Diabetic Hypoglycemia

Hypoglycemia – For Family & Friends

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If you are involved with a Type-1 diabetic, or have a friend or family member with diabetes, it’s very important to understand hypoglycemia – low blood sugars – and what to do when you see them happen.

Why Do Low Blood Sugars Happen?

Hypoglycemia occurs when a diabetic’s blood glucose drops below normal levels. which a non-diabetic’s pancreas keeps from happening.  It can happen very suddenly, is usually relatively mild, and can be treated quickly and easily by eating or drinking a small amount of glucose-rich food.

All of Us Get Them

Almost all Type-1 diabetics get hypoglycemia occasionally. No one is immune, and, when it happens, it can be very sudden.  In one moment, you’re absolutely fine, then your blood sugar unexpectedly plummets, and in the next moment you can be in trouble.   Recovery can be fast – 10 minutes after getting some form of glucose into your system – either by mouth, if you are awake and will accept it, or intravenously if a paramedic is involved – and it’s like the episode never happened.  If left untreated, however, hypoglycemia will get worse and cause confusion, clumsiness, or fainting. Severe hypoglycemia can lead to seizures, coma, and even death.

Most Low Blood Sugars are Out of Our Control

Hypoglycemia episodes happen for a variety of reasons.  Some are just caused by mistakes – like misjudging the amount of insulin you take for the food you are eating – but most are as the result of other things. Emotions and stress, for example, can send blood sugar out of control, sometimes causing it to go rapidly up or down.  Medications, illness, or unexpected food ingredients can all lead to a low blood sugar.  Sometimes a very high blood sugar can also cause a “rebound effect”, where your blood sugar goes from very high to very low in a short period of time.

My Low Blood Sugars

My low blood sugar episodes are unique to me, and all diabetics may not experience them in the same way as I do.  I’ve found, however, that many of us have similar experiences.

Hypoglycemia, for me, almost always starts with a vague sense of “something being wrong.”  Things just don’t quite make sense, and I’m not able to fully understand why. This is the result of my brain not getting enough glucose, and it begins to shut down and not function properly.  In my first 15 years of diabetes, this shutdown was accompanied by other readily recognizable symptoms: sweat, sometimes pouring off me, shakiness, lethargy, lightheadedness, dizziness, hunger, nausea, or a tingling or numbness in my lips or tongue.  I could immediately identify these as low blood sugar symptoms, even in my somewhat reduced mental state, and be able to take corrective measures.

Hypoglycemia Unawareness

After those early years, I developed a common long-term diabetic condition called hypoglycemia unawareness, where I no longer get any symptoms until my blood sugar is very, very low – too low for my brain to respond.  I then became almost incapacitated, both mentally and physically.

What Can Happen Next

When I get to this point, pretty much anything can happen.  I’ve fallen off a bicycle, after riding normally for hours, directly into traffic.  I’ve been unable to get out of a movie theater seat.  I’ve had a bad car accident, luckily with no injuries, because I was no longer coordinated enough to drive and was seeing double.  I’ve passed out in a chair while watching television.  If it happens in the middle of the night – 4AM is the witching hour – I’ve had a seizure and not been able to be awakened.  I’ve also been woken up by a paramedic, surrounded by friends and family, after they’d tried to revive me and failed.  I once woke up with my head covered in blood, after beating it repeatedly against the headboard in unconscious spasms.

These incidents are all unique to me, happening over several years, but each happened even though I was being extremely careful – testing my blood sugar more than 10 times per day, watching everything I ate, and taking care of my diabetes.

Are these extreme examples?  Certainly.  Do they happen to every diabetic?  Absolutely not.  But my experience has been that every long-term diabetic may have similar stories, and their family and friends nod when they hear them described.

Living with a Type-1 Diabetic

So if you’re the wife, husband, lover, or friend of a Type-1 diabetic, days sometime come with a unique set of challenges.

How Quickly – And How You React – Can Makes a Real Difference

First, it’s important to quickly recognize symptoms – slurred speech, confusion, disorientation – and understand when you see them that the diabetic is starting to be in trouble. How you express your concern at this stage can make a huge difference in how the diabetic responds.  For me, a stern “You’re having a low blood sugar – do something about it!” almost never works – in my increased emotional, and decreased reasoning, mental state, I will immediately resist and  insist “I’m fine.”  However, simply changing your approach to “Are you feeling OK?”, or better yet, just handing me a glass of orange juice, means I’ll usually accept it, even with my somewhat diminished brain power.

Your Fast Action Can Really Help

Remember that the diabetic is in an “altered state” at this point, and you are in a very unique position to help.  Your fast and positive response can stop an extreme low blood sugar from developing, and save the diabetic from a more serious situation.  I can tell you countless stories of my friends and family taking this approach with me – at parties, on the tennis court, and in holiday situations, where stress is always high.

Different People React in Different Ways

Some people deal with a diabetic’s low episodes much better than others, and it can definitely affect the overall relationship.  I’ve found some people take my low blood sugars quite personally –  saying things like “why do you let this happen?”, or “why do you keep doing this?” I’ve also seen resentment develop over time  – “Why do you keep doing such embarrassing things?”

Other people take the situation almost in stride, and simply accept low blood sugars for what they are – a condition we diabetics have where we sometimes need help – and be happy, as someone who cares about us, that they can give it.  For these people, there is a special place in my heart, and I’ve been lucky enough to have many in my life.

It’s always important to understand that the diabetic is not just “letting it happen”. No matter how much we pay attention, we can still end up with a serious low blood sugar.

A diabetic friend described his feelings:

“All my life, I’ve provided for my family.  I love my wife, and I’m a good husband, and we’ve put our children through college together. I have been, in all ways, a solid base of support for our family.  And yet, every time I have a low blood sugar, I wake up feeling like a complete failure.”

This is a very personal part of being a Type-1 diabetic.  We all experience it, but it’s not often discussed.  The doctors and health care professionals we deal with regularly really don’t know how to discuss it, and we often feel uncomfortable talking about it, even with our closest friends or family members.

I Feel Things Were Probably Going to Get Worse For Me

I currently live alone, always a precarious situation for any diabetic, at any age. Additionally, I knew the increased insulin my body was requiring might eventually lead to other long term problems.  I began to feel a bit like a time bomb, waiting to go off.

I came to the conclusion that, for me, hypoglycemia was probably going to be the “it” that was going to eventually “get me”.  The only question was when it was going to happen.