Extreme Wake-up Call

"Complacency": My new scariest word in the "diabetes dictionary". Worse than "low" or "ketone" or "A1c" or possibly even "hypoglycemia" or "complication." Complacency almost cost us last night. BIG TIME.

According to dictionary.com, complacency is a noun, meaning a feeling of quiet pleasure or security, often while unaware of some potential danger, defect, or the like; self-satisfaction or smug satisfaction with an existing situation, condition, etc.

I'm not suggesting that I suddenly became unaware of the dangers of diabetes after 6+ years of my son living with the disease. Rather, I think, for a little while, I stopped worrying so much about the possibility of danger to him specifically because his numbers have been so good for so long. I got so used to the good numbers that I temporarily forgot that diabetes is anything BUT predictable. 

I do nighttime checks almost every night, and for the past few weeks, Dylan's nighttime numbers have been pretty close to perfect. Usually 5.0-9.0 mmol/l, (90-162 mg/dl) with the odd 4.0 mmol/l (72 mg/dl) or 10.0 mmol/l (180 g/dl). Nothing too outside of ideal range. 

Last night I was going to bed just before 11:30pm and I knew I had a very long day coming up today, working 11 hours straight (I have since taken 1/2 the day off). Plus, I was sick earlier in the week and still wasn't feeling 100%. I was exhausted. And yet for some reason it suddenly occurred to me that I should test Dylan. Not at 2:00am, but right then, at 11:30pm. I grabbed his tester and went in to room, to discover him lying in bed, awake. He had thrown off his covers and was lying in his boxers only. An alarm went off in my head. Because Dylan has had nighttime hypoglycemic seizures in the past (see Dear Seizure), my first thought was that he had had a seizure and I had somehow missed it. After a brief check for evidence of seizure, and talking to Dylan, I realized that was not the case, he was just really warm. Another alarm went off in my head. A quick finger poke revealed a blood glucose reading of 1.6 mmol/l (28 mg/dl). I shook my head in disbelief, thinking I must be really tired and the meter is really reading 11.6 mmol/l. No, it was 1.6 mmol/l! A retest with a finger from the other hand came back with a 2.0 mmol/l (36 mg/dl). Holy crap! 1.6 mmol/l is the lowest Dylan has ever been in the 2251 days he has lived with type 1 diabetes.

7 minutes later, after 25 grams of fast acting carbs and a temp basal set at 75% for 4 hours, and he was up to 2.2 mmol/l (39 mg/dl). Another 8 minutes and he was 2.5 mmol/l (45 mg/dl). 30 minutes after the first test he was up to 4.3 mmol/l (77.4 mg/dl) and I finally exhaled. At 1:30am he was 5.1 mmol/l (92 mg/dl), but at 4:30am he was back down to 3.7 mmol/l (66.6 mg//dl). Another 25 grams of sugar and another temp basal of 75% for 4 hours. By 5:30am he was 7.4 mmol/l (133 mg/dl) and at 7:30am he was 10.4 mmol/l (187 mg/dl).

Fast forward to now, where we sit with blood glucose levels stable, but on the low side all morning. Dylan has a full blown cold, complete with sore throat, stuff nose, and low grade fever. The exact same cold my daughter had last weekend, and I had earlier this week (see Immunity Breakdown). I know the illness is responsible for the low readings, and his numbers are always wacky when he's sick, but when Dylan went to bed last night he felt fine. As so I was complacent. 

I honestly have no idea what caused me to test him at 11:30pm last night. Call it intuition, motherly instinct, gut feeling, whatever. All I know is that one test very well might have saved his life. And though I know it will drive my crazy, I keep asking myself, what if I hadn't checked?