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