My low blood sugar “tells” have changed over the last twenty-seven years, ranging from numb lips to crying jags to shaky hands.  The scariest symptom of all, though, has been the complete absence of symptoms, which is part of the reason why using a CGM has been such a big leap forward for me. 

Dan Fleshler has had type 1 diabetes since 1962. He blogs (more seriously) about the lessons and mysteries of diabetes at The Insulin Chronicles.  And today, Dan has offered a tongue-in-cheek guest post about his hypo signals (including one about lettuce that made me laugh out loud).

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“Hypoglycemic unawareness” plagues me and many other people with diabetes (PWDs). It occurs when the body’s warning signs of low blood sugar –sweat, fatigue, blurred vision, etc.– either don’t kick in or aren’t recognized. When that happens and we’re unaware that we need to eat glucose, our brains don’t get enough of it and the result can be irrational and even dangerous behavior.

I’m thinking about getting a continuous glucose monitor (CGM), which will beep when I have low blood sugar. But I’m worried that I won’t be able to get used to it and hear that sometimes CGMs don’t work. Fortunately, there is another solution offered by clinicians: every PWD should develop a set of telltale, distinctive, personal warning signs to help them recognize their lows.

In my case, I know my blood sugar is getting too low whenever:

  • I pick up two heads of lettuce from a supermarket bin, call them “Paul” and “Ringo,” and loudly berate them for the break-up of the Beatles. When that happens, I know it’s time to grab the glucose tablets!
  • I walk up to a policeman I have never seen, bare my teeth and accuse him of causing the pogroms against Jews in the Ukrainian town of Kishiniev, in 1904 (my grandmother used to tell me about them).   That’s a sure sign, a dead give-away!
  • I find myself repeatedly shouting “Meep meep,” like the Roadrunner cartoon character, when I am being chased by a policeman whom I’ve accused of causing the Kishiniev pogroms.
  • I find myself agreeing with Glenn Beck.  Danger! Danger! My brain is starving for glucose!
  • Just before a Yankees game, I stand with the scalpers outside of Yankee Stadium and shout, “Who doesn’t need tickets?! I’ve got no tickets!”  Another telltale signal: I ask people walking towards the Stadium, “Excuse me, have you seen the philosopher Ludvig Wittgenstein?”
  • I burst into tears and feel heartbroken because I can’t manage to kiss the small of my back.
  • Cradling my cat Sammy in my lap, I tell him, “You’re leaving for Swarthmore tomorrow and I know freshman year won’t always be easy. I want you to know you can call me any time. I’ll be there for you.”  You’ve probably read that some dogs can recognize when their owners have hypoglycemia.  Sammy has learned to leap out of my lap whenever I mention Swarthmore. Works every time!

Hypoglycemic unawareness can be a very serious problem.  If it haunts you, please consult your physician or certified diabetes educator and find ways to prevent it.  They should help you develop your own personal, internal barometers.  Of course, please feel free to use mine.

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Dan, thanks for posting today.  Lettuce know if you have any other strange symptoms that crop up!  😉