freakin' scary

ok, not sure anyone knows that I'm type I insulin-dependent diabetic. The "real" diabetes, as I like to call it. Where it's not your own fault you have it, but rather a genetic thing. (Maybe with mom telling me not to eat a spoonful out of the sugar bowl as a kid, because I'd get diabetes, I should have listened.)

Anyway, I'm on an insulin pump, which works really well. It's hooked up via a skinny tube to an "infusion set" on my stomach, and I just have to rotate the site for the hookup every 4 or 5 days -- as long as the reservoir of insulin lasts. I get a steady-stream "basal" rate, and then I give myself a "bolus" whenever I eat food -- more food means more sugar in the blood which means I need more insulin to get that glucose to the cells in my body. The main thing is that there's a relatively consistent ratio between the amount of carbohydrates I eat and the amount of insulin needed to "cover" the increased blood glucose level.

So a couple of days ago, I'd had a blood sugar level of about 160 in the morning. Not as good as a normal level of 100, but not the worst thing in the world. Usually I'm between 80 and 130 over the course of the day. Well, the temperature was in the 90s a couple of days ago and I went down to Dairy Queen....got a large chocolate cone dipped in cherry. Now, I'm not sure exactly how many carbohydrates are in that, but I know enough about ice cream to figure out something close -- and hey, I use a machine to test my blood sugar level, and if it were too high, I just take more, and if it drops too low, I get all hypoglycemic feeling and I can eat something else to bring the glucose level back to normal. Plus, I figured another couple of units of insulin would incorporate bringing the 160 back down to 100, not including the extra for the ice cream.

Well, something screwy happened. My blood sugar level shot through the roof. Like, 450 (I think it's milligrams per deciliter of blood). I can also tell hyperglycemia because I get a faint ammonia-like smell from ordinary surroundings. So I panic, and take some more insulin....no help, it's now 520. I keep giving myself extra booster boluses (the pump just feeds more insulin through the tubing into my body subcutaneously at the infusion site, like a needle would). Still nothing all afternoon. I hit 582 on one reading, the highest I've ever had. And I can't figure out why it's not coming down. I tried gagging myself to puke up the rest of the ice cream, but of course, ice cream that's been in your stomach a couple of hours just is all gooey and doesn't puke up when you'd like it to.

Eventually I gave up, hysterical, around 3 pm, and drove home. By the time I was home I was back down to 429. I took out one of my old pre-pump needles and gave myself a shot in the butt of even more insulin, then went for a walk (okay, I mowed the lawn, but that's walking). By 5 it was down to 303, and I cooled off swimming in our little pool. A couple of hours after that it was down to 130.

So THEN, I figured I was okay to have dinner, which was just some vegetable soup -- not a lot of carbohydrates there. I did over-bolus myself just a small bit there, but that was because hey, no insulin had been working. I had taken out the infusion set, to move it to another spot, just in case the fatty tissue where I'd been hooked up wasn't absorbing the insulin right or something.

Well, that might have had something to do with it, because the rest of the night I was hypoglycemic. Readings of 47, 64, 51, 71, etc. All the while I had to eat a bunch of peanut M&M's (aw, poor me, right?) and drink almost three-quarters of a bottle of sugary root beer. Somehow I think the exercise of the late afternoon freed up all that insulin that was in my system all at once. I scarfed a bunch of cheez-its and went to bed, and woke up yesterday with a normal 88 reading. That shouldn't have been so hard.

The worst part was that when I was removing the old location's infusion set (the connection point for the insulin tube) it seemed that it wasn't secured in place right....and then I smelled my shirt the next morning and it smelled like insulin from the bottle (it smells like the latex of a freshly-opened band-aid)....which makes me think that part of the problem was the insulin at the point of connection. (The infusion set has a twist-off feature, that allows me to disconnect and re-connect the tube from the pump, so that I can take a shower or go swimming, with just a cover to the point of insertion. I think I wasn't twisted back on properly and insulin was going through the tube and leaking out instead of entering my body.)

The worst part is that next week I have to have my regular bloodwork for my 3-month checkup. They say that the blood test measures a three-month overall average of my blood sugar level based on hemoglobin. But there's no way having a 582 for a few hours won't skew my results even a bit higher than they would, had I not forgotten to go for the bloodwork last week like I should have.

And so now I have to explain this to the doctor in a couple of weeks. If my lab results are too high, he won't buy the excuse that one bad day skewed the whole three-month average!