Sunday, April 10, 2016

Dead In Bed

Did you think that might be what happened to me some time in the last year and a half? I am happy to report that I am still alive and well, just not feeling like I had much to say on the topic of diabetes and pregnancy or birth. At least, not that seemed worth sharing out loud. You know how sometimes you'll have something percolating in your mind, but it's not quite ready to drip out for consumption by others? That is sort of how all my thought trails about diabetes and childbearing have been in the last 15 months. Very often these trails about how to have diabetes and children at the same time lead me into anxious ends, fearful ends, dead ends. In reflecting back, a great deal of all my pregnancies have been spent traveling these anxious paths, many of which I've shared here.

I cut a new one of these anxiety-ridden paths when I learned about a syndrome for Type I diabetics called "Dead In Bed Syndrome." Have you heard of it? It is a phenomenon occurring in Type I diabetics only, and it has been compared to sudden infant death syndrome (SIDS). An average Type I diabetic, apparently young and healthy, will go to bed without showing any symptoms of any kind of distress, and simply fail to wake up in the morning. It is hypothesized that a prolonged low blood sugar during the night may cause cardiac dysrhythmia that results in death, but that is only a theory and no one really knows. A CGM sensor on at least one sufferer failed to alert him to the trouble with his blood sugar, but did show that his blood sugar was below 30 mg/dl for a couple of hours before he passed.

So if you're a diabetic, it's one of those things that you're glad to know about...but only kind of.

I have had my share of nighttime lows, both within and without pregnancy. There have been a few nights where I have slept so deeply that I wonder if my blood sugar was below 40 mg/dL for a few hours and I was more unconscious than sleeping. I once woke up to my alarm clock a full twenty minutes after it started buzzing, and my blood sugar was in the 30s when I finally got up to check it.

For now, I have planned to get a CGM of the Dexcom variety, but this is obviously not a fool-proof method of prevention as mentioned in the example of the man above. I have set an alarm clock for myself to wake during the night (at 2:00am), but this is also not a fool-proof method of prevention as noted in my recent experience. My husband is gone at night during the week, so I'm feeling rather vulnerable to the risk this poses for me and for my children. Who will be there to care for the sweaty, thrashing, sleep-talking mess that I sometimes become when my blood sugar gets low during sleep? Will it be missed, and I simply slip from this life into eternity?

The one thing that I will say about this is that low blood sugars at night happen whether I'm pregnant or not. These last 21 months have taught me as much. I will not let my endocrinologist imply that future childbearing is inadvisable simply because of low blood sugars.

So I will do the only thing that seems reasonable to do when you're confronted with fear for your life and you've done everything else you can to prevent it: every night, before I sleep, I will entrust my children and myself to Almighty God, and pray that He cares for us both in this world, and that He guides our passing into the next.

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