The past weekend has truly been frustrating diabetes-wise. I don't know if it the immense summer heat that Denmark along with the rest of Europe are experiencing at the moment, the reactions of my body being out of wack or whatever. Anyway my BG levels sure has taken roller coaster rides all weekend.
Saturday morning I started out on the low side (2.3 (41)) which made me re-check about an hour and a half after breakfast. At this time I was up to 11 (200), and because I had reasons to believe that I would shoot even higher, I took an additional bolus of 2 U by pen (I don't know why I didn't use the pump for that). At lunch time I was in range at 4.5 (81) and I used the pump wizard to calculate lunch bolus. The pump suggested 4.7 U for my 1.5 slice of rye bread, 1 glass of milk and a small banana (estimated carb count: 69 g). Bearing in mind that I had just finished 8.5 km bike ride for grocery shopping, I figured this dosing reasonable. However, a couple of hours later, I could hardly wake up from a book-reading-induced power nap on the sofa when the phone rang, so I figured I better check the BG. I usually suspect a low, when I have trouble waking up from sleep, and as I was also hungry, I was rather surprised to see a 15.4 (277) result on my meter. I corrected for this, again using my insulin pen rather than the pump, and once again I was back in range at dinner: 4.6 (83). We had dinner at one of Jimmi's colleagues - home-smoked trout with homemade white bread as starter, grilled trout with potatoes and mixed salad as the main course, and homemade ice cream for dessert. Very delicious! The main course and the dessert was about 1.5 h apart, so I thought I might do a quick check to assess the amount of insulin needed for the dessert: 15.6 (281). WTF?!!! At that time, I started to suspect that either the insulin in the pump had gone bad (it was due for a change and fill-up the next day), the site was not working properly or other pump-related issues were causing these crazy sugars. Thus, I corrected with my pen once again - and of course I was low later that night :-/ I checked before going to bed and was 3.5 (63), so I had an apple and went to sleep.
At 9 o'clock the next morning I was 2.3 (41), and because it had now been 12.5 h since my correction with pen, I thought that maybe I was wrong, maybe there wasn't anything wrong with the insulin in the pump, maybe I had just misjudged the amount of insulin needed for the first two courses last night. So I bolused with the pump, and didn't check again until lunch: At 12.30 PM I was 18.6 (335)!! This reading closed the deal for me, and besides taking a correction and lunch bolus with my insulin pen, I also changed the site and reservoir, hoping that this would help. There didn't seem to be anything wrong with the site, or anything blocking the tube, though. The rest of the afternoon and before dinner BGs were fine, 3.9-5.9 (70-106). I had planned to go for a bike ride in the afternoon, but I postponed that due to a thunder storm. After dinner the weather was dry, but still warm and because of all the rain it was rather humid. I went for a good ride on my mountain bike, 27 km, but I ran into a nasty hypoglycemia attack on the way, and I am actually surprised that I managed to get home safely. I do have glucose tabs along with me when I ride, but I just never got around to eat any yesterday, so when I arrived at our home Jimmi was out with the trash and even at distance he could see that I was in need of something sweet and rushed to get something to put in my mouth. I didn't test at the time so I don't know how low I was, but the way I experienced it a good guess would be around 2 (36). Anyway, I started feeling a bit better and hit the shower before hitting the couch to enjoy the strawberry and ice cream (sugar free ice cream) treat that Jimmi and I had agree upon at dinner. I bolused a bit conservative for this, 1.4 U for approximately 50 g of carbs, due to my bike ride which will usually affect my BG both during the night and the next morning. Before going to bed at 10 PM I tested 7.2 (130) which seemed perfect about an hour and a half after strawberries and ice cream.
In the middle of the night (I don't know what time it was, because I did not look at the clock - this is intentionally because otherwise I will have even more difficulties getting back to sleep when my mind calculates how few hours are left before I am to get up!) I woke up, having to go to the bathroom. I usually don't have to get up at night, so this, along with the line of unexplainable highs of the weekend and a dry mouth, made me suspicious. Sure enough: 21.4 (385) - the record of this insane weekend! Again, this made be doubt my pump, and a correction of 5 U was taken by pen. That made me wake up at perfect 5.8 (104), determined that today I will evaluate the function of the insulin in the pump by closely monitoring my BGs after boluses taken by the pump. For breakfast (6.45 AM) I bolused with the pump, and once I got to work at 8 AM I tested again: 3.9 (70). That is a bit too low to work with so I had a small snack of 10 grams of carb, because if the breakfast bolus was working as it is supposed to do then its tale along with the effect of yesterday's and this morning's bike rides will lower my BG even more throughout the morning.
At 9.45 AM I was up to 9.7 (175). Hmm, not quit what I would expect if the morning bolus was working. I usually eat 0.5 slices of rye bread mid morning, so I bolused for this and the slightly high BG by the pump, 1.9 U, and postponed my snack for 45 minutes while getting a sample ready for LC-MS/MS. Out of curiosity, and to get a feeling of the effect of the insulin delivered by the pump, I tested again at 10.30 and got a reading of 9.6 (173). This is certainly not impressive, so I think that I am back to using my flex-pen the rest of the day, and then I will try another vial of insulin when I get home. If that does not solve the problem, I am getting back to Lantus, Actrapid and NovoRapid by injections!