Fall-ing Blood Sugars

During my daughter's first autumn with diabetes, almost a year after her diagnosis,  something weird began to happen. She started to experience low blood sugars.  Lots of them.  At all different times of day.  She wasn't eating less.  She wasn't more active. This new pattern seemed to have come out of nowhere. 

Stumped and worried, I called our Certified Diabetes Educator.  She instructed me to cut back the dose of long-acting insulin.  I agreed to do so, but asked if she had any idea why this might be happening.  She made a couple of guesses.  Maybe her pancreas was giving insulin production one last effort in what clinicians call the 'honeymoon period' of diabetes.  Maybe she'd been growing for a time and had stopped.  More likely, though, we'd never know.

We still don't know, but what's really curious is that it's happened every fall since then.  It makes very little sense. In fact logic would lead one to assume the opposite would happen.

Fall is the season of slowing down.  She's settled into a chair at school all day, and homework takes up a good chunk of every afternoon.  School leads to more moments of stress. Apple desserts, heavy dinners and in our family, birthday cakes should be leading to high blood sugars.  Yet usually around the first of October, this bizarre pattern begins.

Yesterday's mid-morning low blood sugar call from the nurse's office after a bowl of cereal and an apple for breakfast was unprecedented.  Monday's post-gym low was less surprising, but that she didn't crest over 100 again until evening was unsettling.  Eating a brownie covered in m&m's at noon on Sunday with a blood sugar of 110 an hour afterwards was pretty awesome, but disconcerting at the same time.  Last night's blood sugars of 65 at 1:30 a.m., 80 at 2:30 a.m. and 90 at 3:30 a.m. and their related juicing and basal rate tweaking were exhausting. 

Needless to say, her fall A1C is always the best of the year.  Disappointment inevitably follows when the inexplicable cloud of pixie dust has passed and the high blood sugars creep back in. 

A quick internet search revealed no documented evidence of this phenomenon.  Sharing of similar stories and amateur speculation as to the root causes are welcome of course!