With the appearance of continuous glucose monitors (CGM), like the Dexcom G6 that don’t require daily fingerstick calibrations, many people have fallen out of the habit of using a fingerstick meter to manage their glucose levels. I’m testing a lot less frequently than I used to but there are situations where a confirming fingerstick saves me a lot more trouble than it creates.
I’ve been struggling some with a trend of lows around midnight, a few hours after I go to bed. These lows often require more than one glucose treatment. I think they are caused by basal rates set too high, something I now call a “basal low.” We all know the feeling of just wanting to handle this situation quickly so that we don’t fully wake up and then face trouble getting back to sleep.
Making the effort to do a fingerprick is the last thing you want to do. I often just eat a glucose tab and roll over. Unfortunately, these lows have been more persistent and 15 minutes later, the alarm is sounding again. I’ve learned from experience that I can cycle through the alarm, treat and another alarm cycle until I treat one too many times and my blood sugar goes high for the rest of the night.
Two nights ago, I was woken up with a low alarm (65 mg/dL), treated with one glucose tab and rolled over. Fifteen minutes later the urgent low 55 mg/dL alarm sounds. I then thought, ok, maybe I am indeed low and need another glucose tab or perhaps my first treatment just hasn’t metabolically registered yet.
Reluctantly, I dragged myself out of bed and stuck my finger – 90 mg/dL. So my suspicion was confirmed, I returned to bed without another glucose tab, no more alarms and I woke up in the morning at 93 mg/dL. I would have been so easy to eat another glucose tab (or two!) and return to sleep and bounce into hyperglycemia for the rest of the night.
In these situations, I think of a fingerstick as a way to look 15 minutes into the future. It’s not really the future but a CGM often lags a meter by 15 minutes.
I find this framing makes it easier for me to find the energy to do the fingerstick and make better informed decisions. Instead of feeling like I’m burdened with this additional task, I see it as an opportunity to see into the future and make a better call.
As humans, we have this incredible ability to reframe reality and instead of changing any of the facts in a situation, we can see it from a different perspective and make better decisions.
It’s a small thing that has helped me. I now see my fingerstick meter as a magical tool at times that can allow me to see 15 minutes into the future. It makes those difficult midnight decisions a little easier. Anyone else use this technique?