High and Low Sugar
I want to try to explain how it feels to have low or high blood glucose as compared to being in a normal range. Sometimes I can remember everything that happens while I am treating for either low or high, other times it is like a blur, and I don’t really remember anything. The trick for me is to try to catch the warning signs early, and try to treat the symptoms before they get out of control. Sounds easy, but you have to be aware of how you are feeling, all the time. You have to keep your diabetes in the fore front of everything else that goes on. Not always easy when, for example, you’re driving in Atlanta at rush hour, or trying to write in your blog. J Sometimes I simply don’t have time between feeling the signs, until it is too late. Especially the low BG’s. They will sometimes drop from normal to way low with only a minute for me to recognize it is happening. Maybe I overestimated the carbs in the food I plan to eat, maybe it is my antibodies leave some beta cells alone, and I get an overdose of insulin. Who can say for sure, it just happens.
Highs are a little bit easier to deal with. But the highs sneak up on me sometimes too. I usually know the reason behind the highs. I will eat just a little bit too much, or eat something I know will spike me, and not take insulin. Sometimes it is something that usually does not affect me much, but for some unknown reason, it does. Nuts are an example. One day I can snack all day long on nuts, and will be good, other days, one nut will send my BG skyrocketing.
My first year or so after DX’d was probably the hardest to deal with. My A1C was 11 or 12, meaning my average BG level was around 270 to 300. Not pretty. The problem was, when I would get my BG down to a more normal range, around 150, I would feel like what I now recognize as starting to go hypoglycemic, or having BG around 50. I thought the doctors, and all the websites I was looking at were crazy. They wanted me lower (than 150) most of the time. How could that be, if I felt so bad when I was close to 150? On one hand I wanted to get under control, but on the other, I didn’t want to feel bad. I wanted it all to happen at once. When I finally realized that you just couldn’t do it all at once, is when I started to really feel better about it all. After 3 ½ years, I am almost at the recommended A1C, (below 7), but it has consistently been going down. Highs are not normally too bad, unless they hang around for more than a couple of hours. I now normally check my BG seven times a day regularly. If I see a high, then with the pump, set up a correction bolus and a couple of hours later it is pretty much back to where it needs to be. I usually feel a little confusion, and then maybe thirsty. If it is a stubborn high, one that will not go away, I will get a dull ache across the middle of my back. I will feel hungry, but my stomach will feel full, like I just ate. I guess the best way to describe that is eating Chinese food, eat a full meal, and feel hungry an hour later, but don’t think you can eat just one more bite. Then there is a general, overall feeling of just lousy. Sometimes I just want to lie down and sleep, sometimes that works to get things back to normal. Other times it is just not eating, and pumping insulin.
Low BG’s are scarier. Especially the ones that come on quick, and will not go away. When a low comes gradually, are not so bad. I usually start to feel it when the BG starts to get below 70. I feel light headed, and hungry, but this is a real hunger, like I haven’t eaten in a long time. The lows that come on slowly are not so bad, it just means that I took a little bit too much insulin for what I ate, or maybe my basal is working too well (if possible). It is just a matter of eating something, a little bit, but because I feel real hunger, I want to eat everything in sight. To combat that I prefer to eat a slow acting carbohydrate (I mentioned many times, M&M with peanuts) will quell the hunger, and still increase my BG to where it needs to be in a short time. A banana will work just as well (better, health wise) and I keep at least one with me all the time. Many people will tell me that bananas will make the sugar go up too much, but most of the time I seem to do just fine. By the way, even though I mention the chocolate a lot for lows, I will eat a banana more often to treat lows, and save the chocolate more for a reward. Most doctors, diabetes education personnel will recommend (highly) against using slower carbs for treatment of lows, but I like to do this because I can monitor the progress better, and will not tend to overdo it by eating too much. The ones that sneak up on me require immediate action, thus a fact acting carb. Here is why I say lows are scary. I get really fuzzy, I can’t think straight. More recently I noticed that it starts to look dark, and it seems like I am looking at things thru a fish-eye lens or looking thru a tunnel. I feel weak, and talk funny. Many times I will repeat a word, or can’t say the next word, even though I know what I want to say. At work, I think that it is kept too cold, and I will usually wear a light jacket, but when the low BG hits, I will actually sweat a lot. And then shake. I know what I need to do, eat something, but sometimes I just don’t feel like I have enough strength to. It is confusing. I keep some glucose tablets for those times; fortunately I don’t have to use them too often. What I do, is eat one or two of the tablets (depending on how low) and a slow acting carb, for the same reason as above.
Then there are the other bad times, the wild swings, the going from high to low or low to high too fast. It is like going from bad to worse, and then back again. It is really frustrating, you fix one thing, and start to feel better then you start to feel bad again with the other symptoms start so you fix again, hoping you don’t over-fix just to do the cycle over and over. In the beginning of my “adventure” was like that. I had to learn how much fixing was needed. Unfortunately, there is a lot of trial and error to this. I use a range method to correct either highs or lows. For example, if my BG is 50-60, just a banana or a bag of M&M’s will work. Below 50 calls for a glucose tablet or 2, and a banana, to get back in normal range. If I feel low, and I am above 70, a banana and a little insulin. For the highs, I use a wider range, usually a 50 points spread of BG levels. So, for example, if I am 200-250, I will correct with a certain amount of insulin, 250 – 300 use a little more insulin. In both cases, I will check BG again in about an hour, then, if needed, another correction. So far, these methods seem to work for me, to keep me from over-correcting.
The most frustrating thing is when you find something that you can eat (and like) that is fairly predictable, to stop being predictable at all. A search for something new begins, trial and error, hoping something, anything will work. My whole diet has changed several times, especially breakfast. I have tried everything from bacon and eggs, to oatmeal, to whole grain cereal and milk, to even skipping breakfast. Within a couple of months, I always end up too high in mid-morning. Oh well, variety, the spice of life.
It is really hard to explain how it feels to be high or low, either way it is confusing, frustrating, irritating, scary, all at the same time. It is just an all-around terrible feeling. Trying to find the best way to deal with all of this is a challenge, to say the least, for all involved. My wish, for you, is your challenges are few.