Sometimes diabetes reminds me of the age old question “What came first, the chicken or the egg?”. In diabetes lingo I’m pondering “What came first, the ketones or the crud?”.
Last night I went to another JDRF Type 1 Adult event, and it was fantastic! (Hopefully I’ll get a post up about it soon . . . . ) While there, I had my favorite salad and some wine. This particular salad is always a tricky bolus for me, because it contains candied walnuts and a honey dressing. To make things trickier, sometimes the salad seems loaded with walnuts and at other times it has less (and sometimes Pete snags a few off my plate and at other times he cons me out of more than a few). Basically I do my best SWAG bolus and adjust later if necessary. Before bed I needed about a half unit correction and that seemed fine.
Fast forward to 4:30 a.m. when I woke up feeling cruddy. I didn’t have a CGM sensor on because I’d decided to take a rare few days off, so I got up to test my blood sugar. I was shocked to see 273 glaring back at me! Even with the candied walnuts, popping a number in the 270s after that salad was crazy. I bolused my correction, drank some water and tried to go back to sleep. By 7:00 a.m. I was feeling really sick to my stomach. I managed to hold things together and when I dragged myself out of bed and tested, I was happy to see I was back down to 144.
Unfortunately that didn’t last long. A couple hours later I was back up to 259 despite the fact that I felt too icky to eat anything. It occurred to me that I should check for ketones, and sure enough the strip quickly turned that pretty purple shade indicating Moderate. So I’m drinking lots of water, I took my correction by injection, and I’m trying to eat a little something. I've also happily ended my CGM vacation and fired up a new sensor, grateful to be able to keep close track of what is going on.
But I can’t help wondering, do I have ketones because I feel sick? Or do I feel sick because I have ketones? If the injection brings me back into range, I’ll change out my site and see if that clears up the highs and the ketones, and hopefully the queasiness. And I suppose I’ll have my answer. But right now I’m in the endless chicken / egg circle of wondering what came first, the ketones or the crud?