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The Low Blood Sugar Beatdown.

My total daily dose of Humalog insulin varies between 23 and 34 units, depending upon if I'm correcting highs or consuming waffles (faffles) instead of eggs.  Going above the 34 units means I spent the day eating my way out of an Olympic swimming pool-sized cheesecake.  (And there were those weeks at the end of my pregnancy when I was at 91 - 110 units per day.  Holy third trimester.

Last Friday, my total daily dose was 18 units of insulin.  For the whole day.  Because I spent the majority of it watching the Dexcom arrows hit the deck:

My meter confirmed this Dex BEEEEEP! with a 45 mg/dL.

This photo was taken from the side of the road, where I had to pull over and treat this low, then wait to come back up before I headed back out.  (Meter showed me at 58 mg/dL for this one.  Glove compartment stash of fruit snacks and a banana to chase it down for the win.) 

And the day closed with numbers tumbling again. 

Caloric consumption for a day like this is staggering - each low blood sugar came with it's own snackfest of fast-acting sugar (juice or glucose tabs), and some slower-digested carbs.  I'd see a spike, but wouldn't bolus it down, yet the effing numbers still plummeted.  Several times throughout the day, I hit numbers under 55 mg/dL, and those lows hung on way longer than their supposed 15 minute shelf-life. 

"Dude, I'm cured," I said to Chris through a mouthful of glucose tabs.

"Let's go get pizza, then," he replied.

I spent the day in a creepy, low fog, running the battery down on my Dexcom from obsessively clicking the buttons, and blowing through about 15 test strips out of justified paranoia.  Diabetes, on a day when numbers won't behave, is a full-time job.

"You look sad," someone said to me.

And it's hard to explain that I'm not sad, I'm just whipped into a quieter, more exhausted version of myself. Lows sometimes come and go without any fanfare at all, but when you spend a whole day under 60 mg/dL, it's that whole penguin truck thing again.

Saturday morning started with a blood sugar of 194 mg/dL, and I was oddly relieved. 

"Not cured anymore.  Still diabetic," I joked to Chris. 

He looked slightly disappointed.  I think he still wanted pizza.  ;)


Oh, don't you just HATE when that happens? Those are the days when your fingertips are sore from being obsessively tested, you're sick of the taste of candy and juice, and you'd love to sleep through the night without waking up to test.

Wouldn't it have been nice if you'd actually been cured??

Had to laugh at the "Dude, I'm cured comment." But the thought has occurred to me, during episodes that seem to occur a few times a year, that maybe Faustman is correct, Type 1s bodies do manufacture insulin, just that the beta cells are usually killed off immediately. And this is proof of that theory. So I am hopeful that these scary low days mean one day, if they can stop the autoimmune attack, no further treatment may be necessary, even for long-standing Type 1s. Hope and pray.

I've had those "Dude, I'm Cured!" moments, too. I know it's not true, but it's like matching the first number in the Powerball, and fantasizing that the other five just might match your ticket, too. Only here, the stakes are even higher than a $300 mil jackpot.

Cool new Dexcom by the way. Nice and white. But the Error Code of old makes more sense than what I see on this one.

This is the sort of stuff that reminds us that we really don't have a grasp on all the myriad things that influence BG. Sometimes it amazing that we do as well as we do.

I had a day like that a week ago. I was running the visuals at church and couldn't get my numbers to go up. It was so very frustrating. I kept asking one of the sound guys to go to the lobby to get juice for me. It was awful.

Sorry, I left something out of my comment.

The whole "you look sad" thing, it happens to me all the time. It's so very, very hard to explain to people who don't live with chronic conditions that no, you're not sad, you're exhausted, or not feeling well, or in pain, or whatever, because they just don't understand. Sometimes I wonder, do people who don't live with health issues really feel GOOD every, single day unless they're sick? Because I'm so used to the headaches, the exhaustion, the just plain feeling icky--I forget what it used to be like.

Nice cat hair on photo #2 there.

Lows are terrible. I wish there were an effective low blood sugar simulator so other people knew what it felt like.

This happens to me every month the week I have my period. The week before period starts I have epic resistance - like my insulin+pump+infusion sites are totally broken. Nothing seems to get my bgs under 200. Then my period starts and it's like all those extra boluses finally kick in and I barely use any insulin at all and can eat anything. At least I'm finally seeing the pattern...anything like that for you?

"You look sad." That statement hit home. The frustration, trying to hold it in, wondering what you are doing wrong. You want to cry, but instead "look sad."

Has your doctor ever considered gastroparesis? Your stomach nerve is fried and your food takes hours to digest rather than minutes. I had a lot of stomach problems before. I changed to a 2 hr square bolus after meals and fewer lows or what-the-HEdoubleHockeySticks highs. Expensive to test for- I waited until I met my deductible for a diagnosis.

My Dexcom looked almost like that today - couldn't get above 100 most of the day, and now it keeps dropping to the 40s and 50s tonight. It's so true that we don't have any idea what's going on with our pancreases or BGs Casabby - and it IS amazing we do as well as we do. It's strangely comforting to know I'm not alone in all of this. Thanks Kerri and all the rest of you!

wow, I love love the comment about pizza. my husband would and sometimes does mention pizza, I believe it is his most missed food...lol. What is it about pizza and diabetics that goes so wrong, I mean I hear it all the time that almost every diabetic has issues with pizza???

Wow! I don't have days like that very often, but every once in awhile I experience one. I had a week like that, this past December. On the worst day of that week, after I had downed a juice box after every class I taught at school, I ended up finding out from a urologist that I had a kidney stone (a gigantic one that I couldn't feel) and that my left kidney was totally blocked!

PERFECT comeback: "Let's go get pizza, then," he replied.

He's sharp!!

by the way... I hate days like those, too. I calls 'em 'Sticky Lows'

Wow! As mom to a 14yo boy I rarely see these kind of numbers. He is a eating machine-- we jokinly say he has 3 aholes! lol He had a high day and had 2 things happen on the ping we never had.. went over the max dose bolus amount of 18 u which is 4 years old so bumped it to 30 and then next day warning of over daily units (100) bumped that also. He has grown and setting were never changed frm 4 years ago BTW any news on the new Animas pump? Warranty is up!

Days like these frustrate me...especially on a day that I am home with my 2 yr old and 8 month old! And my husband is one of those "I have to have a reason for why everything happens!" So I can't ever just be low:)

I figure on days like this...those new birthday cake oreos are worth trying!

My 7 year old has Type 1. We went through about 10 days of me being positive she had been cured in the night by the pancreas fairy. It was a long hard 10 days for her. Still not sure what really was going on. The dr. cut her Lantus in half. She is back to normal again (whatever normal is).

Kinda glad to see that someone else's graph looks like that. At least I know that I'm not the only one who has days like that and for no real rhyme or reason. It surely does beat the body down that's for sure!

"Dude, I'm cured" made me laugh out loud! I've wondered the same thing when I've had a string of lows. Crazy how that happens and we have no idea why. The "you look sad" comment also struck me. I get asked that from time to time too. I'm not usually sad, but do tend to be really tired or overwhelmed by my diabetes and other chronic health problems sometimes. I too, wonder what it must feel like to feel good on most days. I don't have too many days where I feel good, and when I do, I always notice and really, really appreciate them!

Thank you so much to everyone who is commenting. I love the comments as much as I love Kerri's essays. I feel validated, I feel stronger and I feel like I am not alone. Thank you.

In the years after having my daughter, I was having horrific lows. My mother told me to ask my endocrinologist if I could have a hysterectomy as they seemed to occur a day or two before my period. He told me he thought that was extreme. I heartily agreed! He did tell me that continuous birth control pills might be a good idea. My Gyne MD agreed. It made a HUGE change in my control! It's not that I never got low but they were way fewer and farther between. I'm 52 now and just stopped taking them. They got me through menopause without issues too. I am a nurse and it makes me crazy to hear MDs tell female diabetics that their hormones don't effect their sugars. I have 33 years of type 1 under my belt with no complications at all yet. My A1c runs between 7.1 and 7.3. I'm always aiming at 6 something! Hope this helps someone out there.

The dude I'm cured made me laugh as well, I say that ALL the TIME! I say crazy things when I am low and I too hate these days of fighting lows. You are exhausted and that is of course when people comment are you ok, you look tired, are you having a bad blood sugar day? It is exhausting trying to explain it as well. It is nice to know I am not the only one going through this and feeling exactly like you do.

Had one of these days today...WTH is going on. Check and was 46, ate a swiss cake roll, 2 glucose tabs and checked again and was 53 so I ate my lunch and an oatmeal cream pie without bolusing and now 2 hours out i'm 101...should be 300. UGH

Do you pump 15 minutes before your meal? That helps prevent the spike in sugar for me.... I reduced my A1C from 7.3 to 6.2 in two months just by pumping 10-15 minutes before I eat. It made a huge difference!

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