There’s never necessarily a good time to have a low blood sugar: Whenever they happen, they’re bound to be at least a little inconvenient.
But I was thinking about it the other day and it occurred to me that there is most definitely a worst time for a low blood sugar…at least, for me.
And that time is the middle of the night.
I love sleeping, but like many adults, I simply don’t get enough of it. So when something like a low blood sugar interrupts my slumber, it’s downright intrusive and honestly a bit scary, because I always have an underlying fear that I’ll sleep through my Dexcom alarms.
Take a recent middle-of-the-night low blood sugar for example…I was dealing with a lingering low at 1:30 A.M. I’d only been asleep for a couple of hours when I heard my Dexcom sound. I ignored it the first 3 times it went off, but something – my intuition, maybe – told me to roll over and at least check to see the level that my Dexcom was reporting.
I was somewhere in the 60s: low enough that I needed a juice box. I promptly drank it and got settled back under my covers, assuming that I would shoot back up in no time.
Not quite. I don’t know how many minutes later, but I looked at my Dexcom again and it said I was 56. I did the whole “confirm the number with my meter” shtick and ate some glucose gummies to supplement the juice box. I was irritated and my eyes were oh-so-heavy, but from there I forced myself to turn the television on and try to get distracted by a show so I wouldn’t fall back asleep until I knew that my blood sugars were stable again. Before too long, I was heading up, so I did my best to lull myself to sleep, though I tossed and turned for awhile before I finally did drift off.
All in all, I lost about an hour to an hour and a half of sleep because of this one instance! Not all of my lows are like that – sometimes I can fix them in 5 minute flat, other times they keep me up for upwards of two hours – but it doesn’t even really matter. It’s more so the principle of the thing.
Plus, think about how freakin’ ridiculous it is that people with diabetes have to eat something sugary to come up from a low – that in itself isn’t wild, but it IS grating to have to do in the middle of the night when you aren’t hungry and were enjoying a deep sleep. Also…ever try drinking orange juice after you’ve brushed your teeth? It’s unpleasant, to put it mildly.
So you have it: The middle of the night is the absolute worst time for a low blood sugar, in my semi-expert opinion.
There should be an asterisk after this blog title…because this is going to be about the lowest bg that I can really remember and have an actual blood sugar to associate with it.
Let me elaborate…
My real lowest low happened when I was in high school – I got out of bed one morning, stumbled down the stairs, and slurred to my mom that I wanted a bowl of Special K cereal for breakfast (she couldn’t understand what I said and promptly panicked before realizing I must be low). I don’t know what my blood sugar level was that morning because I neglected to do a fingerstick check, but I do know that it was a downright freaky incident that’s cemented in my memory.
But another new incident recently occurred that shook me in a similar way.
It was 1:30 A.M. I was nodding off when I heard my Dexcom alarming. I checked it and was somewhat surprised to see that I was 92 with two double down arrows. (I say “somewhat surprised” because in the earlier evening hours, I spent 3-4 hours chasing a stubborn high blood sugar and definitely wound up stacking insulin doses.)
Even though I wasn’t feeling any low symptoms, I decided to start treating the low. I ate two boxes of mini raisins, equaling about 20 carbs…
…and swiftly grew worried when I saw the number on my Dexcom app to continue to drop.
Okay, let’s have another box of raisins.
Alright, let’s do a fingerstick check.
Sheesh, I’m fumbling around in the dark, trying to locate my meter…
By the time my Dexcom said “LOW”, it was confirmed on my meter that I was, indeed, quite low. 35, to be exact.
And that was a number that frightened me.
Thank goodness I wasn’t alone when I was dealing with this 35 (that wound up lingering for a solid 15-20 minutes before slowly creeping up about 45 minutes after I ate my first box of raisins).
Thank goodness I had someone there to make sure I had plenty of sugar in my system before I fell asleep.
Thank goodness I had a can of regular ginger ale, some Reese’s, Dove chocolates, and popcorn all within arm’s reach (yes, I really did need to eat all those carbs in order to treat this one low).
Obviously, I recovered from this scary low, but it taught me that now that I’m living alone and won’t always have someone around me in the middle of the night, I should start thinking about inviting someone to follow me on the Dexcom app.
The next day, I talked to my parents about what happened and the three of us agreed that my dad will receive notifications if/when my blood sugar drops below 55. I feel a lot better knowing that he has access to my levels and that he knows to contact me if I’m low.
I’m not exactly grateful that I experienced this very low blood sugar…but I do appreciate that it’s reinforced the importance of having a nightstand fully stocked with low treatments as well as making sure that my family has a way of checking in on me when I may need their support.
We all know that 2020 has been a sucky year, so it’s not exactly surprising that immediately following Halloween, the world seemed to throw itself into the holiday spirit.
Between the commercials on TV, Black Friday sales, sparkly decorations, baking galore, and Hallmark movies, the Christmas season kicked off early and with major vivacity. Normally, I’m the kind of person who prefers to enjoy one holiday at a time, and I was somewhat repulsed to see all the Christmas merchandise in stores before Halloween was over.
So even though Thanksgiving hasn’t even come and gone yet, I’ve abandoned any remaining willpower I’ve had to hold off on decorating for Christmas. Like the rest of society, I simply couldn’t hold back my desire for some cheer!
One afternoon last week, I decided to haul up my Christmas tree and its accompaniments from the basement and start the process of decking the halls…
…but my diabetes had other ideas.
I’d just finished assembling my modest tree when I heard my Dexcom alarm sounding off, alerting me to a low blood sugar.
And I hate to admit it, but it didn’t surprise me – I’d felt the oncoming low for about 10 minutes prior.
I just wanted to decorate so badly that I was willing to ignore my blood sugar in order to embrace the Christmas spirit!
Alas, not too long after I heard that alarm, I knew I had to change my priorities as I started to get sweaty and a little woozy…so I left my tree naked and sought out a low treatment, slumping at my table in defeat while I ate it.
My diabetes told me it was too early to decorate for Christmas at that moment in time…
But you know that I told my diabetes otherwise later that night when I spent hours trimming the tree!
‘Tis the season and ain’t no way that my diabetes will prevent me from basking in it.
The thought occurred to me that I should write a blog post on this subject sometime around 3 A.M. after I shoveled a slice of cheddar cheese into my mouth.
Low blood sugars combined with odd hours of the night aren’t foreign to most people with diabetes, but they can be…interesting when you aren’t prepared to handle them with low snacks stashed away in or on your nightstand.
To elaborate, I almost always have a box of raisins or a bottle of glucose tablets sitting on top of the nightstand next to my bed – but there are those times that I run out and forget to replace them.
In those situations, I really have no choice but to eat everything in the kitchen head downstairs and scavenge in the kitchen for something that will bring up my low blood sugar.
Usually, I consume things that make sense – a handful of cereal, a glass of juice, a few marshmallows…whatever the kitchen is stocked with that will work fast. And this is absolutely the best tactic when dealing with a middle-of-the-night low because it helps ensure that I will be able to get back into bed (and hopefully fall asleep) as soon as possible.
But every so often, I go absolutely apeshit in the kitchen and EAT ALL THE THINGS!!!!!!!!!!
Okay, not ALL the things, but definitely way too many things.
I blame it on the fact that my body is in that savage, must-eat-food now mode: Hungry and full cues aren’t a “thing” in that state. So I kind of mindlessly eat junk until the symptoms of my low blood sugar go away. This can take at least 15 minutes, so as you may be able to imagine, I can go overboard with food consumption.
And my choices can get more than a little weird.
Here are the most bizarre food items that I’ve eaten when dealing with a middle-of-the-night low blood sugar. I classify them as “strange” because either 1) they don’t do anything to help low blood sugar because they’re low carb, 2) they’re kind of disgusting, 3) the quantity is odd, or 4) a mix of all of those qualities:
A slice of cheddar cheese (mentioned in this post’s introductory sentence)
About one-third of a Nutella jar (that was so yummy but damn I shudder to think about the calories and fat in that serving)
Too much peanut butter to quantify (please see above comment RE: Nutella)
SUGAR-FREE syrup (emphasis on the sugar-free because WTF was I thinking when I straight up drank two swigs from the bottle)
Exactly three frosted mini wheats (I don’t even LIKE this cereal but I guess in this situation I thought that consuming no more, no less than three was a brilliant idea)
Pickles (not weird at any other time of the day because I love pickles but maybe not the best snack in the early morning hours)
Welp, now my stomach is churning slightly as I think about all the junk I’ve eaten at ungodly hours of the night…if you don’t mind me, I’m off to go restock my low snack supply on my nightstand so I don’t have to make any early-A.M. hour trips to the kitchen any time soon!
For anyone who may be unfamiliar with Baqsimi, it’s a relatively new form of glucagon that comes as a nasal spray. I haven’t had to use it yet (and I hope that I don’t ever have to, really), but there’s a lot of pros to Baqsimi when comparing it to a traditional glucagon kit:
It’s shelf-stable – it doesn’t have to be refrigerated.
It doesn’t expire until 2.5 years from now.
It’s completely ready to go as-is, no mixing or measuring needed.
It’s compact and totally portable.
It’s easy to use (and understand how to use!).
All of those factors contributed to my decision to finally pull the trigger and ask my endocrinologist about writing a prescription for me. It’s not that I’m suddenly worried that I’ll need Baqsimi; for me, it’s more of a peace-of-mind situation. I always thought that my glucagon kit was next to impossible. Sure, I know how to use it, but I have to refresh my memory every so often because there are so many steps involved in the process: inject the syringe into the vial, mix the contents, wait for the glucagon to turn clear, stick the syringe back into the vial, withdraw the liquid, and then finally do the injection…there’s a lot going on there. And if I actually did need glucagon one day due to a severe hypo, I wouldn’t exactly be able to easily walk whoever I was with through the process because I’m sure I’d be totally incapable of doing so (depending on how bad my symptoms were).
It’s just a lot to ask of every single one of my family members and friends to know exactly how to inject glucagon into me in the event I ever needed one of them to do that, so having Baqsimi on hand takes so much of that fear and anxiety away.
And the icing on top of the cake is that it was super easy for me to get Baqsimi…like, it only took a few hours, which is amazing. All I did was reach out to my endocrinologist’s office using their online messaging system, ask my doctor for a script, and…bam. It was sent into my local pharmacy, and before long, I was cruising through the drive-thru with my dog to pick it up. I’m lucky, too, because all I had to pay was $25, thanks to my insurance (sometimes, it’s not as bad as I think it is).
Twenty-five bucks for peace of mind and a life-saving medication…that’s something I can get behind. I’m glad Baqsimi has finally joined my diabetes toolkit.
Anyone who has ever experienced low blood sugar knows that it’s an icky feeling.
The shakiness. The sweating. The desperate desire to eat the entire contents of your kitchen.
It’s an unpleasant experience, but the one thought that has always made low blood sugars slightly more bearable for me is that I have to consume fast-acting, sugary, yummy carbs that are medically necessary. I’ve had some fun with that medically necessary bit in situations over the years: “Hey, stay away from that cupcake, I need it for my blood sugar!”
In any case, I’ve come up with my 10 favorite low blood sugars treatments that I’ve discovered work best for me…and tend to also be pretty tasty (well, maybe not #3, but everything else is a winner for most people in the flavor department).
1. Marshmallows. Even though I feel like I’m playing chubby bunny (you know, that pointless game when you see how many marshmallows you can fit inside your mouth at once and your cheeks puff out like an adorably plump rabbit munching on carrots) any time I consume a marshmallow, I can’t deny that they work incredibly well for low blood sugars. While I don’t mind the flavor of marshmallows, I definitely don’t love it, so I can always resist the temptation to over-correct a low blood sugar when I use marshmallows to treat it.
2. Mini boxes of yogurt-covered raisins. This has been my go-to for almost 10 years now because they’re just so convenient. The mini boxes are highly portable and contain about 11 grams of carbohydrates, which is perfect for not-so-bad lows that just need a little boost.
3. Glucose tablets (or gummies). They’re the old standby for a good reason: They were specifically made for treatment of low blood sugars, and they’re also extremely quick and easy to consume whenever, wherever (cue Shakira and her hips that don’t lie).
4. Frosting. So bad for you, but so good to eat by the spoonful when dealing with low lows. I don’t often have frosting on hand, but if I have some leftover from baking, I’ll throw it in the fridge and try to forget that it exists until I need it for a low blood sugar.
5. Orange juice (or a juice box). I feel like juice was a signature treatment for lows in my childhood: Since small children often drink juice boxes, it made a lot of sense. But back when I was working in an office full-time (sigh), I had a couple of juice boxes stashed away in my desk drawer because I got a kick out of feeling like a little kid with her juice boxes while sitting her grown-ass adult woman’s work cubicle (yes, I know I’m kind of weird. Embrace it.)
6. Starbursts. In college, I met a fellow type 1 in my social psychology lecture hall who swore by carrying starbursts for low blood sugars. She explained that four of them had the exact same amount of carbs as four glucose tablets, but they were far superior in taste because, well, starbursts are candy. I’ve kept this in mind over the years and its come in handy: More than once, I’ve been in a situation where I’ve had to get carbs fast but didn’t have glucose tablets on me, so I bought a sleeve of starburst to treat oncoming lows. They work well and they’re especially delicious when using the pink or the orange starbursts (not the yellow or red…fight me on it).
7. Skittles. What I love about using Skittles for low blood sugars is the 1:1 rule. One Skittle has one carbohydrate, so it’s extremely easy to figure out how many will bring up blood sugar, depending on how low the low is. 10 works well for when I’m in the 70s, whereas I might have 15 when I’m in the 60s. All bets are off when I fall below 60, though, and I’ll settle for a large, uncounted handful – maybe the whole dang bag – instead.
8. A piece of fruit. Ooooh, a genuinely healthy option on this list! The horror! But it’s a fact that fruit works just as well as any piece of candy or sugary treat for bringing up a low. I’m not talking about a single blueberry or strawberry, though: I’m talking either an apple or a banana – something that has some genuine carb content to it in a single serving.
9. A couple handfuls of cereal. This is a riskier choice because the lack of restraint I have around cereal when I’m low, but who else can relate to waking up at 2 A.M. to treat a low and being too tired to measure something out, so out comes the cereal box and handful after handful of Lucky Charms or Cookie Crisp are consumed in a very short span of time?! There’s no questioning cereal’s efficacy in a hypoglycemic situation, but when it comes to controlling the amount eaten…well, that’s a hard thing for me to do.
10. Fruit snacks/gushers. Embarrassing story from my childhood: Remember those commercials in which kids who ate gushers had their heads turn into giant pieces of fruit? Well…I was convinced that eating gushers would lead me to the same fate, so I avoided them until one day I finally realized it was just a stupid commercial (albeit with very freaky graphics) and it was totally safe to consume gushers. And thank goodness, because they’re delicious and great for lows! So are fruit snacks of just about any variety, though I’ve had the most luck with Mott’s and Welch’s fruit snacks.
Do you have any low blood sugar treatments that I didn’t mention here but should consider trying? Drop a comment to let me know what it is and why it’s your favorite!
Peanut butter and jelly. Batman and Robin. Mickey and Minnie. Name an iconic pair, and…
…I can guarantee that it won’t be conference calls and low blood sugars.
Indeed, I can attest to how much the two DON’T belong together because I faced a rather annoying one the other day.
It happened during one of the many weekly meetings that I now attend virtually along with the rest of my department at work. Not only do I have to dial into these meetings, but there is a video component, as well. Fortunately for me, all that I’m doing is listening during these meetings instead of talking, so I can stay on mute for the duration of most of them, and occasionally make various facial expressions that show I’m listening.
So I was, indeed, on mute when the shrill BEEEEEEEEEEEEP BEEPBEEPBEEPBEEP of my CGM receiver started. And thank goodness I was, because that sound is enough to derail anyone’s line of thought.
But rather than address the low right away, I was a little stupid about it.
I decided to wait as long as possible before I corrected it.
I know, I know – that’s a dangerous game to play. But hear me out! My meeting was running from 12:30 to 1:30. I planned on having lunch right after the meeting, and it was already 1 o’clock when my CGM started shrieking. I thought I could wait to treat it with my lunch food…but that’s not what ended up happening.
I started feeling low, low. Like, shaky, sweaty, unable to focus on anything that my group was discussing, and ravenously hungry.
So I did what any person with diabetes would do when their blood sugar is that low – the only thing to be done, of course, was to whip off my head phones, turn off my camera, sprint into the kitchen, wolf down a handful of raisins, and jump back onto the call.
Oh, and turn off the camera again for another 30 seconds or so (in the 15 minute window of time it took for my blood sugar to stabilize) to capture a picture of myself on the struggle bus that is the recovery process from a low.
The whole ordeal stood out to me because it’s very different from the last low that I remember experiencing during a work meeting. That one happened when we were all still in the office, and I had to get up and dismiss myself from the conference room so I could grab a package of fruit snacks from the office kitchen.
That one was much more disruptive, but I handled it much more promptly than this one.
This one wasn’t even noticed by a single person on the conference call (and if someone did see me pop off camera for a moment, I’m sure they just assumed I was having connectivity issues).
This one I didn’t react to immediately, and I ended up being punished for it because I missed out on some meeting information due to my inability to concentrate and the need to finally treat it.
This one and that one do have one thing in common, though: Low blood sugars absolutely do not complement meetings, conference calls, or any sort of work-related task, ever.
It seems like a new fitness trend is “going viral” every week: between aerial silks, SoulCycle, and at-home fitness mirrors (in which a real trainer appears in your mirror and you get to watch yourself while they talk you through the workout – whoa FUTURISTIC right?), there is a plethora of ways to get physical that don’t involve standard, boring weights or treadmills.
I recently had the opportunity to try one of the most random, and possibly cutest, fitness craze…goat yoga. Yep. Yoga, but with goats.
It’s exactly what it sounds like. You move through a series of yoga poses, but there just happens to be adorable baby goats roaming around the class. They aren’t shy about making their presence known, either. When they aren’t bleating or searching for goat treats under your yoga mat, they’re actually JUMPING ON TOP OF YOU. It doesn’t matter if you’re in a tabletop pose (see my photo, above), downward dog, child’s pose…they’ll find a way to climb on you and turn you into their personal jungle gym.
It was a little disconcerting at first, and it was damn difficult to focus on flowing through yoga poses because you didn’t know if or when a goat would hop on your back or accidentally brush up against you with its horns.
And it was virtually IMPOSSIBLE when my blood sugar went low halfway through the class.
I knew that I was starting to feel off after I completed a short series of bird-dog crunches. I felt oddly exhausted after doing five on each side, so I went to go check my CGM data on my phone when I realized I didn’t have access to any, because I’d just inserted a new sensor that morning and the warm-up period wouldn’t be complete until the end of the goat yoga class.
Great timing on that one, Molly.
I decided to give it a few minutes before I took any corrective measures. So I just sat there, watching people struggle to get bendy with goats running amok. It was really pretty funny, but my sense of humor was shot, thanks to my low blood sugar.
I’m a little embarrassed to admit that the goat factor also prevented me from correcting my low right away, but…well, those things were germy. They’re farm animals, of course they will be messy and smelly. But they were literally peeing and pooping on our yoga mats, and precariously closely to our clothes/bodies. Forget feeling like I needed to sanitize my mat when the class was over – I felt like I needed to power wash MYSELF, at max intensity, just so I could feel totally clean again. So the prospect of checking my blood sugar in the middle of everything seemed absolutely unsanitary and virtually impossible.
But…like, I had to suck it up. After all, I didn’t want to do that thing that goats do, which is faint. Except they do it in a semi-cute way, and because they’re born with a condition that causes muscles to seize up when they’re startled. And there was no way I was about to faint due to a stinkin’ low blood sugar in front of a bunch of strangers and goats.
So I forced myself to navigate to the clean, protected patch of land that my backpack was perched on, dodging poop balls on the way over, and immediately grabbed my hand sanitizer so I could cleanse myself before reaching into my backpack and consuming a small box of yogurt-covered raisins. I still felt gross about it, but I did the right thing and took care of myself.
And I’m happy to report that by the end of the class, my blood sugar was on an upswing and not one goat had peed or pooed directly on me. Sweet success!
I want to change how I react to high and low blood sugars.
Well, I think that it’s about time for me to address my intense fear of low blood sugars, but I also feel that I need to reconsider how I define high blood sugar. I’ve been sick and tired of dealing with constant highs, sprinkled with a few lows, so all of that together has motivated me to come up with a plan.
My plan is two-fold:
Step 1) Change the low and high thresholds on my CGM from 80-180 to 75-160.
Step 2) Pay closer attention to my body’s cues when my blood sugar is low.
The first step was extremely easy to follow. I modified the settings on the Dexcom app on my phone so I’m only alerted when my blood sugar goes above 160 and below 75. I’m hearing my Dexcom alarms more often as a result, but I’m also responding to these alarms more frequently, meaning that I spend less time overall above/below my goal blood sugars. It requires a little more work and patience, especially since I experienced a lot of stress and a cold in the weeks since I’ve made the change (stress + sickness = shitty high blood sugars), but I know that it will be worth the effort.
The second step is slightly trickier. I’m the kind of person who starts treating a low blood sugar early – I’m talking as “low” as 90. And that’s not low. Unless I have several units of insulin onboard or I’m about to do a moderate intensity workout, there’s no need for me to eat anything when my blood sugar is 90. But it’s easier said than done, because I actually do start to feel low blood sugar symptoms at 90 (not all the time, but definitely a chunk of it).
So I’m hoping that this is where step one will come in handy. I’ll use my new low threshold on my CGM to reorient my body’s recognition of low blood sugars. I’m also going to work on not panicking when I start to feel low…because I think that’s the real root of my problems. In the last several years, I’ve developed – for no apparent reason – a serious low blood sugar phobia. I do everything I can to avoid them at all costs, and that’s probably contributing to my recurring high blood sugars. And that is definitely not good.
I’m over living my life on a blood sugar roller coaster…so I’m looking forward to smoother sailing with this plan of mine. Updates to come, for sure.
Okay, to be TOTALLY honest, low blood sugars aren’t – and won’t ever be – fun. Nine times out of ten, they can be inconvenient, upsetting, and even scary (depending on how low it is). But like most things associated with diabetes, I try to look at the bright side every now and then to remind myself that it could be worse. So even though I don’t welcome low blood sugars in just about any circumstance, I decided to look at them, and their less-than-pleasant side effects, from another perspective. Hence, this three-item list that explains what makes low blood sugars slightly more tolerable to me.
The sweat. I detest sweating. I don’t care if sweat is the result of a good workout or a day spent at the beach – it’s gross either way. And it’s definitely not an attractive low blood sugar symptom. But…on the other side…I tend to sweat a LOT when my blood sugar is low and it makes me feel like I’ve just had an excellent workout without any effort or exertion on my part. So I guess it’s kinda like gleaning the health benefits that you’d get from sitting in a sauna for a bit? IDK…it’s a bit convoluted but just agree with me on this one.
The excuses. I’ve made it a personal mission to try to avoid using my diabetes as a scapegoat. There are times, though, that it really does prevent me from doing something in a timely manner/when I’m asked. For example, if I’m experiencing a low blood sugar at work and a colleague comes by to talk to me and ask me for something, I do find it’s best to let them know that I can’t attend to it right away because of the blood sugar. Nine times out of ten, people understand, and they let me treat it accordingly. And it gives me time to just relax and deal with it, taking the stress away from a situation by simply being honest about it (so I guess it isn’t really an excuse, but sometimes I feel a little guilty about using a low as an out on something. Low guilt is real, people!).
The cake. (Or really any food when you’re low. Because it all tastes delicious. But nothing is quite as satisfying as cake.) I think the inspiration for this blog post came when I was enjoying a big, fat slice of cake in order to bring my blood sugar back up. My goodness, some foods just taste beyond amazing when I’m using them to treat a low. The sweeter it is, the more satisfying it is to both my taste buds and blood sugar levels. And anyone who has experienced a low blood sugar before (people with and without diabetes) can attest to the fact that food is simply a million times better when it’s being consumed at a time that your body is URGENTLY telling you to feed it.
Alright…now that I’m looking back at these three things, I’m kind of laughing at myself. Because I can TRY to make low blood sugars a more positive thing, but let’s be real, they still kind of suck. But I guess there’s no harm in trying to be upbeat about them.