Tuesday, April 10, 2012

The “Psych” Phenomenon

Has this ever happened to anyone else? You check your blood sugar before bed only to find that it is unusually high (something like 150+). This makes no sense to you because you ate a normal meal of a normal size and injected a normal bolus amount. But you tend to believe the number on the screen (or maybe you sacrifice a few more test strips just to be sure) and so you give yourself a corrective dose and head off to bed. Four or five hours later you suddenly wake. You’re sweaty, disoriented, and your heart is racing. It takes a minute for you to feel the familiar light headedness and shaky fingers. Blood sugar is crashing. You manage to put the thought together through a muddled mind and slowly make your way down to the kitchen for a glass of your favorite glucose packed beverage.

Or maybe you’re a seasoned pro and this is a trick you have experienced before. Instead of correcting for the unusually high blood sugar, you go off to bed without any extra insulin. When you wake the next morning your blood sugar is a very normal 80. But how? It was 190 before bed, and you certainly weren’t exercising in your sleep.

I spoke to Dr. Michaels at the Barbara Davis Center once about what I have termed “The Psych Phenomenon.” While he is a Type 1 himself, he seemed somewhat unfamiliar with the idea. But his best guess seems a good explanation to me. The problem during a Psych episode is that your pancreas makes the same amount of insulin it normally does, but the entire process is very delayed. So that correction you took at 10:00pm brings your sugars down to a normal level, but a few hours later, that gallon of insulin that your beta cells have been trying to create since dinner suddenly rushes into your blood stream.

Generally, I only experience this phenomenon after a couple days of pancreas abuse (knowingly inflicted or accidental). And it tends to last anywhere from a few days to a couple weeks. I have found that upping the initial dose of insulin taken with dinner can sometimes help. But sometimes that leads to the same problems as a corrective dose. More often, the only way I can put an end to the Psych curse is to stop eating carbs for dinner altogether. I’ll have a small salad or a piece of chicken (it is usually the salad as I lean strongly toward the vegetarian mindset). That way, there is no need for blood sugar spikes or insulin. After a few days of carb free dinners I can usually reintroduce a small, well measured portion of carbohydrates and have everything run smoothly.


Nopal Supplement Experiment Update

Day 1 Blood Sugars (4/9):

  • 5:00 am--77
  • 11:00am-- 71
  • 6:00pm-- 105
  • 9:00pm--183

Day 2 Blood Sugars (4/10):

  • 5:00 am-- 90 (a perfect example of The Psych Phenomenon)

Insulin Requirements:

  • Long term-- 6u/day
  • Short Term-- 1u/30g carb breakfast and lunch; 1u/20g carb dinner

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