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Glucose trends by hour averaged into 90 day blocks during the study course. The yellow line is target maximum glucose level, < 150 mg/dL during sleep and < 180 mg/dL during the day. The orange line is target minimum glucose > 80 mg/dL during sleep and > 70 mg/dL during day. The black line is the average glucose by hour, the gray line spans 15th-75th percentile and any yellow vertical bar suggests an average above threshold, while red vertical bar suggests an average below threshold. PM showed consistently higher sugars than AM.
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Day glucose targets were 70-180 mg/dL while night targets were 80-150 mg/dL (Fig. 1). Hourly glucose trends by 90-day blocks along with target glucose thresholds are depicted (Fig. 1). These times are similar to her historic other ultradian patterns, specifically evening wake and early AM sleep and PM elevations in glucose and midnight until 7 AM declines in glucose (Fig. 1). Somogyi effects of post-hypoglycemia rebound to hyperglycemia were not noted, for instance summer 2016 shows the most AM hypoglycemia, yet the post-hypoglycemia rebound varies little between 90 day epochs (Fig. 1).
Number of events by hour of day and side of onset.
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Seizures were least likely between 6 AM and 4 PM, a time in which glucose in general was normal or hyperglycemic (Fig. 2). The mean time of seizure for LFS was 17:02 and for RFS was 4:23, though time plots suggest closer acrophasic clusterings of seizures than the mean levels, LFS in the evening, RFS from midnight until 4 AM (Fig. 2).