The Adventure Of Low Blood Sugar

Those of us who have diabetes may get a lot of finger-wagging from medical professionals, family members, and even friends about high blood sugar. And it's absolutely true that if we're not managing our condition, if we're eating more than we should, forgetting to take our medication, or eating the wrong things, our blood glucose will be high and our risk of developing complications -- like blindness or strokes or heart attacks or neuropathy (which can cause us to lose an arm or a leg) -- are greatly increased. So I take this really seriously and try very hard to keep my numbers down where they belong.

But since 2008, when I was first diagnosed, I've had a number of adventures with low blood sugar, which can come on fast, is sometimes no fun to deal with, and can be dangerous itself. Low blood sugar can occur if we get busy and forget or don't take time to eat. It can occur if we accidentally take more medication (especially insulin) than we need. And it can occur if we exercise even moderately for a half hour or more. And those are just a few of the examples.

You would think that after eight years of diabetes management, I would never let this happen, but nobody's perfect and you can't always predict when it will happen either. Low blood sugar is considered anything below 70 and the lowest I've ever gone before I caught it was 39! (That time, I found myself standing in front of my kitchen cabinet eating with both hands as if I couldn't stop.) Low blood sugar is dangerous because you can go into a coma and die. So obviously, it's nothing to play with. 

This is why I carry a card in my wallet right in the front that says, "I am an insulin-dependent diabetic." And when I travel, I tend to wear the bracelet I bought to identify me the same way. I always -- always! -- carry two Werther's Originals caramel candies (the kind with the chewy center) in my insulin kit, two in my briefcase, and another two in my purse. That way, wherever I am and whatever I reach into first, I will find them right away. They have 5 grams of carbohydrate each, just like the glucose tablets we can buy at the store, but I think they taste better. Just make sure whatever you carry for this purpose dissolves quickly.

What are the symptoms? Some people get a headache, but my low blood sugar usually shows up first as a tremor in my hands, which will get stronger if I don't get some juice, a piece of candy, or some food into my body immediately. I might feel sleepy or hungry or a little funny in my stomach. I might feel a prickly sensation in my scalp or a heat rush. And if it goes low enough, sweat starts to pour down my face. But sometimes, I've gone as low as 59 without feeling anything. So I take a glucose reading periodically just on general principle.

Because of this, some people with our condition like to use a continuous glucose monitor that sort of plugs into your abdomen and stays there, but so far, I do well enough without it not to want to go that direction.

What do I do if I suspect my glucose is low? First, I check it to be sure. Maybe that tremor or that little rush of warmth was caused by a cup of coffee. I may be tired from going to bed late the night before. Or maybe the air conditioning isn't running right. So I check my BG (blood glucose) to find out. But if it's low, I move quickly to make sure I don't "crash." Crashing can result in losing consciousness, taking a fall, or having an automobile accident -- any of which I want to avoid, of course.

Moving quickly when you're out in public might mean eating a couple of candies or drinking 4 ounces of fruit juice or regular (not diet) soda. Once when I crashed on the way to eat dinner with a friend, I walked into the restaurant and when the waitress brought our menus, I said, "I'm diabetic and my blood sugar has crashed. I need you to bring me half a small glass of regular soda right this minute." Which she did and when she brought it, I ordered an appetizer.

Restaurants can be tricky for those of us on insulin because, if you take your insulin and then the food doesn't come out to the table within ten to fifteen minutes, you can crash. So I tend to wait until my food arrives -- or is absolutely about to -- before I excuse myself and take my insulin.

Once when I crashed while watching a movie, I ran out of the theater to the popcorn counter "rattling" so badly a customer about to be helped said, "Diabetes, huh? What can I do?" I asked the worker behind the counter for a Hagen Daz vanilla milk chocolate almond ice cream bar (with 21 grams of carb), thanked the man for helping me out, and returned to my movie where I enjoyed a treat like all the other movie goers. So a panicky situation turned into a happy one.

Actor and comedian Jim Turner, who has successfully lived with diabetes for forty-six years, can be found at dlife.com (one of my favorite diabetes websites). Here, the Jim Turner Diabetes Theater presents their version of how low blood sugar can affect a diabetic person's day: