When I first heard of circadian rhythms I thought they were an electronic pop band from Manchester.
I then went on to imagine that they had a string of modestly successful hits during the late eighties and early nineties but split after irreconcilable creative differences opened up between the lead singer and the bass player who founded the band in the first place. After years of acrimony over unpaid royalists the members of the band (aside from the drummer, who died after a drugs overdose in 1997) reformed and had a successful reunion tour and an appearance on Later with Jools Holland.
It turns out, however, that my assumptions were wrong.
When I was first diagnosed with diabetes I was taught all about carbohydrate counting and adjusting the amount of insulin I stuck in compared to the amount of carbs I stuffed down my gullet. It all seemed pretty logical to me. So off I went, carefully weighing my cereal in the morning and looking up the carbohydrate content of my pasta in the evening.
With Joan, my diabetic nurse, we worked out that 1 unit per 8 ¾ grams of carbohydrate was good for me. I don’t think it was actually that amount but I remember it was something equally impossible to workout without a handy Cray supercomputer around.Even with my methodical carb counting I still couldn’t get stable levels. In the morning I was far too high and in the evening I was just about right, but tending towards lows. How annoying. At first I thought I wasn’t being accurate enough, so I weighed and measured with aerospace tolerances of accuracy. Orange juice measured out to the nearest picolitre (whatever a picolitre is) and allowing for variations in the Earth’s gravitational field while weighing things out and so on. Needless to say it made bugger-all difference.
Then one day up at the clinic I had a slap-on-forehead moment as my then diabetic registrar mentioned something about circadian rhythms. “Is that a Manchester electronic pop band?” I asked.
No, apparently we have a basic rhythm of hormones and other processes that work on a roughly 24 hour timetable. Messing with your circadian rhythms is thought to cause things like jet lag and seasonal affective disorder.
Diabetes itself doesn’t affect your circadian rhythms directly but they do effect how much insulin you need to put in. According to my diabetic registrar every morning my body prepares to get up and fight a nearby dinosaur and so squirts out a lot of adrenalin (he’s never seen me in the mornings – a dinosaur would have me for breakfast).
Apparently adrenalin has an opposite-ish effect to insulin and a working pancreas allows for this by squirting out more. This is also why your blood glucose can go high when you’re stressed.
So far so good, so what? (As Megadeth fans might say) I found that if I counter-acted this dragon-slaying adrenalin with more insulin my levels came back down to normal. Hurrah!In practice, what I now do is put in twice as much humalog in the morning for breakfast than I would for my evening meal and a touch more than usual for lunch. So great while carb counting is, it needs adjusting according to those crazy rhythms in your head.
As always, results may vary – don’t take advice from a blog, talk to your diabetic nurse!