Low blood sugar (BG) is probably the most dreaded aspect of having T1 diabetes. Low BG happens when there is more insulin than carbs (or sugars) in the blood stream. In order to correct low BG, there either needs to be less insulin or more carbs. The most famous portrayal of low blood sugar is in the movie “Steel Magnolias†(1989) and many people are familiar with the catch phrase “Drink the juice Shelby.†It is a fairly accurate portrayal of low BG except that most diabetics I know don’t fight against the offer of help!
Low BG can be very serious and even life threatening. BG under 70 needs to be treated and BG under 50 is very serious and could cause loss of consciousness and seizures. I once had a BG of 28, I don’t know how I was even still conscious but I can still remember how it felt feeling myself slipping away. Just a couple of weeks ago I had a 44 and had to work hard to keep from loosing consciousness, the desire to lay down and sleep is overwhelming.
It is nearly impossible to explain exactly what a low BG feels like to someone who has never experienced it. The best I can explain it is that it’s like being underwater. I can still hear and see but it’s distorted and I feel like there is a barrier between myself and the world around me. It feels like everything is in slow motion and I can’t completely connect with everything going on. The lower BG goes, the more disconnected I feel from my surroundings. I also get cold sweats and am desperate to eat, especially sugar (think your worst sugar craving on steroids).
There are different degrees to feeling the lows. I can usually tell by how I feel if I’m just starting to go low or if I’m going down fast and looking at the data from my CGM (continuous glucose monitor) will help me decide how to treat my low. My lows are often from mealtime insulin hitting me before the carbs from my meal. So most often I can temporarily suspend insulin and that will be enough to stop going lower and allow my mealtime carbs to bring me back up. In these situations I really try not to eat or drink any carbs because if I do, then once my mealtime carbs do catch up, my BG will go really high.
But sometimes I start to go low and feel the symptoms of the low developing and need some carbs to combat the low. My first go to is a granola bar, it’s 19 carbs which is a good amount to start with. A lot of times that is enough to stabilize the fall and usually won’t shoot me too far up the other way. But if I’m going really low, I always have apple juice with me which is quick and effective to bring me back up. But I save it for last because I will tend to go too high. But with how serious a low can be, sometimes I have to choose to do what is best in the moment and deal with the fall out later. And there are always times when I have a low and don’t feel like eating but I have to!
Low blood sugars are dreaded not just because the symptoms feel horrible but because it is so hard to treat it just enough without ricocheting back high. When BG is low, it can be impossible to think clearly or logically which is why it’s important to have a plan in place beforehand of how I will deal with a low. When low, it may only take a minute or two to eat/drink what is needed to bring BG back up but it can take up to 20 minutes for the feelings of the low to go away. It can be really hard to be disciplined to not keep eating because my brain will still be screaming at me to eat even when I know I’ve had enough. And sometimes I’m just impatient for the low to go away and I know the more I eat, the faster the feelings will subside. So although many times I can responsibly treat a low, there are times I have way overeaten and then spent hours trying to get my BG back down. Lows are just hard!
Like all T1 diabetics, I try to be responsible with my lows. But I’ll admit that I have driven when I shouldn’t have because I was too low. In each situation, I thought that I could handle it (because I was only feeling a little low) and I didn’t want to be late. So I treated the low while I was driving instead of doing the responsible thing of pulling over and waiting until the low cleared up. But I know in hindsight, I was feeling too impaired to be driving safely. Thankfully God has protected me in each of those situations but I have felt incredibly guilty for what could have happened. I once again resolve never to drive (or do anything else irresponsible) when I am low and you are welcome to hold me accountable.
No matter how well controlled or disciplined I am, lows just happen. I even had a low while writing this blog post and had to take a break! Sometimes being more active than usual or hormonal changes will cause a low and sometimes they happen for no known reason. They can’t always be predicted or avoided. Having CGM technology that warns me that I’m going low has been wonderful at helping me get out in front of a low many times, it’s a game changer.
But if you ever see me (or any person) look like I’m in trouble, slurring speech, slow reactions, acting strange, don’t wait for me to ask for help (because I might be too off to remember how to ask), offer help! I will always have juice and granola bars in my purse or offer me any sugar you can find. I won’t turn down help if I know I’m in trouble. And never be afraid to call 911 if it looks like I (or anyone) needs help and aren’t responding to your attempts. Low BG can be life threatening and you may just save my life â¤ï¸
