Tingly

I knew something was wrong when my tongue inexplicably began tingling.

It was a sudden, prickly sensation – almost like I had pins and needles on my tongue. (This is a sensation I get in my feet when I’ve had them in a certain position for too long and I need to get the blood flowing properly again. A quick Google search taught me that just about anyone can experience this, so odds are you already know what I’m talking about.) And it lingered for a solid 20 minutes, making my entire mouth feel as though it was simultaneously numb and on fire from the unrelenting feeling.

This is my new(ish) low symptom: tongue tingling.

And I hate it.

It only seems to occur when my blood sugar hits the 50s or 60s, which doesn’t happen too often. But when it does, it hits me so abruptly that it catches me off guard every time. It’s an unpredictable phenomenon – usually, my first sign of a low blood sugar is feeling shaky/sweaty/dizzy. Once I feel those initial signs of a low, I’m pretty good about being quick to do something about it by grabbing something sugary to eat…and when tingly tongue strikes, it can make the entire eating experience unpleasant because it almost feels like I’m having an allergic reaction to my low snack. And it lasts longer than it takes for my Dexcom to pick up on a recovering low blood sugar.

I’ve genuinely been worried that I was having an anaphylactic reaction in addition to a hypoglycemic event, prompting me on more than one occasion to run over to the closest mirror to check and make sure that my mouth and face aren’t swelling up or turning red. Let me tell you, it’s enough to deal with the low blood sugar sensation – feeling like I’m having an allergic reaction on top of that makes a normally easy-to-deal-with low that much, well, suckier, to be blunt about it.

I classify it as only sorta, kinda new because I’ve dealt with something similar in the past. In fact, roughly 4 years ago, I wrote about “a fuzzy towel tongue” feeling that I experienced after a low blood sugar. It’s funny that I wrote about it because I think at the time, I only ever felt that a handful of times, and the symptom seemed to disappear. But now, it’s apparently back with a vengeance, as the tingling feels much worse now than the numbness I’d felt a few years back.

At least I know that I’m not alone. I’ve talked to my fellow T1D mother about this and she’s also experienced it, in addition to the folks I’d interacted with in the context of my original post on the matter. It might not be fun, but there’s (quite literally) strength in numbers.

The Emotions of Low Blood Sugar

This post was originally published on Hugging the Cactus on October 8, 2018. I’m sharing it again today because as I sat down to write a new post, my blood sugar tanked…frustrating the hell out of me by taking away any and all creativity. But it did remind me of the timelessness of this post, and how the emotions of a low blood sugar can be so varied. Read on for more…

Previously, I’ve written about what it feels like to have low blood sugar. While many people with T1D feel the same symptoms as me when they experience a low, there are even more who experience a wider variety of emotions and sensations.

Renza, a T1D Twitter friend of mine, did a little investigating into how others would describe what it’s like to have a low blood sugar. She sent a tweet that read:

#Diabetes friends. I’m crowdsourcing (again). If you had to use ONE WORD to describe how hypos/lows feel to you, what would it be. Go!! #Hypoglycaemia

She received nearly 100 responses, which I’ve compiled into the below graphic.

Looking at this word collage is a bit startling because it represents the vast array of feelings associated with low blood sugar. Most of them are negative. A handful of them start with the prefix “dis”, which describes something with an opposing force. A couple of them relate to feelings associated with eating. And just about all of them can be summed up as sensations that I wouldn’t wish on anyone.

To me, this graphic serves as a stark reminder that diabetes is more than just a chronic illness that affects the body: It affects the mind, too.

The Inconvenience of Low Blood Sugar

Blood sugar drops (and spikes, for that matter) are never convenient, per se. They often take my attention away from the moment or experience that I’m in, and it just so happens that there are times when it’s a bigger deal than others.

Case in point? The blood sugar plummet I dealt with in the middle of reactive dog class for my pup.

Let me set the scene: It was a warm October evening in New England – perfect weather for walking a dog around the neighborhood. That’s exactly what my classmates and I were doing: We had about a dozen dogs that were only just outnumbered by humans getting walked in repetitive loops. The challenge was to test the dogs for their reactivity and correct them whenever they tugged too hard on their leashes or got too excited by another dog, person, or squirrel that was also out and about.

The training exercise itself wasn’t difficult; in fact, it was nice to watch the sun go down and chat with the other dog owners in the class while I kept my dog by my side. But what made it a challenge was when all that walking in circles finally caught up with me and my blood sugar and I started to feel an oncoming low.

I was stressed about it, because I was feeling the shaky/dizzy symptoms of a low, but was struggling with finding a good time to correct it. After all, it would’ve been kind of weird for me to randomly start gobbling down some fruit snacks in the middle of a conversation with the other dog owners, and I really wasn’t up for explaining diabetes to everyone and taking attention away from the training. I thought I was in the clear when it was my dog’s turn to be walked by another trainer – my hands were free and I totally could’ve eaten something quickly – but I balked at it because again, I found myself engrossed in conversation as I was given pointers for walking Violet.

In hindsight, I probably should’ve excused myself from the training exercise to sit down and eat my fruit snacks, but I simply wasn’t in the mood for dealing with my stupid diabetes at this point in time. This is the one hour per week that I’ve got with my dog that is solely focused on training her, and I wanted to be present in the moment. But I’ve got to acknowledge that I can only take good care of my dog if I take care of myself first, and I neglected to do that as soon as I should’ve in this situation.

Ah, well. It was what it was, and luckily the low happened towards the end of the class so I was able to eat my fruit snacks in the privacy of my car without having to explain myself to anyone. Next time, I’ll be better prepared with a sugary drink (like Gatorade) that will be much easier to consume without explanation while walking my dog.

What Happened When My Blood Sugar Crashed in the Grocery Store

I knew something was wrong when the walls of the soda and seltzer aisle felt like they were closing in on me, Star Wars-trash-compactor style.

You would think a blood sugar is no sweat (pun intended) in a place where food is so easily accessible, but this experience was far from it.

On a recent trip to the grocery store, I went low. And when I say low, I mean low – I wasn’t just shaky, I was sweating literal bullets and having a hard time seeing straight in front of me.

My boyfriend – thank goodness he was there – knew something was wrong just by looking at me. He suggested that I grab some fruit snacks from my backpack and I heeded, tearing open the small foil packet and tossing the contents back as quickly as I could. I chewed, grimacing as I tasted the strangely saccharine, perfume-y gummies, but I barely cared about the taste. I just wanted to feel better. That’s when my boyfriend placed a hand on my back, noting my clammy state, and escorted me over to the dining area at the front of the store.

“Just stay here, I only have a few things left to grab. Maybe you’ll be feeling better by checkout time,” he said, before asking me if I was okay to be left alone.

I was. I hated that he was seeing my like this, in this vulnerable, sweaty state that seemed impossible in the chilly air of the grocery store. I told him I would sit and wait there for him, fighting the feeling that I was a small child waiting for a parent to finish up some boring adult task. As I nearly collapsed onto a chair, all I wanted to do was shrink so nobody could see me: It seemed as though all sets of eyes in the vicinity were locked on me, the perspiring wonder who looked quite unwell.

I was only on my own for about 5 minutes, but time dragged as I anxiously awaited my boyfriend’s approach to the checkout line. I thought I’d wanted to be alone as I let the fruit snacks kick in, but turns out the opposite was true. I clung to his side as I slowly registered that I felt safer around someone who knew exactly what was wrong with me and how to handle it if things got worse.

As we exited the store and loaded the groceries into the car, I noted that my shakiness was dissipating, as was the beads of sweat on my body. This low episode was over and I was relieved to be on the other side of it. I was also relieved that I didn’t have to go through it alone: turns out lows are a bit more bearable when you have someone else with you to help you through them.

What It’s Like to Wake Up in the Middle of the Night with Low Blood Sugar

You stir suddenly from a dreamless sleep, knowing that something must’ve disturbed your slumber but not quite sure what it may have been.

This blog post was inspired by a recent middle-of-the-night low that went…well, exactly as I wrote it here. I wrote in the second-person perspective so you might be able to imagine what it’s like, if it’s something you’ve never experienced before.

Reflexively, you reach over to where your phone is perched on your nightstand. You check your notifications and confirm what you’d been hoping wouldn’t be a problem tonight: Your blood sugar is low and you must do something to fix it.

You unroll a couple of Smarties from their package, almost surprised at how dexterously you do so. After all, it’s an odd skill to have honed over the course of your life to be really good at opening up packages of the food just moments after you were sleeping soundly, but you’re accustomed to it. You chew up the Smarties as quickly as you can, grimacing slightly as their sweet-sour taste mingles with traces of toothpaste from when you brushed your teeth before bed. You sink back against your pile of pillows, sighing, as you wait for your blood sugar to come back up.

You wait. You wait some more. You scroll mindlessly through various apps on your phone. You’re not feeling better. You wonder to yourself, how much more do I have to do to fix this? You wish you weren’t alone right now. Low blood sugars are scary to deal with on your own, especially when they sneak up like this in the middle of the night.

Your mind begins to spiral as those nasty “what ifs” enter your thoughts. What if you plummet further? What if you lose a lot of sleep over this one pesky low? What if you don’t recover from this low and…?

Just as you begin to think of the most unpleasant scenario, you realize that your shakiness has subsided. The sweat on your skin has dried and your vision seems to be less foggy – it’s hard to tell in the dark, but not wanting to turn on anymore lights, you settle back into bed more comfortably and close your eyes.

You hope you can go back to sleep quickly. You hope that you don’t have to wake up again for the rest of the night for any blood sugar-related issues. You hope that you aren’t exhausted because of this one tomorrow.

You hope that tomorrow night is different, but with diabetes, you never know.

5 Ways Hot Weather Affects Diabetes

I’ve posted this on Hugging the Cactus a couple of times now – once in 2018 and again last year. I’m sharing it a third time today because we are in the throes of summertime now that July has arrived, and I needed a little reminder as to why it’s important to take certain precautions when it’s hot outside to take the best possible care of myself and my diabetes…

The summer heat seems to be here to stay in Massachusetts. We’ve experienced several weeks of soupy, high-heat weather that *almost* makes me long for cooler, autumnal days…but not quite, because that just means winter (and snow – blech) is right around the corner.

Truly, I do enjoy the summertime. To me, summer is about trips to the beach, ice cream consumption (and lots of it), barbecues with family and friends, long walks in the neighborhood, and endless outdoor adventures. Aside from all of those lovely things, summer also means that it’s time to be a little more diligent when it comes to my diabetes. That’s because hot weather can play some cruel tricks on a T1D’s body. What do I mean by that? Here’s five ways diabetes can be affected by hot weather.

Another thing to know about hot weather and diabetes? It will most definitely trigger ice cream cravings. Bolus accordingly.
  1. Dehydration can lead to high blood sugar. Everyone knows that it’s important to stay hydrated when it’s hot out, but it might be less common knowledge that dehydration can directly affect blood sugar. There’s a scientific explanation for this: If not properly hydrated, the body sees an increase in blood glucose concentration because blood won’t flow as easily to the kidneys, making it difficult for the kidneys to get rid of excess glucose in urine. The best way to prevent this, naturally, is to drink plenty of water and monitor blood sugars.
  2. Sunburn can drive up blood sugars. I’m very familiar with how a sunburn can result in higher blood sugars; in fact, just last week I was dealing with a particularly gnarly sunburn on my thighs and belly that not only made my numbers higher, but also really hurt. My skin was literally damaged, so the stress from the injury lead to retaliation from my blood sugar. Luckily, it only lasted about 48 hours, but those couple of days were challenging as I dealt with sticky highs that were practically resistant to insulin. And for the record, I DID apply sunscreen – numerous times – when I was at the beach. Next time, I’ll seek shade under the umbrella.
  3. Sweat can make it difficult for devices to stick. I don’t know a single medical device that’s immune to prolonged exposure to moisture/water, but that doesn’t prevent me from spending as much time as I can outdoors/at the beach/by the pool in the summer. Thank goodness for Skin-Tac wipes and medical adhesive tapes that help preserve my precious pods and sensors!“
  4. Insulin can overheat. There’s a reason why insulin vials come packaged in cartons with directions that specify what temperature insulin should stay at in order for it to be safe to use. Insulin can spoil easily when it reaches a certain temperature, so it’s important to store it in a cool place when the weather’s warm. I alternate between a mini portable cooler (that can hold 3 vials of insulin) and a pouch from FRIO – both do an excellent job at keeping my insulin cool.
  5. Low blood sugars can occur more frequently. Summertime is prime time for outdoor activities that result in higher energy expenditure. So it’s no wonder that blood sugar tends to plummet in hot weather. Looking at it on the bright side, it’s an excuse to eat even more ice cream – but it also means that monitoring how I feel and checking blood sugars often is that much more important.

Regardless of the diabetes challenges it may cause, I love summer weather, and I know I’ll miss it the moment the first snowflake falls this year.

A Security Blanket

I never thought I’d come to think of a nasal spray as a security blanket, or something that would provide me great ease of mind, but that’s exactly how I feel about my Baqsimi prescription.

I’m all stocked up on Baqsimi for the time being.

Baqsimi is a nasal glucagon that is a million times easier to use (or at least, understand how to use) in an emergency situation than those old red kits from the days of yore. In all my years of diabetes, I never could remember step-for-step what the process was like for using glucagon – in fact, I had an app downloaded on my phone just so I could practice it every so often as a refresher, but even with the app I felt ill-equipped to use glucagon on myself, or anyone else for that matter.

That’s why when I first heard about Baqsimi a few years ago, I breathed a sigh of relief. Finally, there was an option out there besides glucagon! The freedom to have choice, rather than be forced to stick with something, goes a long way in life with diabetes…in life, period. I was excited that I could choose to keep Baqsimi on hand just in case I ever did experience a severe hypo, a possibility that has always frightened me, especially when I started living alone a year and a half ago.

And when I was recently taking inventory of my diabetes supplies, only to discover that my Baqsimi was expired, I made it a priority to get it refilled as soon as I could because of just how much I’d reaped the benefits of peace of mind. So I made a point of calling my doctor and asking for fresh prescriptions for both Baqsimi and insulin, because it just so happened that I was running low on my Humalog stash.

A couple days later, I went to the CVS drive-thru, picked up the prescriptions, and drove home. While driving, I couldn’t help but feel so grateful that it was actually easy for once to do something for me and my diabetes that was necessary and would provide me comfort. If only it could be like that every time.

My “New” Low Blood Sugar Treatment of Choice

The concept of a “low blood sugar treatment” makes me giggle, because it implies that the glucose (sugar) needed to bring levels back within range is basically medicinal. Sugar? As medicine??? Kind of, sort of, pretty much when it comes to fixing a low.

Over the years, my preferred low treatment has taken many forms. In the early days of my diabetes, it was usually glucose tablets or orange juice. In most of my youth, juice boxes were number one, but as I got older I felt ridiculous carrying those around, so I switched to fruit snacks and kept glucose tablets around as an old reliable. In college, I loved mini boxes of yogurt-covered raisins (they were great for less urgent lows, with roughly 10 grams of carbs in one teensy little portable package). And in my adulthood, I’ve rotated through a mix of all the aforementioned items, but with a brand-new one entering the forefront for me as of late.

And that new one is…Smarties!

One of the many Smarties stashes I’ve got scattered around my home.

Yup, Smarties, the classic candy that just might be the most ideal low blood sugar treatment I’ve used in recent years. There’s solid grounding behind that logic: For starters, Smarties come bundled up in tiny rolls that are easy to slip just about anywhere – a pocket, a glovebox, a nightstand, and the list goes on. Smarties don’t melt and withstand just about any weather condition. They’re also perfectly portioned, with one roll containing 6 grams of carbs so it’s convenient to eat just one for a slightly low blood sugar or 2-3 for more stubborn lows. There are even giant Smarties rolls that are great for when I need a quick blood sugar boost before a workout – I just eat one or two individual giant-size Smarties and I’m good to go. And despite being reminiscent of chalky glucose tabs, they do taste significantly better and I swear they dissolve faster compared to their drugstore counterpart.

All those pros and nary a con for me to nitpick…I think I’ve finally found the best low blood sugar treatment for myself – for now, anyways.

The T1D Taste Test: My Unofficial Ranking of Drugstore Glucose Supplements

This blog post was originally published on Hugging the Cactus on June 27, 2018. I’m sharing it again today because it’s a blog post that has a surprising number of views – likely due to the fact that people have strong opinions (rightfully so) on glucose tablets and their various iterations! Read on for my thoughts on the best version of drugstore glucose supplements…

You may have heard of glucose tablets, but what about glucose gummies? Or liquid glucose, or glucose gel? Have you tried any of these forms of glucose?

The four forms of glucose (that I’ve tried).

I’ve used them all, and I’ve formed some pretty strong opinions about each of them. I thought it’d be fun to rank them in order of most appetizing to least appetizing, because while they can effectively and efficiently correct low blood sugar, they certainly aren’t created equally:

  1. Best Tasting: Glucose Tablets. I can hardly believe that the most boring variety is the winner here, but it blows the competition out of the water for several reasons. For starters, glucose tablets come in an array of flavors. Orange, raspberry, fruit punch, grape, tropical, and sour apple are among the flavors I’ve tried over the years, and most of them are palatable. Plus, glucose tablets are most akin to actually candy: I’ve described them as giant Smarties to inquiring friends in the past. While actually Smarties are more fun to eat, glucose tablets are their closest counterpart in the diabetes world, making them a number-one choice in low blood sugar situations.
  2. Runner-Up: Glucose Gummies. I’m awarding second place to glucose gummies, mainly because of their novelty. It’s not particularly a standout in other categories like taste and texture. The gummies only come in three flavors: grape, orange, and apple, leaving something to be desired in terms of variety. And all three of those flavors taste a little…off, like there’s a little too much artificial additives going on. Maybe this was done deliberately to distract from the texture of the gummies, which tends to be hard/stale in my experience. It’s nice that the gummies have a layer of sugar on them to convey the likeness of real gummies, but that stuck-to-your-teeth feeling makes it harder to appreciate the gummies for what they are.
  3. Third Place: Glucose Gel. I’ve only ever found glucose gels in the fruit punch flavor at Walgreens – do they actually come in other flavors? Besides being one-note, the gel is a unique texture situation…not quite a liquid, not quite a solid. Gels aren’t a mainstay in my low blood sugar kit because I’m not fond of having to slurp them out of the pouch like a tube of Go-Gurt; in fact, I’d much rather have yogurt from a plastic tube than a gel because the yogurt is much tastier. The gel is just too artificial, with a medicinal aftertaste. And it doesn’t help that the consistency of it reminds me of hand sanitizer.
  4. The Loser: Glucose LiquidIt’s surprising that the glucose liquid wound up in last place, because on the surface, it had a lot going for it. I liked that it came in a small bottle and it seemed like it would be super easy to consume. All I’d need to do is pop the cap off and swig it down. But MAN, the taste was HORRIBLE! I thought I’d like the mixed berry flavor, but it tasted so supremely saccharine and fake that I could scarcely force myself to swallow it. I know, I know, it’s liquid glucose, it’s supposed to be very sweet. But this stuff was just over the top. I definitely will not be buying glucose liquid again any time soon. I’ll stick with my tried-and-true tablets.

Do you agree with my rankings? Did I miss any form of glucose that can be bought in most drugstores, and you think I should give it a try? Let me know in the comments!

A Rookie Mistake

You’d think that 24 years of living with diabetes would turn anyone into a seasoned veteran of the condition, but even the most experienced people with diabetes slip up and make mistakes every now and then…

Case in point? Me, because I neglected to make sure I had a way of monitoring or checking my blood sugar when exercising…and then experiencing a scary low that I probably could have caught sooner, or maybe even avoided, if I hadn’t been so careless.

This all happened because I inserted a new Dexcom sensor just before taking off for my 3-hour self-defense class. I knew that the sensor’s warm-up period would end and that my continuous blood sugar readings would begin partway through class, so I felt fairly comfortable going without a blood sugar meter as a back-up. After all, my Dexcom sensors almost always start up without any issue, so I was trusting that this one would follow suit.

And that was my biggest mistake: trusting my technology.

Any time I make a rookie diabetes mistake, my palm goes straight to my face in embarassment.

When the warm-up period was complete and the class was taking a quick water break, I decided to check my Dex to see what my first blood sugar readings were. I was surprised (and instantly annoyed) to see that instead of a number, my Dexcom was displaying a request for a blood sugar calibration – just like the old G5s used to ask for upon insertion of a new sensor. I couldn’t understand why this happened, but I knew that pondering the matter wouldn’t make any difference…the only thing that would get my Dexcom running normally again was the finger stick checks, which wouldn’t be possible for me to do until I got home from the class because I was without my meter.

So I had no choice but to rely on nothing but my instincts and sensations in order to get a sense of where my blood sugar was headed for the remainder of the class.

And let me tell you, I can’t remember the last time I felt so vulnerable in terms of my diabetes. I was running on zero information, other than the fact that I typically can feel oncoming low blood sugars and that I tend to feel thirstier when my numbers are on the upswing. It was disconcerting – even more so when a little while later I started to feel shaky and dizzy, like I was starting to go low.

I knew I could either 1) treat what I thought was a low blood sugar and deal with the potential consequences (high blood sugar) when I got home, or 2) take a chance and ignore the low symptoms because I couldn’t confirm whether or not I was actually low. I hate to admit it, but I let a good 15-20 minutes pass before I decided it was better to correct what felt like a low rather than run the risk of passing out in front of the entire class. Turns out that I made the right call to treat my low: I felt much better after I ate some fruit snacks, and my blood sugar when I got home that evening was in the low 80s, indicating that I probably avoided a pretty nasty low in class.

While the whole incident could’ve been easily avoided, it did remind me that I ought to take some of the trust that I have in my technology and distribute it a little more evenly between it and my instincts. I proved to myself that in emergency situations, I don’t need a meter or a CGM to pick up on low blood sugars (though I obviously would prefer to have that equipment at my disposal at all times). Instead, I need to trust my instincts more and procrastinate less when it comes to taking an action – because if I had waited longer than those 15-20 minutes, the situation could’ve escalated and then I would’ve really been kicking myself for leaving my meter at home.

Rookie mistakes suck when they happen, but at least the silver lining is that there’s always a lesson to be learned (or reinforced) when they do.