I Get Low, Low Blood Sugar That Is!

Recently I’ve had numerous non-diabetic people ask me, “what does low blood sugar feel like?”  “How do you know your sugar is low,” “How long does it last,” etc.  There may be others of you out there that are curious, so I’ll give you my two cents.

If you webmd hypoglycemia, which is the clinical term for low blood sugar they say that the symptoms are: shakiness, hunger, lightheadedness, and sweating.  Let me tell you, there is a lot more to it than these 4 symptoms. 

Front side of my medicalet

 Now, since I’ve been diagnosed I have been incredibly blessed to never have lost consciousness due to low blood sugar, though I’m sure I’ve been very close.  Passing out, coma and death by hypoglycemia are possible and that is why it is very important to stay on top of blood sugar readings and ALWAYS carry a glucagon (emergency kit), glucose tabs and snack.  It is equally important for those of us with diabetes (type 1 or 2) to wear a medicalert bracelet stating type of diabetes, name and medication.  I have always worn one and the few times I’ve had to take it off, I’ve panicked.  The idea of being somewhere and something happening and no one knowing why is scary!  

For me, the most common symptoms are shaking, cold sweats, very rapid heartbeat, heat that radiates so strongly from the inside of my body that I feel like I’m in a volcano and weakness.  When I say weakness, what I mean is that my limbs feel heavy, unsteady and as if I cannot control my muscles like I should be able to.  Typically the heat, cold sweats and strong shakes happen mostly at night.  They will wake me up from a solid sleep and I can usually guess that my sugar will be under 55mg/dl.  When the night time lows hit, I won’t say that I panic but I’m definitely more concerned.  The night time lows tend to be lower than day lows since it takes me longer to wake up and determine what’s going on. 

One of my worst episodes

An example of a bad night low was about 3 years ago.  My husband and I had traveled to visit a soldier from his unit that lives in PA.  Riding in the car and having my typical eating and exercising habits off had caused some turbulence in the blood sugar department as traveling normally does with me.  Before bed I set my meter up on the bed stand as I do every night, along with my cell phone which I use on a regular basis as a flashlight to check at night so I don’t disturb my husband’s sleep.  I was at a normal level when going to bed, but around 2am I woke in a confused, panicked state.  I was shaking so badly that I dropped my glucometer on the floor, I couldn’t find my cellphone on the bed stand in the dark, I didn’t remember where I was and by the time I finally got blood in the strip it registered as “LOW,” oh crap, oh crap, oh crap, serious panic mode.  I tried one more time, “35,” now I am shaking, confused, freaking out, sweating like a pig but cold at the same time and I couldn’t remember my husband’s name!  I stumbled around in the dark bedroom until I kicked the bag I’d packed with food.  I quickly began stuffing my face with muffins that I had made for our trip, almost choking before the noise woke my husband.  I must have looked like death because he even looked scared.  I was purely in survival mode.  

Now I’m crying, I’m scared, I still don’t know his name, I cannot even remember the name of my hometown…I think it starts with an A.  Oh who cares, I need another 37,000 muffins.  This shaking won’t stop, dear Lord I’m hot, I’m cold, I need to change my clothes because I’m soaked, God please don’t let me pass out, I keep dropping muffin everywhere, turn off this stupid insulin pump, my fingers won’t work, how do I turn this thing off?  I’m so confused.  I cannot move from my muffin eating spot on the floor, my legs don’t work, I can’t feel my arms, how are they getting the food to my mouth?  I don’t know, I don’t care.  Where’s the milk?  Do we have milk?  Oh God please make this stop.  These are the thoughts going through my brain meanwhile you’d never know it because my body is in a complete daze.

After about 30-35 minutes with this episode the shaking was gone, the sweating had stopped and now just the cold remains and I am so incredibly tired.  My body usually needs time to recover from these.  It literally wipes out all the energy I have.

Besides this episode, I’ve had dozens of others.  After 8 years of being together, my husband is pretty good at noticing the symptoms like aggravation before I do.  I have a tendency to get pretty feisty when I’m low.  My hubby will say, “You need to go check, you’re grouchy and I bet you’re low.”  Usually he’s right.  He’s also pretty good at noticing any glassy look to my eyes or if I am looking a little dazed and making me test.  Low blood sugar sometimes will sneak up on me and I won’t realize it is happening until I hit 50mg/dl.  That is a little frightening.  There have been times that he and my mom have had to feed me mashed up bananas or stick a juice box in my mouth, typically I could do these things myself even with a low but I tend to get emotional with my bad lows and I’ll be crying, inconsolably crying at that.

Do you guys see why cops may not realize the difference between a drunk and a diabetic?  We’re emotional, we may slur speech, can’t control our limbs like normal, we’re confused, we’re a mess.  So to all my cop friends out there take note to check for diabetes in folks!

Now I’ve covered what it feels like/symptoms, and obviously how I know is by how I feel and then testing.  How long do most episodes last?  Eh, depends on the reading but 15-20 minutes and I’m typically back to normal unless it was a significant drop (below 55mg/dl).  

What I always carry. Juice, tabs & glucagon.

If you need to help someone having a hypoglycemic episode and they are still conscious, a juice box works well, glucose tabs, bananas, most diabetics are taught anything with 15 grams of carbohydrates.  For me every 1 gram of carbohydrate will raise my blood sugar roughly 5mg/dl.  Therefore, if my sugar is 60mg/dl and I eat one glucose tab at 4 grams of carbohydrate my blood sugar should rise to 80mg/dl.  The hard thing is to keep from over doing it when correcting for a low.  They are scary and the symptoms typically last longer than the actual low itself.  As a diabetic when we over correct with food for a low blood sugar we rebound and will end up with a very high blood sugar…it’s a vicious cycle!

I suppose since I’ve covered low's, I’ll cover high’s in the near future.  Hyperglycemia is another lovely beast that accompanies this disease and reminds me that numbers rule my life.  

The long and short of this post, if you find me drinking a juicy juice box, help a girl out ;-)

~D

Oh Diabetes, You Confuse Me. . .

A rainy afternoon is fitting for my diabetes situation today.  There are days where my diabetes behaves seamlessly; my blood sugars are as perfect and flawless as a beautiful spring morning with the sun shining, birds chirping and flowers popping through the soil.  Then there are the days where despite my best efforts my sugars are dismal, disappointing and messy, much like the unexpected spring showers that bring soggy days and gray skies.  Unfortunately, today is the soggy spring day.  Just when I think I have the best system figured out for treating my diabetes, it’s almost as if my body decides, “Eh, let’s shake things up a little and piss her off.  Here, have a blood sugar of 250!” 

I literally eat the same breakfast every day and some mornings post-breakfast my blood sugar will creep up 100 points, while the next day the post-breakfast reading will be 10 points from where it was pre-breakfast.  I will take the same insulin dosage, within the same 10-15 minute window in the morning and the numbers can be drastically different day to day. 

Diabetes is so tricky, it is affected by everything.  Changes in my sleep will affect it, what time I wake up will impact it, hormonal “monthly” changes most definitely affect it and then there is the stress monster.  Stress, no matter good or bad stress causes my sugars to go insane.  If I have an argument it is guaranteed to skyrocket, if I have an interview, skyrocket, planning vacation, skyrocket, intense exercise, skyrocket, being stressed about my diabetes, skyrocket, living, skyrocket (it feels that way sometimes). 

Is there a way to live a stress free life to obtain optimal numbers?  Is there a way to live a “perfect” life with diabetes?  Will I ever figure out the mysteries of this disease? The answer is most likely no to these questions.  What I have to realize is that stress is inevitable and I have to let things go, walk away, count to ten, get a message, imagine people in their underwear, whatever it takes.  I need to remember that while my numbers may not be perfect, I’ve come a long way and made lots of progress in my care.  I have to realize that maybe I’m being too hard on myself and I just need to ride the glucose roller coaster that is my life today and be happy that, while not perfect, at least I’ve made it this far. 

~D

Diabetes Through the Years

First off let me say thanks for taking your time to read this piece.  It took me quite some time to put everything into words.  What I am trying to convey in this piece is how diabetes, while part of my life, has meant something different to me at each stage of my life.  Sometimes it consumed every aspect of my life while other times it was behind the scenes as an afterthought. Regardless of how front and center or back behind me it was or is diabetes has changed who I am and has changed my life forever.  

D-Day

October 1995, I was 8 years old and in 3^rd grade.  I was looking forward to Halloween, dressing up and eating candy until my stomach hurt, or until my mom took it away from me, whichever came first.  Instead the 2 weeks leading up to Halloween went like this…

Jumping off the school bus with my little brother, we raced inside.  It was a Friday afternoon and what kid wasn’t excited about 2 days of freedom?  We had our normal afternoon snack, my mom said there was something different going on, but I didn’t notice.  All I wanted was something to drink, and not just a glass of juice or tea or water, but more like a pitcher of anything.  I was thirsty, like if I didn’t have something to drink my tongue might just fall out of my mouth and dry up right in front of me.  I continued to play with my siblings but besides wanted to drink everything I could get; my play time kept getting interrupted because I couldn’t stop having the urge to go to the bathroom. 

Well, all of you familiar with diabetes know, these are the key symptoms.  My mom kept an eye on me all weekend and told me Sunday night at dinner that I was not to have a snack before bed or to eat breakfast that we would be going right to the doctor’s office on Monday morning.  Monday morning came and off we went, where my mother explained to our GP what was going on, they did a finger stick and came back to the room and blurted out, “Your daughter has diabetes.”  Mom burst into tears, I was confused, but since mom was sobbing, I thought, “I’m dying, I’m going to die!  This is really bad if mom is crying like that.”  The doctor and nurse tried to console both of us and explain to me what was wrong.  From there they sent me to a pediatrician and then onto the pediatric unit of our local hospital where I spent 1 week learning about diabetes and being poked and prodded like cattle.  When I finally came home, my mom and dad kept me out of school for another week to help me adjust to my new life, needles, needles and more needles followed by insulin vials, glucometer strips and glucose tabs.  I remember each time the phone rang, I secretly prayed it was the doctor’s office saying they had made a mistake.  Too bad that phone call never came.

This was my new life.  October of 1995 this was when I went from a child to an adult.   The old me was gone and the new me, the diabetic me, was here taking on the burden of a disease, becoming responsible and having fear and worry become part of my every day. 

8 year old me after diagnosis with my hideous medicalert necklace

Elementary School and Middle School

Being the only kid with diabetes sometimes had its perks.  Not that I took advantage, but if I was hungry I ate in class, if I had to go to the bathroom I went and if I didn’t feel good I left class.  No one questioned the only diabetic kid in town because no one really understood diabetes. 

Elementary school and diabetes to me meant being a little different, but most of my friends liked being able to get out of class with me to walk to the nurses office, so no biggie there.  Moving on to middle school though, diabetes took on a whole different meaning.

Pre-teen and beginning teen years with diabetes were tough, especially as a girl.  Having diabetes meant I wasn’t like my friends.  I had more trips to the nurse’s office, I had to take more insulin usually in the middle of the day which meant more shots, and there were more low blood sugars more frequently in class.  I went on my insulin pump during middle school, which was cool for a little bit but eventually only added to my non-normalcy.  Teachers would stop and tell me pagers weren’t allowed in school, and kids would ask a gazillion questions about it.  I started referring to it as my “idiot detector,” because only idiots would repeatedly ask me to take off my “pager” even after I had already told them it’s an insulin pump.   A slippery slope started during these years as well.  My doctor’s had foolishly told me having an insulin pump meant that I could eat whatever I wanted.  Who does that?  Beyond dumb!  So there began my battle with body image, eating issues and exercise. . .

I wanted to be like everyone else, especially the more popular girls eating junk food and staying skinny.  These were the days when schools were first having Little Debbie cakes in the lunch rooms as well as vending machines for fruit punch.  Wanting to fit in, I did more damage than good to my body.  I ate that crappy food, knowing the consequences but risked it because I wanted to be normal.  Fudge rounds and a canned fruit punch would be my lunch, not every day but frequent enough that I recall wanting to fall into a deep sleep within 20-30 minutes after lunch (gee I wonder why? I’m sure my sugar was sky high).  I think back to how stupid I was, eating practically 100grams of junky carbs for lunch.  The outcome, a bigger jean size, higher A1c and more insulin-not so great!  My solution was far from intelligent, bouts of starvation diets where my thinking was, “well if I don’t eat my blood sugar will be lower (helping to lower my A1c) and I’ll lose weight and be like the popular girls.”  My poor mother never knew the crazy things I did until recently, and one of these crazy stints actually caused severe hypoglycemia with a reading in the mid 20’s, numb arms and complete confusion and the inability to feed myself.  Luckily I never lost consciousness and I was with my mother when it happened.    Moving onto high school and dating with diabetes. . .

The Teen Years in Full Effect aka High School

Oh high school, such a mixed bag, boys and dating, soccer and friends and my sidekick diabetes.  Let’s start with dating. 

Kicker for the varsity team

I was always an open book with my diabetes, I never hid it but high school opened a new can of beans, especially with the boys.  Yet again, dating and diabetes to me meant I was not like all the other girls.  I was embarrassed, was afraid of being judged, I was afraid of being different.  What if my finger pricking freaked out my date?  What if I passed out on my date? What if, what if, what if?  My first date I remember planning what diabetic essentials I absolutely had to take to be safe and thinking how I could discreetly hide my glucagon.  Instead of enjoying my date I spent my time terrified of a low or high blood sugar, pump malfunction, what if he wants to eat food I can’t, etc., not exactly what a teen girl wants her first date to be.  (Luckily, when I met my husband at age 17, I had gotten over feeling awkward with diabetes and dating.)

Where I did find my stride and I wasn’t different was the soccer field.  I had diabetes but despite it I was strong, I was determined and I was able.  Granted I did some stupid things like not waiting to be fully recovered from lows before I took the field because I became OBSESSED with the game. During the high school years I learned of the dreaded high blood sugars from intense exercise and trying to combat those after a handful of 90 minute, stressful games (which all of I had to disconnect my pump).  Half time team huddles for me consisted of blood sugar checks and correcting highs with my insulin pump or lows with the nearest juice box or whoever had Gatorade would share.  I had a great group of girls and a great coach that looked out for me and I could forget about my diabetes for a slice of time mid-game and just be Dorothy.  

Goodbye Home, Hello College & A Serious Relationship

What a jump from my tiny, fishbowl town, to a school that had more students than my town’s population.  Having diabetes in college meant so many things; I was really on my own with this disease!  No one knew me here except for my roommate, there was no one else to look after me or help me out.  It meant being the college kid at the party with the water bottle while everyone else was drinking.  It meant when I did drink I was usually scared beyond belief that my blood sugar would whack out so badly who knows what would happen, but peer pressure is a tough thing sometimes.  It meant that I addressed every professor on the first day of class and filled them in on my diabetes and I usually sat very close to the front row. Diabetes in college meant (at least for me) that I was more responsible.

An awesome thing that happened during this time period was the fact that I allowed someone else in to my diabetes realm to help me other than family.  My now husband was the first guy that I shared everything about my disease with and let him help me with everything, finger sticks, changing my insulin in my pump, treating my lows, my anger at my highs.   

This is when I learned that having diabetes and a relationship meant NOTHING!  Having diabetes didn’t cause judgment, embarrassment or for him to look at me differently.  I was just a girl and he was just a boy and my diabetes didn’t matter when it came to love.

I graduated Cum Laude with a business degree in 2009, with a diamond ring on my left hand and a wedding planned for June.  What would diabetes and newlywed life, working full time and being a real adult mean?

Welcome to the Real (business) World

I want to warn everyone reading this that not every diabetic has the same experience that I did in the workplace.  However, having diabetes and working meant that I needed an understanding employer that accommodated me needing breaks for the bathroom, blood sugar checks, dealing with lows or highs, lunch and my endocrinologist appointments every 3-4 months.  My position started out with management that understood all of this but quickly changed once I went from part time to full time. 

What T1D and working turned into was misery.  I almost never had a set lunch time, many days without lunch breaks or breaks at all or I would be called off of my break, trying to control my blood sugar under the amount of stress I had was ridiculous, having many people understand that when my sugar was low I needed to address it right then, not in 10, 15 or 20 minutes.  I had a schedule, but frequently would be packing up for the night and would be told I had to stay meanwhile I was unprepared and would have no dinner and my days would stretch from an expected 8 hours to 10-12.  Overall, it was a bad experience; my A1C began to climb from the long days which exhausted me and I quit exercising, crazy eating schedule, stress, etc. Everyone with diabetes also knows that ensuring our feet are in comfortable, good, supportive shoes is a necessity.  I was regularly harassed by my superior about my shoe choice to the point of tears and she finally relented after saying, “We’re not having this conversation again about your shoe choice.”  Tears filled my eyes, “ugh, if this is because of your diabetes then I guess we just won’t talk about it anymore but you could probably find better looking shoes.”  They were brown clogs and I stood on my feet practically all day behind a counter at a bank, no one cared what my shoes looked like as long as I could deposit their money.  To make a long story short, after 4.5 years of banking, depression and the highest A1C I’ve ever had (7.3%), my husband landed an awesome job and I was able to put this in my past and put myself first.

Taking My Health on as My Full Time Job

There I was at 24, coming out of depression, leaving a miserable job and putting myself first again.  I wanted to take a break from my insulin pump and found many people supporting the theory that I had come to on my own; my tissue was no longer absorbing my insulin correctly due to scar tissue therefore my blood sugars were inconsistent and my A1C was up.   My endocrinologist shrugged at this and became less and less help in the months that passed.  I knew that I had to do something and I became consumed with research and educating myself on nutrition, diabetes, alternative medicine and fitness.  At this point in my life, having diabetes meant that I had to be my own advocate, my own experiment and take control of my health 100%. 

Finishing a 5k in 2012

I slowly began cutting dairy out of my diet, then grains and sources of sugar and was finally 100% paleo.  I saw a drastic turn around in my blood sugars within a week.  I picked up kettlebell exercises twice a week, jogging 2 to 3 times a week and dropped 8 pounds in 2 months.  Everything seemed to be going well and I finally felt that I had found the solution to diabetes management.

This past fall I found Dr. Richard K. Bernstein, a T1D himself and began following his plan.  I approached my new endocrinologist with a well put together treatment plan which included disconnecting from my insulin pump and going back to MDI’s.  My plan also included a ketogenic diet of 30-45 carbs per day from non-starchy veggies, moderate protein intake and a higher fat intake.  I was very surprised when my new doctor got on board and on January 3^rd of this year, for the first time in 12 years, I put my insulin pump in a bathroom drawer and picked up an insulin syringe.  Granted, there are ongoing adjustments when switching from one regimen to another, I am taking at least 6 shots a day and testing my sugar 8 times a day, but I feel great.  I’ve had to experiment with dosages, figure out a different strategy to combat the dawn phenomenon and become my own guinea pig however I feel that it has been 110% worth the extra effort.   My A1C is finally in the 6’s after years of struggling to get it back down, I’ve lost a little weight and I have nowhere near the number of extreme highs or lows that I previously experienced on my insulin pump.

The Here and Now-What Does Having T1D Mean to Me

After years of merely existing with this disease and letting it run its course however it pleased, I finally feel that I’ve gained back control. Having diabetes means to me today that I am blessed.  Yes, blessed.  Why you ask?  Because I don’t know who or how I’d be without it, so while some may consider it a curse, it is my blessing.  Having this disease has opened my eyes to realize the beauty of life, to see how precious life is, how intricate and wonderfully made we are, how complex our bodies are.  It has given me a great passion for education, alternative medicine and holistic nutrition.  This disease has given me a life that at times may be challenging, but it has enabled me to inspire and help others navigate the ins and outs of diabetes and for that I am grateful.  

~D