T1D / Reflecting on Sleepy Mistakes

“Are you okay?” my wife asked around midnight. There was a loud ringing in my ears and I was drenched. I glanced at my watch, which read 39 above a solid line of red dots for the past hour.

‘No,’ I replied as I struggled to sit up and move towards the door. My body hit the wall…’I can make it,’ I thought to myself.

“Sit down. You didn’t look like a person that’s alive. What happened?” She handed me a huge cup of juice.

A finger prick read 52: almost the point of non-deadly, but by no means safe, especially considering the natural rise from feet on the floor and the sheer duration of the mistake. I sat on the bed staring at the closet doorframe in a haze. Short lows are annoying, but long lows while asleep can kill. I felt like death.

I’d switched from Afrezza to Fiasp for the day due to allergies and totally misjudged the insulin decay rate after dinner. So I ate a large apple an hour before bed (normally a straightforward dose of Afreeza) and waited an extra long time for the upward trend before what I thought was a conservative bolus of Fiasp. After falling asleep I managed to mute the CGM alert at 11pm, then proceed to roll over onto my phone for an hour. And I have zero memory of this.

A second downward trend alarm woke me two hours later. I drank more juice and fell asleep again.

Looking at the curves today, the first event was not a logical decision. Did I even look at my watch and phone at 11? How did I grab my phone and dismiss the alert in my sleep?

Technology did not fail me. The curve was clean and clearly downward trending. The G6 alerted as expected. Had this happened during waking hours, there is no chance I’d have gone low, let alone for an hour. Which begs the question: would I be alive today had she not noticed something was off?

This is why I cannot buy life insurance. Nevermind my 5.6 A1C, regular exercise, and otherwise young and healthy body. One wrong move can kill.

Somehow I felt well and grateful by morning, recognizing I could die tomorrow or 60 years from now. Such is true for anyone, but the possibility has always felt remote until now.

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