Reminding Myself How Serious Those Low Blood Sugars Really Are

Meagan Esler

| Jan 30, 2013

I was having my second low of the day at work recently when I got "the headache." If you have type 1 diabetes you probably know the one. It doesn't ever go away quickly and never without having to pop a couple pain relievers. I was popping more than a couple peppermint-flavored chocolates and glucose tabs and waiting for the low to go away before I could even reach for the Advil to help ease the pounding in my head.

My assistant at work paused for a moment and said she was sorry for the way I was feeling. I said, "Thanks, not your fault, I'm fine" and kind of shrugged it off as no big deal.

But as we talked about her family member with type 1, I realized I'm really not "fine."

I was thankful she understood about my diabetes, and for her sympathy. We chatted a bit as I mentioned how often I'd been having lows. She told me that when she and her relative with type 1 were visiting the diabetes educator all those years ago, the educator warned them to be extra cautious about the lows, stressing how dangerous they were.

That made me remember reading something a while back about how one could likely live a long time with some slightly elevated blood glucose levels, but that just one really bad low could cause death. It's a lot to swallow when you realize that the lows are happening so regularly.
They are sadly a normal part of life for me, and though I might get lucky and have a stretch where I don't go low as frequently, they do seem to find me with a vengeance.

I tend to go low at work a lot. I have a huge stash of emergency supplies in my desk. An unwitting person who happened upon my desk drawer would probably think I needed a sugar addict intervention. My glucose tabs, sticks, gels, and various other candies, snacks, and bars are there to keep me conscious as I move furniture and do the other physical tasks that are a part of every work day for me. I have tried injecting less insulin and reducing my long-lasting injection to avoid so many lows, still, they seem to sneak up and somehow surprise me anyway.

After more than 18 years with diabetes, I realize I barely flinch at the lows anymore. That worries me. I treat them and move on like I should, but maybe I need to pay more attention to why they happen so often. Without panicking and totally overreacting, I need to remember that they are dangerous and are not okay.

I may have been very lucky that I've been able to remain conscious to treat my own lows with the exception of one occasion in my sleep, but that may not always be the case. That luck could easily run out at any time. Lows are scary and serious and they shouldn't be such a big part of my life. I'm going to watch a bit more closely to try to catch them before they catch me.

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Posted by ewrummel on 31 January 2013

During the last half of November and all of December I had lows on 33 out of 45 days. One was a 28. Another was a 21! That is a first and was very scary. I didn't feel that low. I've lost a lot of weight but for no apparent reason. My endo thinks I have a malabsorption problem. If the food is not being absorbed the insulin I took was therefore too much. I'm seeing a gastroenterologist to try to solve the malabsorption problem. In the meantime I'm cutting back on my insulin and monitoring my sugar more closely. And I'm looking into a CGM.

Posted by Anonymous on 31 January 2013

Meagan, once again you have written a gripping article. Well done! My child gets lows too and usually the difficult ones are in the middle of the night so I get up every night at 3am to check if this is one of the bad nights. Some times it means staying-up so that I can give him his fast acting carbs then slower acting carbs and waiting for his glucose levels to stabilise at a safe level. I do worry that in future, like you say, 'that luck could run out'... especially when he grows up and he himself will need to catch the lows before they catch him. Thank you for writing this piece. It is so REAL!

Posted by Anonymous on 31 January 2013

Oh my Meagan, you couldn't have said it better--16 yrs with this and like you I get lows and "shrug them off" Interesting, because at my last doctor visit he read me the riot act on lows--NEED TO AVOID them--yeah yeah, but you're right One "really bad" low, could mean.....death. Yikes! And my desk looks the same way :-)

Posted by Jerry Smith on 31 January 2013

The complications of severe hypoglycemia are very serious: seizures, coma, cognitive impairment, and DEATH. Meagan may be approaching a situation where her hypoglycemia awareness is impaired. Continuous glucose monitoring (CGM) technology may provide help in minimizing the risk of these complications.

One problem with CGM is that Medicare and many health insurers will not provide coverage because it is PRECAUTIONARY. There is a cost benefit in that CGM can PREVENT emergency room visits and/or hospitalization for many subject to hypoglycemia inawareness. In some cases, the cost of CGM can be offset by reduced use of testing strips.

Posted by Anonymous on 31 January 2013

I'm curious why you haven't looked into a CGM (continious glucose monitor). I have found the Dexcom to be very accurate and they've made it to last 7 days before you have to change.

Posted by Anonymous on 1 February 2013

Meagan, have you seriously considered an insulin pump and/or CGM? Trust me, either device or both combined will help you prevent frequent low blood sugar and increase your productivity at work.

Posted by Anonymous on 1 February 2013

If not already doing so, consider making sure that each of your meals and snacks are balanced w/ protein; e.g., Bkft PB toast and fruit OR cheese toast and fruit OR eggs/toast OR mini bagel w/ cream cheese; Snack e.g., fruit w/ nuts OR fruit w/ cheese stick OR PB w/ crackers OR cheese w/ crackers; avoid long spaces w/o intake (long spaces e.g., more that 3 - 4 hrs); RD, CDE

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