Brief Meditation on Lows

I’m unable to predict when I’m going to have a hypoglycemic episode. They don’t happen often, and when they do, after I’ve gotten my blood glucose back up and after I’ve fought off the desire to eat half of what’s in the kitchen, I try to think back and reconstruct events leading up to the low blood sugar so I can figure out what to do in order to prevent it the next time.


Short of an obvious (and unintentional) overbolus — a rare instance indeed — putting my blood-dotted, lancet-pricked finger on a specific cause for a low is an exercise in maybes and what-ifs. There are just too many factors contributing to each hypoglycemic episode. Too, too many. In hindsight, of course, I try to and am often able to think I know what it may have been. “Oh, that’s what it was!” Because the desire for a eureka moment is strong in me. I want to know. And I’ll think I’ve figured it out, the one or two reasons I sank into that miserable, sweaty, shaky, foggy-brained fifteen minutes of 45 to 60 mg/dl.

How do I avoid, for instance, Tuesday’s low in the checkout line at the grocery store, during which the clerk’s ringing my purchases and I’m pacing back and forth trying to figure out how to treat the low that’s arrived. In my brain the connections aren’t happening. Yes, a sugary soda right there in the checkout cooler. Root beer! Oh, but there’s an entire rack of sweets. Twix! Not good for me. Not a good way to treat.

But something, I need something. Fruit. I don’t want fruit. Milk. Blech. What should I choose? And oh, but good god am I hot. I’m sweaty. Can they see I’m sweaty? Should I take off my jacket? Do people know what I’m going through? Of course they don’t. Are they staring? I can’t think straight. Should I tell the cashier, the bagger? I’m an adult, dammit, figure this out. Fix it. You know how to fix it. Get that soda. But do I need to pay for it first? No, no I don’t. Open up the root beer and take a swig, a few sips, that’s all. You want those carbs in your mouth. Those carbs on your tongue begin the trip back to good.

Then I can walk to the car, sit in the car, check my glucose in the car, wait out its rise in the car, in the parking lot, in the car, in the cold, snowy afternoon (oh sweet, sweet cold! I’m so hot right now, so sweaty, wiping my forehead and hyperaware of my shirt clinging to my back). Then I’ll drive home. Then I’ll think about this incident. I’m sure that if I change the things I did that led to this I won’t let it happen again. I’ll avoid another low. At least one like this. A low that sucked.

Except they all suck. And it will happen again. Seeking that one thing that led to the low — be it bolusing too much for an afternoon snack, changing up my exercise routine, taking cold medication or cough syrup, enduring a stressful meeting or worrying about something I have no control over — what it may have been caused the hypo is no doubt a confluence of any number of things, each of which is weighted differently in its contribution, but each of which is important, each an arm on a very sensitive and difficult-to-balance mobile of good blood glucose control.

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  • Carla

    Well said. I’ve had the same experience. And yes, people do notice that you are sweating because I’ve had people ask me if I’m having a hot flush.

  • Brendon Livingstone

    Then of course there is the low blood sugar during a work conversation or work meeting. You are supposed to be a professional and you can no longer string a simple sentence together. Struggling to talk without babbling, how possibly can you pull off exiting the conversation or meeting elegantly to sort out your blood sugars. They are certainly sent to test us sometimes.

  • marcie

    Man, I HATE those episodes. Thankfully, they’re much less common now than they used to be.

    Actually, I HAVE found it helpful to go ahead and say something — even if it’s just “sugar.” Most people in food service understand enough about low blood sugar being an immediate problem that they’ll at least get their manager. If you keep saying it to a clerk in the store, they’ll call the manager, either because they understand or they’ll think you’re nuts. 🙂

    Seriously, I’ve had my mind go so far away during lows that was the only word I could say, and it got me the help I needed. And once I was able to be more sensible, I’d find the hard candies in my pocket.

  • Kaye

    I’m a lot more worried about the highs I’ve been getting lately – like in the mid-400’s. I went to bed at 451 one night and woke up at 103. What kind of damage am I doing to my body?? I’ve checked my meter and it’s not that. I have sleep apnea so am always tired, but I just realized that when your sugar is high like that, it makes you tired also. So I’m having a hard time differentiating between high sugar and the sleep apnea. I have to work for the insurance to pay my medical bills and I’m just plain tired every day 🙁
    I wake up to flashing lights when my sugar gets low at night, and sometimes I have to slide down the stairs to get to the kitchen because my legs are so wobbly. Then like Eric, I want to eat everything in sight, even though I know it takes about 20 minutes to get in my system. This, of course, causes a high blood sugar afterwards. Living alone is the scariest of all. What if I don’t wake up! I agree, having Diabetes sucks!!

  • John_C

    Begs to ask what are you eating that would allow such wild swings? Also a good idea to check your reading before a meeting or public venture. Bad things happen however ‘most’ of the time there is a good reason for it.

  • Florian

    Been there done that many times. As a T1 with hypoglycemia unawareness I obey RULE #1,ALWAYS CARRY GLUCOSE TABLETS. Why? Because you never know when the demon Hypo may strike.

  • maryann salvin

    52 yrs with Type 1 this year. The hidden-never ending unawareness that makes the low blood sugars so dreadfully critical can happen when you least expect it- sudden or extremely slow when you keep putting off either checking your blood glucose or correcting the problem by treating quickly!!! you can’t make that decision- that is the real problem- Once you start wondering what to do, it almost is too late for you to help yourself. A zillion times over it has happened to me at all different times of the day or sleeping. I’ve come back to life- with my husband treating a non-functioning wife, no response or knowledge what is happening. Glucagon kit used-then treating !!!!!! to try and recover once awakened/ only to go back to sleep to try and recover the next 12 to 24 hrs to feel back to normal can be a slow process – 1-2 hrs or up to three days depending what is going on minor or severe type low your body had just gone through. No response or conversation is a real bad situation especially if the insulin pump is still pumping insulin in your body so be sure to turn pump off / or SUSPEND and remember later to connect pump correctly and really know what you are doing before connecting, to regain your new day or night that is ahead of of you. I have been helped more than once by just shoving sugar two- three- or four tsps of sugar that I keep in a small container that has helped me- dissolves quickly. We of course are not doctors but they are not patients and would never really know what the body goes through. May everyone continue on their journey of a brand new day. sincerely, Maryann Salvin

  • maryann salvin

    dear Eric and family- Thank you for sharing your personal journey. May your continued journey be filled with lots of sugar near by and high expectations every day to overcome any obstacle that may occur. My low’s and my solutions in the previous paragraph seem extreme but they never have gone away. Severe lows because of the unawareness that is occurring, real sugar can be the fastest way to correct it for myself. I like yourself had the thyroid problems and guess what that too can be irratic so we all as patients must continually have patience faith & hope. Fond regards with sincere wishes always. Maryann Salvin

  • Graeme

    For people with Type 1 there is an option you may not be aware of – service dogs trained to detect hypoglycemia. More information is available at Dogs4Diabetics ( As service dogs, they can go anywhere with you that a guide or other service dog can go – in fact, many of them have been through training as guides for the blind. Full disclosure: I know the founder and his dog, but have no other connection with the organization.

  • M.S.

    Dear Eric,
    Thank you for sharing so many posts about sugar-drops! I think my family and doctor think I’m making it all up – I don’t think they can tell I’m sweating b/c I usually have to TELL them … I’ve told them where I keep glucose tablets in my purse … I’m not on inuslin so there’s nothing to bolus, but there’s also no real pattern/reason (at least it’s nothing I can detect after scrupulous food/activity logging) to explain why I have them, and I’ve experienced all the feelings except I don’t have the brain fog. I am fully aware and able to keep doing whatever it was I was doing, except that I can’t because I’m sweating and all I want to do is EAT CARBS and stop sweating! I replied on another of your posts that I once had a sugar-drop an hour after eating a healthy lunch while I was sitting in a chair having a haircut! I’ve never had one at night (well that’s not really true, I had one, once, early after my dx 2 years ago) but if I did have them regularly, I think I’d keep some juice boxes in my night-table. I hate waking my husband up, and I sure don’t want to go down the steps feeling so icky and weak-legged. And Idk if it’s just me, but while I sweating and ravenous (boy, sounds like a mad dog lol), I also have to go to the bathroom really bad! And our only one is upstairs. Well thanks for providing this forum for me, I’m done venting for now.