Do you know when its a low?

When I have gone too low, I normally become unsteady on my feet, I start talking about weird stuff, I ramble and/or I speak when nobody is really talking to me.  I recall once discussing turtles on the moon quite seriously with my parents while they were trying to feed me late at night.

A low blood sugar often feels similar to a high for me, but if I really think about it there are some distinct differences.  Saying this, some of my symptoms are not always present and some appear sometimes when they do not at others so it can be confusing.  For example, if I am beginning to feel low the first sign would normally be that I begin to feel a little bit clammy and I can sometimes notice my hands shaking a little bit; I may also start to yawn more than normal despite not being physically tired.  Yawning is also a symptom of being high for me, but it is a different feeling.  When I have a high blood sugar I feel very drained and tired, but when I have a low blood sugar and am yawning I am still wide awake and alert.  I like to think that it is my mouth opening up and doing something like eating and attempting to tell me that I need to eat.

I start to get symptoms of a low blood sugar anywhere below 4.0mmol’s/L; it’s not always at the same number that I start to feel low and I can test sometimes and be 2.8mmol/L on a rare occasion without even realising it.  After 18 years of diabetes I am still unsure as to why this occasionally happens but more often than not, I know when my blood sugar is going down and I can stop any hypoglycaemic (too low) events from occurring.

When I go too low, hypoglycaemic, I am usually still in the position to eat but I will refuse to eat anything I don’t like or that does not taste good.  I hate thick jam on toast, but I will happily eat toast with a thin layer of jam which will get very close to the same effect with me, I will happily eat biscuits or fruit as well.  I will also happily drink a glass of milk or juice in most circumstances.  I never used to think of milk as something that I could have that would help bring me out of a low blood sugar, but it in fact has nearly as much sugar as a glass of juice, so it is definitely something to be aware of if there happens to be no emergency juice in the fridge.

Often when I have felt low, I just want to eat and eat and eat to fix it, so I am safe, but I think I have learnt over the years that this is an average way to fix it as it sends my blood sugar levels very high thereafter.  I think that this is a tendency with a lot of people who have diabetes but, despite your instincts, it is a counter-intuitive way of treating a low blood sugar level as you end up chasing it with insulin for the rest of the day.  I have found that if I am going low, I can do one of two things.  I can either suspend my insulin pump, which I often do at work to prevent a low.  When I do this, I do not necessarily need to eat anything, but after a short period of time my blood sugar will begin to rise again and when I sit down for dinner my blood sugar will be back up at a good level of 6.0mmol/L.  This does not always work, but if I have just been working, and have no extra insulin on board, it is a pretty safe option that suspending my pump, so that I have no more insulin going into my body for a period of time (usually an hour), will encourage my blood sugar levels to increase.  Otherwise, something as little as an apple, or a biscuit, a glass of milk or a slice of bread will bring my blood sugar back up to suitable levels.

Again, I’d like to emphasise that diabetes is such a variable condition and people’s experiences of the exact same thing can be miles apart and can involve different feelings and different remedies.  I know that I am occasionally shocked when I feel like I am low and I test my blood sugar level to find out I am high.  This happens, even after 18 years.

I strive to have a good Hba1c; this is an average of your last blood sugar levels over 3 months which is usually tested through a blood test before an appointment with my endocrinologist.  For people with diabetes a good Hba1c should be around 6.5% (48mmol’s/L).  For other people, a good Hba1c is between 4 and 5.9% (20-41 mmols/L).  Sometimes this goal and endocrinologists encouragement to reach this goal has ended up in more hypoglycemic events than normal in a week.  It is through these experiences that I have learnt to always listen to myself and to my body and to take things that other people say with a pinch of salt.  My aim is to have good management of my diabetes and to prevent long term complications; this has always been my aim despite what the doctors say to do.  If you are diabetic and reading this, or if you are not, you should not let what other people say affect your health management in a negative way, if it does, stop and go back.  You are doing your best and you will get to your goal with time but it can’t happen as quickly as clicking your fingers.  Take each day as it comes, ask questions, and live each day to its fullest; if your mind is happy, your diabetes is more likely to be happy too!