Friday, June 4, 2010

Waking up is hard to do

Every single morning, I wake up, blearily walk to the kitchen, do a BG, and then bolus.

"ZOMG, Karen, is your fasting BG always high??" you're obviously wondering. But no, you wily D-genius, I'm afraid it's not because it's always high - that, at least, would be some overnight basal I could tweak. The reality is I bolus even when I'm starting out the day in the 70s or 80s. I have to if I want to curtail my morning jump.

Take this morning, for instance, which was completely typical. I got out of bed at 7:30 with a BG of 80. "Excellent work last night!" I think, and confirm the thought with a peek at my smooth 3-hour Dexcom graph. I pop .3 (roughly half of my hourly basal rate), unhook when my bolus done-boop chimes out, and then go take a shower. Once I'm turbaned and bathrobed, I quickly scoot to the kitchen to hook back up - a twenty-minute basalfree period at the very most.

Right about the time my train starts to cross the Manhattan Bridge, "the climb" kicks in. By the time we've hit Canal Street on the other side, my purse is vibrating with Dex high alarms. When I plop at my desk at 9:00, I check the damage - Dex is topping out over 170, but my meter BG says 136. A 56-point leap in 90 minutes with no food or anything? Not horrible, not awesome.

The problem, of course, is that this doesn't make any sense. If I sleep in until 11:00 on a Saturday, the climb doesn't happen. I still do the same routine, but my BGs stay flat. So it's not my basal rates. And it can't be the unhooked-period, since I cover for that with a little fancy mental math and pop half an hour's worth of basal before a shower. It has been driving me crazy, as I've been killing myself to try to figure out what the heck is going on.

Enter Twitter. I lobbed out the question and, lo and behold, I'm not the only one who has this problem. It seems @BadPancreas and I both get a BG bounce just from waking up! The more I think about it, the more that math makes sense:

(1 girl who loves sleep + snooze alarm) x lateness from using said snooze alarm x stress from running around late = 50+ point leap in less than two hours

I think my next step will be trying to get up a bit earlier - ha! -  to test out the hypothesis. In theory, if I can give myself some wiggle room, zap the stress of feeling late (and having to scramble around and run out the door), perhaps I can mitigate the bump a bit. Unless some of you lovely D-geniuses have a better idea you want to share?!


  1. Let me know if you figure anything out! Some days are different than others -- I think I get the biggest spikes when I have to, you know, figure out what to wear and start thinking about work. I've been told it's just the adrenaline that comes with dragging one's ass out of bed. One more reason to stay in, as far as I'm concerned!

  2. YEAH... mine jumps every morning. I wake up between 6 and 8, test, and if I get up I take 3 extra units of insulin. If I go back to sleep, I take 2. (That seems like a ton but it's not for me haha). It keeps me down...and of course i'm still perfecting the wake up routine. My endo says I should be able to control it with basal rates...I have yet to see that. Anyway you are definitely not alone.