One sleepless night I had a thought that changed everything. I often awake in the night with high blood glucose. I haven’t been able to prevent these spikes, and they disappear by dawn, leaving me with a glucose level that’s too low, and setting off my Dexcom alarm.
So I lay there in the dark with one dog cuddled up to me and the other snoring blissfully on the floor, thinking about a work colleague’s advice. Her husband has type 2 diabetes and they benefitted from a visit to a diabetes educator. She kind of implied I should make an appointment — I might learn something.
My defensiveness rose like bile in my throat. I’ve been diabetic for 20 years and feel I know everything. My diagnosis is latent autoimmune diabetes in adult (LADA or type 1.5) I thought I had a handle on it — but here I am laying awake because of a nighttime glucose spike.
Plus, my weight is a problem due to the insulin. Insulin, while life-saving, takes glucose out of the blood and stores it in the body’s fat stores. I can lose weight through fasting but as soon as I start eating again, it piles back on. The doses of the 12-hour insulin is constantly changing on a day-to-day or dose-to-dose basis. My daily units recently have increased from 24 units to 70, then slid back down. Nothing in my diet or lifestyle has changed. So frustrating, either facing a low or a spike.
Obviously I have glucose that’s difficult to control and impossible to keep within an acceptable time-in-range (usually a target TIR is 70%). And I don’t know if my low-carb diet is serving me well. It’s just become a habit. I have a job that keeps me moving but I’ve never noted any benefit on my glucose from exercise — except for my 10 minute dog walk first thing in the morning.
My relationship with my endocrinologist continues to be frustrating. He’s in Vancouver and I’m on Vancouver Island (a four-hour ferry/drive away), so we do telephone appointments. I spend a few minutes talking with a tech and then get a few minutes with the endo. Everybody seems in such a rush. Nobody asks me anything useful, and it feels like a bad speed-dating session. I tried summarizing my issues in an email but he only reads them during the telephone appointment and tells me they’re too long. No acknowledgment of what I said.
As a retired journalist, I did some research and asked my medical support about insulin pumps. These pumps inject fast-acting insulin when needed, taking away the need for long-acting insulin. When I asked the tech if I could have a pump, I was told I needed more glucose control. Huh? I thought the point of insulin pumps was to give me control?
Anyway, back to my sleepless musings. It occurred to me that a diabetic educator might just advocate for me with the endo to get me an insulin pump. I need support from somewhere and this might be the ticket. The next day, I called the DE office and made an appointment. By the time I walked in the office, I was uncharacteristically emotional, but it was the long-suppressed frustration boiling to the surface.
“You’re in diabetic burnout,” was Pam’s assessment. “I absolutely can advocate for you getting an insulin pump.”
She showed me four options and explained the benefits of each. Oh my God, I felt a tingle of hope. No more chasing my glucose up and down — no more 12 or 24-hr insulin. These pumps keep reservoirs of short-acting insulin and work with my Dexcom to adjust as necessary. I don’t have to do hardly anything.
I checked into my Pharmacare coverage and what is covered through my employer (although at 65, I’m not interested in working forever). Plus, a development that takes care of all diabetic costs is a new Canadian program that will cover all pharmaceutical and equipment costs of diabetic citizens. It takes effect in March 2026.
I decided that a good fit for me would be Omnipod 5, and did some research. Holy crap, it’s awesome. The only thing I need to brush up on is knowing how many carbs I’m eating. Currently, I go for the “guess and correct” method. Once the Omnipod sense how I react to glucose, it adjusts the dose to keep me in range. How cool is that?
I’ve been in touch with the Omnipod rep who had me fill out a form. They will get the required signature from my endo, so I don’t have to let him stand in my way. Now I await word from their customer service people.
I have to accept that my low-carb diet has messed with my metabolism. I’m getting spikes from my low-carb choices, because my body is lacking its usual fuel of carbohydrates. So it’s turning protein into fuel and is spiking glucose as a reaction. It’s messed up, but not really surprising. This is probably what’s behind my nighttime spikes.
Clearly, prior to getting a pump, I need to reintroduce carbs and get my metabolism back on track. I went shopping yesterday and bought a bagful of previously banned foods — fruit (pineapple, strawberries and peaches), tomato spaghetti sauce, elbow macaroni, microwave popcorn. I also got ground beef, celery, sweet peppers and a yellow onion because I had a particular dish in mind — what my mom called goulash. Sort of a spaghetti sauce with macaroni. Haven’t had it for years, and making it reminded me of my mom who died in 2014. She wasn’t one for displays of emotion, but would show her feelings by making comfort food. I’m not one for emotional displays either, so I felt grateful to reconnect with this culinary comfort food from my past.
While I’d long thought that eating sweet fruit, pasta and popcorn would send my glucose into the stratosphere, I noticed everything is…dead flat. No insulin needed for fruit? Bizarre! I’m sure it won’t last, but while my body gets reacquainted with carbohydrates I get a bit of a holiday from carb-dosing.
I’m letting my body call the shots. I’m hoping this change will deal with my ongoing fatigue and dull headaches. And hopefully, by the time my pump arrives I’ll have my body’s metabolism back on track.
Amazing how things can work out.
Leave a Reply