The Hunter-Gatherer (![[info]](http://l-stat.livejournal.com/img/userinfo.gif){kind=small} faustin) wrote,@ 2009-05-30 11:31:00 |
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what, me update? The ugly wake-up
Trying to restart (blogging) with baby steps.
Most days are near perfect. Seriously, I mean that, despite the following which is the ugly part.
Almost everyday I wake up sick, in pain, and miserable, due to the following weird dynamic between my sleep cycles and my insulin schedule. My body preps itself to wake based on the wake times it has already adapted to. This prep process includes the big cortisol release, which amps up blood glucose.
My sleep cycle gets set mostly by my need to inject Levemir (long-acting insulin) at 06:00. So my body revs up at about 5:15-5:30, my surging blood sugar sickens me and wakes me up by 05:30. I take my blood sugar, and it's usually high, which pisses me off. CRITICAL: I don't think I fully understand what causes the inconsistent morning highs. It's about 67-75% of days that are like this.
Of course, if my surging blood sugar at ~5:20 keeps waking me up, what happens next? Naturally, my body adapts to the expected wake time of 5:30 (I've been laying there with my dreams disturbed by the feeling of sickness, coming conscious, slowly realizing that my BG is high and that's what's wrong.)
You would expect a continuing feedback loop, pushing me to earlier and earlier wake time / prep process / cortisol release. My morning schedules, I believe, short circuit that. Some days require big correction. Some corrections knock me out, and I roll with this, because I don't have a client until 08:00. Most days I have clients at 06:30, 07:00 or 07:30 so my actual Jump Up and Hit It Hard times vary.
The inconsistency seems to confuse my body's adaptation. About 1/2 or 1/3 of the time, I wake up at 04:30 with my blood sugar amping up high ---- presumably in anticipation of the 5:30 wake up which was caused by antiicipation of the 06:00 wake up. Many days, this HIGH is 280-330, which is a crushing blow to my AVG BG and STANDARD DEVIATIONs, which lately are the most important numbers in my life.
The next 2 hours is made miserable by the timing and effect of corrective insulin and the pressures of my morning's activity. I take Novolog, my preferred fast-acting insulin, to correct my high blood sugar. Because of the "dawn phenomenon" (this whole body-prep process which amps up BG and also decreases insulin sensitivity), the insulin takes a long time to act.
I lay back down, feeling sick, and the Novolog makes me drowsy and finally knocks me out about 45 minutes later --- about 5-10 minutes before I have to jump up out of bed and get ready in < 20 minutes. This is extraordinarily difficult: to rouse oneself from a smothering insulin surge. I hate it.
The ordeal doesn't always end there. If I have a "date" to workout with someone, at perhaps 06:30 or 07:00 or 07:30, the insulin surge makes me extremely weak. Once in a while, I'll be unable to force myself through the workout. This has happened about 3 times in the past year. The mental effects are much clearer, as I'm slow and muddled. Sometimes, I have planned a client's workouts in advance but cannot remember what I planned, which can be very frustrating.
* * *
Want a happy ending? Most of this misery (not all of it) is caused by my insulin schedule of injecting Levemir. I do three daily injections of Levemir, which is unusual. The insulin is designed to be injected once every 24 hours. The marketing hype promises that you can inject it once and have a stable, even delivery, keeping your blood sugar level in the absence of meals (you take care of the meals by injecting a different, fast-acting insulin).
I found that Levemir does NOT offer a stable, even delivery over 24 hours. I had to switch to TWO injections a day. I still experienced a curve -- less delivery at the beginning, then heightened delivery, then waning delivery. If you get this big curve over a 24 hour period, you have very poor blood sugar control. If you break up the 24 hours into 2 curves, you get some overlapping effect, which mitigates the different deliveries. I have had to break it up into 3 overlapping curves. Hence my Levemir injection schedule, at 06:00, 14:00 and 22:00.
The happy ending: I'm restarting on the insulin pump very, very soon. Insurance is reviewing my claim / prescription data and will confirm in about two weeks. This is going to be a tremendous improvement to my life.
Trying to restart (blogging) with baby steps.
Most days are near perfect. Seriously, I mean that, despite the following which is the ugly part.
Almost everyday I wake up sick, in pain, and miserable, due to the following weird dynamic between my sleep cycles and my insulin schedule. My body preps itself to wake based on the wake times it has already adapted to. This prep process includes the big cortisol release, which amps up blood glucose.
My sleep cycle gets set mostly by my need to inject Levemir (long-acting insulin) at 06:00. So my body revs up at about 5:15-5:30, my surging blood sugar sickens me and wakes me up by 05:30. I take my blood sugar, and it's usually high, which pisses me off. CRITICAL: I don't think I fully understand what causes the inconsistent morning highs. It's about 67-75% of days that are like this.
Of course, if my surging blood sugar at ~5:20 keeps waking me up, what happens next? Naturally, my body adapts to the expected wake time of 5:30 (I've been laying there with my dreams disturbed by the feeling of sickness, coming conscious, slowly realizing that my BG is high and that's what's wrong.)
You would expect a continuing feedback loop, pushing me to earlier and earlier wake time / prep process / cortisol release. My morning schedules, I believe, short circuit that. Some days require big correction. Some corrections knock me out, and I roll with this, because I don't have a client until 08:00. Most days I have clients at 06:30, 07:00 or 07:30 so my actual Jump Up and Hit It Hard times vary.
The inconsistency seems to confuse my body's adaptation. About 1/2 or 1/3 of the time, I wake up at 04:30 with my blood sugar amping up high ---- presumably in anticipation of the 5:30 wake up which was caused by antiicipation of the 06:00 wake up. Many days, this HIGH is 280-330, which is a crushing blow to my AVG BG and STANDARD DEVIATIONs, which lately are the most important numbers in my life.
The next 2 hours is made miserable by the timing and effect of corrective insulin and the pressures of my morning's activity. I take Novolog, my preferred fast-acting insulin, to correct my high blood sugar. Because of the "dawn phenomenon" (this whole body-prep process which amps up BG and also decreases insulin sensitivity), the insulin takes a long time to act.
I lay back down, feeling sick, and the Novolog makes me drowsy and finally knocks me out about 45 minutes later --- about 5-10 minutes before I have to jump up out of bed and get ready in < 20 minutes. This is extraordinarily difficult: to rouse oneself from a smothering insulin surge. I hate it.
The ordeal doesn't always end there. If I have a "date" to workout with someone, at perhaps 06:30 or 07:00 or 07:30, the insulin surge makes me extremely weak. Once in a while, I'll be unable to force myself through the workout. This has happened about 3 times in the past year. The mental effects are much clearer, as I'm slow and muddled. Sometimes, I have planned a client's workouts in advance but cannot remember what I planned, which can be very frustrating.
* * *
Want a happy ending? Most of this misery (not all of it) is caused by my insulin schedule of injecting Levemir. I do three daily injections of Levemir, which is unusual. The insulin is designed to be injected once every 24 hours. The marketing hype promises that you can inject it once and have a stable, even delivery, keeping your blood sugar level in the absence of meals (you take care of the meals by injecting a different, fast-acting insulin).
I found that Levemir does NOT offer a stable, even delivery over 24 hours. I had to switch to TWO injections a day. I still experienced a curve -- less delivery at the beginning, then heightened delivery, then waning delivery. If you get this big curve over a 24 hour period, you have very poor blood sugar control. If you break up the 24 hours into 2 curves, you get some overlapping effect, which mitigates the different deliveries. I have had to break it up into 3 overlapping curves. Hence my Levemir injection schedule, at 06:00, 14:00 and 22:00.
The happy ending: I'm restarting on the insulin pump very, very soon. Insurance is reviewing my claim / prescription data and will confirm in about two weeks. This is going to be a tremendous improvement to my life.
