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Walking the Euglycemic Tightrope
October 3, 2006
It was time for dinner and I was hungry. I mean, I was really, really hungry! It was in my early days of using insulin—I took two injections a day of Regular and NPH and ate a set amount of carbohydrates at each meal and snack. Dinner, as I recall, was 60 grams.
Searching through the refrigerator and cupboard, looking for foods that were very low in carbohydrates, I found a few things to put on my plate. But how many carbohydrates did I have? For some reason, I couldn’t seem to count them up.
So I filled my plate the best I could, hoping I had enough carbohydrates, and did the only thing that made sense: I ate dinner with a cocktail fork.
At least, it made sense at the time. Was I low? You betcha!
Low blood glucose is the bane of people with diabetes who take insulin or other drugs that promote insulin secretion. If you maintain tight control, it’s not much of a slip from what the medical profession calls euglycemia (normal blood glucose) to hypoglycemia (low blood glucose). Since I have Type 2 diabetes, I’m not as prone to going low as people with Type 1, but I’ve had my moments.
Once, at a restaurant—with very slow service, I might add—a sandwich I ordered came on a hoagie bun instead of the more common round bun. I tried every way I could to figure out how to eat it, but the details seemed to escape me. When my husband asked if he could help, I assured him I was FINE! (That, by the way, is a common response from somebody who is low: “I’m FINE!”) I finally said I needed a round bun—which was eventually brought to the table.
As I was transferring the contents of the sandwich from the oval bun to the round bun, I noted that the sandwich was now cold. “Do you want me to get you another one?” the server asked.
“I have…to eat…this…one!” I hiccuped as I burst into tears. In the middle of a packed restaurant.
Why didn’t I have some fast-acting carbohydrate, you ask? Actually, I had. I’d been gulping down glucose tabs, raisins, and I forget what else, but my blood glucose just kept going down, as if all the insulin I’d taken that day had gone into a black hole and suddenly now decided to emerge.
On the other hand, I’ve been known to eat the total opposite of what I should to treat a low. For example, I know I should eat some glucose tabs, but mixing up some Feta cheese with herbs and olive oil and eating it with a baguette just sounds a lot better.
There’s also the “but first…” scenario. As in, “I know I need to get something to eat, but first I need to put the laundry away.” And, as you’re doing that, you notice that the drawers need to be cleaned out. But first, you need to make the bed so you have a place to put the contents of the drawers. But first, the bed linens really need to be changed. But first, you need to organize the linen closet. And on and on.
The kind of cosmic joke of hypoglycemia is that just when we need brainpower the most, we don’t have any. We’re also in a state of denial. (”I’m FINE!”) It frequently becomes easier for somebody else to recognize the signs before we know we’re in a bit of a spot.
My husband says he can tell when I’m low because “Your eyes glaze over, you get grouchy, and you look like you could bite the head off a rattlesnake.” (Gee, thanks, Dear. And that time I came in from a bike ride in a foul mood was because I was hot and tired and deserved to be angry—not because my blood glucose was 42!)
The next time you’re out with your friends who have diabetes (you do have friends who also have diabetes, don’t you?), see if you can recognize a low. Actually, you don’t even have to know the person has diabetes. Once I was out and a man at the next table was acting very belligerent, so I emptied out my stash for him to choose from. My instincts were correct: He was low.
If you’re on the phone and your friend starts talking about the little birdies singing in the morning (or some such nonsense), she’s probably low.
Even if you’re online chatting with a friend, you may be able to tell—especially if the other person asks which end of an orange to start peeling first.
It isn’t easy to walk the tightrope between high blood glucose and low blood glucose, and sometimes we fall off into the shark-infested waters of hypoglycemia. Just remember to maintain your sense of humor, because your antics while low can be funny once you think about it. A few days later.
But also remember that low blood glucose isn’t always benign and it isn’t always funny (even those few days later). Low blood glucose can kill. A friend of mine died in her sleep, apparently from a low. I still miss her. And others have gone low while driving and injured or killed either themselves or others. If you use insulin or another drug that can cause hypoglycemia, know what your “safe” numbers are—and if you don’t know, ask your health-care provider. Remember to check your blood glucose often, especially before getting behind the wheel or doing something else that could result in injury (or worse), and always carry a fast-acting form of carbohydrate with you.
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