Sugar and T1D: Friends, Not Foes

For someone who doesn’t eat sugar…. you sure do know how to bake….damn those were good

My coworker sent this to me via instant message as a way of thanking me for the cupcakes I’d brought into the office that morning. Before 11 A.M., a dozen and a half or so “butterbeer” flavored cupcakes I’d created were devoured by my coworkers, who gave rave reviews on their taste, much to the delight of this wannabe pastry chef.

This particular message of praise, though, made me simultaneously smile and cringe: It was that comment, again. The one about sugar and not being able to eat it.

Everyone in my office knows that I have type 1 diabetes. And because I make it my mission to spread awareness of how to react in certain situations that a T1D might encounter, most people I work with know that in cases of low blood sugar, fast-acting carbohydrates (i.e., sugar) are essential as they’re the fastest way to fix a low.

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Sugar saves my life from time to time…and no, that’s not an exaggeration.

But every now and then, I’m reminded that no, people don’t always remember what you tell them about diabetes. It goes to show that there’s always room for more advocacy…which is why I write about diabetes and won’t stop talking about it to those who want to know more.

As a result, I’m constantly telling people that I can and do eat sugar; in fact, it saves my life from time to time. Maybe that’s the subconscious reason why I love baking cupcakes, cookies, and more: For a girl who relies on sugar sometimes, I sure do know that a baked good every now and then is what helps me stay alive.

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T1D and Grocery Store Paralysis

Yellow roses, gallon-sized Ziploc bags, and iced tea. That was all I need at the grocery store. Three items. I should’ve been in and out in five minutes flat, but diabetes had other plans.

It was the morning of my cousin’s bridal shower and as one of her bridesmaids, I was running amok, getting myself ready and prepping like crazy for the party. As a result, it was the kind of morning that left me little time to consider my diabetes and how it might be affected by the day’s events.

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It’s strange to feel such panic and confusion in a grocery store, of all places.

So I didn’t really think twice about having a bagel for breakfast. Normally, I avoid bagels because eating one tends to make my blood sugars run a little high several hours after consuming it. But a bagel was a quick and easy breakfast on such a busy morning. After devouring the cinnamon bagel smothered in cream cheese (hey, if I was going to indulge on a carb-heavy breakfast, I wasn’t about to skimp out on the spread for it), I got a phone call from my aunt, who asked me to run to the grocery store before I made my way over to her house for final bridal shower set-up.

She gave me a very short, very manageable list of three items to get at the store, so I was certain that it would be fast trip. Once I was showered, dressed, and finished with my make-up and jewelry, I loaded up my car with various decor for the party and headed to the grocery store. I parked in a spot far away from other cars so I could pull out of the parking lot easily, and hoofed it into the store.

I’d just loaded my basket with 18 yellow roses (the only 18 yellow roses in the store, in fact), when my CGM started blaring my low alarm from within my backpack. I was surprised – I figured there was no possible way that I’d go low because of the bagel.

And that’s when what I’ll call “T1D paralysis” hit me.

I froze. I couldn’t remember which aisle I might find plastic Ziploc bags in, let alone that I should grab some glucose tablets from my backpack to correct the low. It sounds ridiculous, but truly, I felt paralyzed and panicked as the alarm went off again, this time more urgently as my blood sugar was tumbling down faster than I could’ve predicted.

By some miracle, I did eventually snap out of it (after what felt like 3 hours but was probably only about 5 minutes). Shaking, I found the plastic bags I needed and zoomed over to an express checkout lane, babbling nonsensically to the cashier as he rang me up. I booked it to the car, cursing myself for parking so far away, and collapsed into the driver’s seat. It was only then that I remembered I needed something for my blood sugar, so I fished a box of raisins out from my purse and wolfed them down.

I sighed as I sat there in the car, waiting for my blood sugar to come back up. Three items at the grocery store was all I needed. But what I wound up with in addition to them was a scary feeling of helplessness – completely and utterly immobilized in a setting in which I was the only one I could rely on to help myself – that freaked me out. I don’t know whether it was the abnormally carb-y breakfast or the stress of party preparations, or some combination of the two, but I do know that this sensation isn’t something I want to encounter again any time soon.

 

 

Fearful and Falling in Target

What do they pump into the air at Target? Is it Afrezza or something? Because that seems like the only logical explanation for the phenomenon that seems to occur to most other fellow T1Ds when we step into a Target store.

Low blood sugars tend to happen at Target. Also known as “Target lows”, they can occur at any Target, big or small, no matter how long or short the shopping trip.

I experienced one last week. And it was severely exacerbated by the fact that I was visiting one in my new city for the first time by myself.

You are a rare gem.
Damn you, Target, for making my blood sugar go low during basically nine out of ten visits.

As you can see from my CGM screenshot, my blood sugar was definitely not low – not even close to it. I was in the mid-250s by the time I headed to the store, which is absolutely NOT where I like to be. But I didn’t take a correction bolus or even raise my basal insulin temporarily, because I guess I just had that feeling about my Target trip. I didn’t bother checking my CGM again after I parked, figuring that I’d do my best to make it a quick trip with minimal purchases.

Forty minutes (I’d been aiming for 20) after I’d stepped into the store and one semi-full cart (oops) later, I started feeling panicky and gasp-y. I told myself no, no, no, I wasn’t going low, I was just maybe reacting strangely to the scent of all the cleansers in the aisle I was occupying. I could deny it all I want, but in the back of my mind, I knew that I needed to pull my cart over, dig through my backpack, and locate my CGM so I could at least be informed of what my blood sugar was doing.

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Honestly, Target and all other retailers should just make glucose tablets free to any shoppers who are having a low moment.

So I did just that. Upon checking my Dexcom app and seeing that down arrow, I practically started hyperventilating. That’s when the following series of thoughts flew through my mind:

Okay, just get to the checkout…

Ugh, why is there only one open?! Guess you’ll have to self-checkout on low brain. Great…

OMG, Molly, you know you can only scan one item at a time…go faster!

You are NOT going to go down in this Target. Not today!!!

By some miracle, I successfully purchased my items and booked it to my car. Once I loaded everything inside, I suspended my insulin and shoved three glucose tablets into my mouth at once, chewing them so fast and furious that it probably deserved its own movie by the same name…(oh, but that’s taken *tee-hee*).

Normally, I would wait for my blood sugar to come back up before even thinking about driving home…but this wasn’t exactly a normal situation. I was on my one-hour lunch break from work, and I was rapidly approaching the 59-minute mark. The rational part of my brain (the way, way, super-far-back part) knew that I would be okay after about 15 minutes or so, but I was just so stressed about being alone in a strange city and wanted nothing more than to return to the safety of my apartment, pronto.

Of course, I had no idea how to actually get home – I needed my GPS to get to and from Target, and I’m sure I’ll need it to get basically anywhere for the foreseeable future – so I plugged my address into my phone’s GPS app.

And yet I STILL managed to take a wrong turn or three as I anxiously drove back to the apartment.

Less than 15 minutes later, I was parked and my shopping bags and I were inside my apartment. And that’s when I fell apart, feeling stupid for letting the low happen and getting lost on the way home…and feeling extra dumb for crying so hard about it.

Yeah, methinks that I’ll be running a temporary basal reduction the next time I plan a Target trip. I don’t want to be fearful and falling again any time soon.

 

Should I Have Called 911?

Unintentionally, I set a personal record the other day. I experienced my lowest low blood sugar – 34 mg/dL. I was alone. And it was terrifying.

Around 1 A.M., I woke up to my CGM buzzing and alerting me to what I presumed was a mild low blood sugar. I definitely felt like I was low, so I quickly ate three glucose tablets without checking and confirming my low on my blood glucose meter. And soon after that, things got really weird.

I tossed and turned for 15 minutes as I tried to fall back asleep. But I just couldn’t get comfortable. To make matters worse, a bizarre, numb sensation invaded my left arm. As I became more and more aware of it, my breathing started to run a bit ragged – almost like I was having a panic attack. Between the breathing and the numbness, I knew something was very wrong.

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What would you have done in this situation?

So I bolted upright in bed and grabbed my meter and kit to do a blood sugar check. And that’s when the number 34 popped up on the screen. I swore out loud, and almost immediately began sweating profusely. As beads formed around my hairline and streams trickled down my back, I reached for my bottle of glucose tablets as well as my phone. I ate three more tablets – wondering why the three I’d eaten 15 or so minutes ago seemed to have no affect – and contemplated dialing 911. After all, I was completely alone and there was no telling whether I’d pass out or need assistance from someone. In that moment in time, I craved talking to someone, anyone, who might be able to stay on the phone with me while I waited for my blood sugar to come back up.

Like a complete idiot, though, I decided not to call 911 and instead took to Twitter…*insert face palm here*. I know what you’re thinking, why the eff did I do that? Two reasons: 1) I wasn’t exactly thinking clearly and 2) I knew that someone, somewhere, within my diabetes online community would be awake and possibly willing to talk to me.

Thank goodness my intuition was right…my sweet friend, Heather, who I had the pleasure of meeting IRL five years ago, responded to my tweet a few minutes after I posted it. She offered to call, but by this point in time, I had made it downstairs and into the kitchen just fine and was helping myself to a cupcake I’d baked earlier in the day (oh, how convenient my passion for baking can be…sometimes). I exchanged a few tweets with her back and forth, and before I knew it, 45 minutes passed from the onset of my scary low blood sugar symptoms. I ambled back upstairs to my bed and checked my blood sugar before getting settled back into it. I was surprised to see I was only 72; after all, I’d consumed about 50 grams of carbohydrates in the last hour, and for me, that’s a lot! Most of my meals don’t even contain that many carbs!

Bemused and exhausted, I slumped against my bed frame and distracted myself by scrolling aimlessly through social media channels. My body and my mind craved rest. Much to the relief of both, I was able to get it before long, once I got confirmation from my CGM and my meter that I was finally above the 100 mark. I knew that I’d likely go up much higher (and I certainly did, waking up at 289 the next morning), but at the time, I just didn’t care. All that mattered was that I was going to be okay.

I’ve been reflecting on the incident on and off the last few days. I’m trying to process what happened and how it happened – was it my new Metformin that triggered it? Was it stress that I had experienced earlier in the day manifesting itself? I drank one beer before I went to bed, could that have done it? Did I take too much insulin before bed, even though I was certain I hadn’t? Lord knows that it could’ve been any combination of those factors, or none of them…but I can tell you this: I haven’t taken Metformin since it happened out of fear. I’ll talk to my endocrinologist soon and revisit my dosing plan with her. I can also tell you that, even as I continue to process the entire ordeal, I’m feeling so lucky that I was lucid enough to take proper care of myself. I know there are many other T1Ds who can’t say the same and have experienced much more awful low blood sugar incidents, so I’m simply counting my blessings right now.

What would you have done, had you been in my shoes? Would you have called 911, a family member, a friend? Would you have waited it out?

That Time Low BG Made Me Mad at the Moon

Low blood sugars in the middle of the night are far from pleasant. But they’re especially grating when you’re just trying to have a sleepover with your best friends and your CGM alarms loudly and urgently, rousing more than just me from a peaceful slumber.

Dammit, diabetes…you’ve done it again.

I don’t know how or why the low happened. I went to bed around 1 A.M. – we had stayed up late talking, drinking wine, and eating snacks – and at that time, my blood sugar was 156. You can’t get much better than that, and it felt even sweeter because we’d eaten pizza for dinner earlier in the evening.

I thought I’d be fine overnight. I might come down a smidgen due to the unit and a half I took to cover a slice of fabulous flour-less chocolate cake (utterly heavenly), but I made the assumption that I wouldn’t come crashing down.

I should know by now…never assume with diabetes.

So it happened at about a quarter of four in the morning – a witching hour, in my mind. I woke to the frantic buzz buzz buzzing of my CGM and quickly acknowledged it, then reached for my tube of glucose tablets. I did it as silently as I could, seeing as I was sharing the room space with my three gal pals. From what I could tell, my super slow glucose tablet chewing didn’t even cause my friends to stir. It seemed that I’d successfully managed to avoid waking anyone up, thank goodness.

I was just starting to fall back into a doze when the frantic low CGM alarm blared – BEEP beep BEEP beep BEEEEEEEEEEEP. Ugh! Upon hearing the first beep I snatched up my receiver, silenced the alarm, and scooped up my test kit and my phone. I tiptoed out of the bedroom from which we were all nesting to the living room, where I searched through my backpack for the Skittles I’d purchased earlier in the day…because that’s right, this 3:45 low blood sugar hadn’t been my first in the last twelve-hour window of time.

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Low blood sugar in the middle of the night can make you feel weird things…such as anger towards the moon.

I plopped myself on the couch and started furiously chewing Skittles. I remember looking out to the sliding glass doors and to the balcony and to the parking lot and then finally up to the sky to see the moon shining brightly at me. It was positively dazzling, yet infuriating with its cheerful gleam. I wanted to yell at it to stop looking so happy. I muttered to myself, “this sucks,” and reclined a bit on the couch while I waited to come up from the low.

Everything was fine within 15 minutes. I was on my way up and could safely go back to bed. And again, I congratulated myself for not waking anyone up.

Or so I thought.

“Did anyone hear my CGM go off in the middle of the night?” I asked my girlfriends, approximately six hours after the incident when we were all awake and about to head out to breakfast.

“Yes! I was wondering what that loud, aggressive noise was,” said one. I cringed, an apology lingering on the tip of my tongue, when she continued with an “are you okay? Don’t worry about the noise, I fell back asleep soon after.”

I was grateful for her reassurance, but also for her concern. It felt good to know that ultimately, she didn’t give (apologies for language) two shits about the actual sound that my low blood sugar caused, she was just worried that I recovered from it okay and could get back to sleep soon after.

I smiled to myself. Hours before, I’d been cursing the moon for merely existing and dealing with an annoying, random low blood sugar. But now, I was cruising at a great morning BG and I was on my way to get a delicious breakfast with my gal pals. Diabetes has its moments, but I sure as heck appreciate it when it cooperates during the ones that matter most. So in hindsight, the 3:45 A.M. low was nothing more than a temporary annoyance, and I was just glad that the worst thing it did was interrupt my sleep (and mine alone) for 10 minutes rather than ruin actual precious time spent with my friends.

Hypo and Tongue-Tied: My Woes at Work

“Okay,” I thought to myself as I sat down for my 90 minute meeting, “My blood sugar’s sitting pretty around 100 or so. I should be able to make it the whole meeting without experiencing a drop, since the last time I gave myself insulin was about three hours ago…”

The fact that I had the audacity to think that my body/blood sugar wouldn’t play any tricks on me is laughable.

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This was my recent struggle at work. Usually, diabetes doesn’t interfere with my work whatsoever. I’m sitting, somewhat stationary, at a desk for eight hours every Monday through Friday. There was an adjustment period to the sedentary life when I first started working at my job, but it’s been more than four years now, so my body and my blood sugars are used to it. Plus, throughout the workday, I go out of my way to fit in extra steps, whether it’s using a restroom on a different floor or parking my car far away from my building’s entrance. Combined with my higher activity levels before/after work and regular workweek eating habits, I’d say that I’ve struck a balance in terms of physicality and diet that makes for an optimal environment for my diabetes to function normally/predictably.

So when I DO experience a high or low when I’m at work, it throws me off…but only for a relatively short amount of time. I’m talking like 15 minutes or so here. That’s right about the amount of time I need to come up from a low. If it’s a high blood sugar, I need even less time to rebound. I simply bolus, drink plenty of water, and move on to my next task. (Only in cases of 300+ blood sugars do I get really nervous – it’s only happened a couple of times, but I’ve had to leave work when that happens either due to feeling sick or needing to go home to deal with it.)

But things were different the other day when I was in the middle of a meeting with a colleague and I could feel the slow and steady drop of my blood sugar. Despite having monitored it closely prior to the start of the meeting, it started to coast down. Here’s the real kicker, though – I’m pretty in-tune with my body and could feel that this was not an urgent low. I figured my blood sugar was somewhere between 65 and 75. I didn’t have my CGM or meter to confirm, and I felt like I could keep the meeting going…so I didn’t do anything about it.

And in hindsight – even if it is 20/20 – I wish I had done something.

Why? Mainly because I felt that I was virtually useless in my meeting. As I reviewed each page of the 80+ slide PowerPoint, I could feel my thinking start to deteriorate. Words were tumbling out too quickly and nonsensically. I wasn’t sure if I was making a whole lot of sense to my colleague. And that’s a feeling that I can’t stand. I don’t like thinking that I may have wasted her time due to my determination to “power through” a low. It’s a perfect example of low blood sugar causing a symptom other than shakiness, sweating, or sluggishness: In this case, it also caused stubbornness.

When I finally made it back to my cubicle, I slumped down into my chair and grabbed a juice box from my low supply stash while my CGM buzzed over and over, letting me know that I was indeed low. Within approximately 8 seconds, the juice box was crushed, and I couldn’t help but think how next time I had a meeting, I’d bring one with me…just in case.

My New Low Blood Sugar Symptom

In the last 21 years of diabetes, my low symptoms have been pretty predictable and easily recognizable: shakiness, sweating, dizziness, and sluggishness are all signs that I need some sugar, stat.

But lately, I’ve started to experience one brand-new and totally weird low blood sugar symptom. I’ve decided to dub it “fuzzy tongue”.

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“Fuzzy tongue” or “terrycloth towel tongue” is now one of my low blood sugar symptoms.

I don’t know how else to describe it other than that it feels like my tongue and lips are covered in a terrycloth towel as my blood sugar starts to fall to a certain level, usually 75 mg/dL or lower. Simultaneously, it’s a numb and tingly sensation that feels so disorienting and makes the process of chewing glucose tablets or drinking juice a little more difficult, because it feels weird to eat or drink when my entire mouth feels like it’s covered in cloth.

In fact, the first time it happened, I took to Twitter to ask the rest of the DOC if there was anyone else who had experienced something like that before. And I was comforted by the many responses I got back that assured me that I wasn’t alone in feeling this strange symptom:

“Yes, from certain lows. Sometimes I feel like my [whole] body is buzzing and fuzzy, if not fizzy. Other times, it’s like my body says, “BTDT! Got the glucose tabs! Move on!”

“YES! This is a new symptom for me too (after 17 years of treating lows)..Thought I was allergic to honey the first time.”

“This is a common one for me. Tongue and lips. I hate it”

“Sometimes I get tingly lips or tingly fingers!”

“That’s almost exclusively how I can tell that I’m low”

“YES! If it’s a prolonged low, I get tingly lips and tongue. It’s super weird and really uncomfortable.”

“I get more of the tingling/partial numbness in the lips (‘fuzziness,’ I suppose) that some have described. Usually this occurs with a bad low (under 50 mg/dL).”

Those are just a few of the replies that my initial tweet received. I found these particularly interesting, though, because one person identified it as a new symptom, too, and others implied that it’s always been an indicator of low blood sugar that’s more likely to occur with “bad” lows. In addition to helping me feel a bit more normal about the discovery of my new low symptom, I also found this to be an example of the ways in which the DOC is uniquely unified. To an outsider, this whole Twitter thread probably makes zero sense and comes across as bizarre. But to someone part of the DOC, it’s just another conversation that brings T1Ds trying to get to the bottom of a ‘betes mystery together.

So even though “fuzzy tongue” is uncomfortable, I’m glad to know I’m not the only T1D who’s felt it…and I’m very glad that my body has found another way to alert me to a low blood sugar, especially since it’s a way that makes me want to correct it more quickly than ever before.