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Insulin Reactions – for the Person with Diabetes
If you are on insulin,
Aiming for tight control means you will have more "low's."
- So, you need to KNOW ALL the symptoms (See Cox),
- You need to know when and how your physician/diabetes educator wants you to treat it (and investigate and report back about what seems to work and what doesn't).
- You can be helped by understanding the psychological interplay with hypoglycemia.
Murphy's Law of Hypoglycemia:
Hypoglycemia will always happen at the worst possible time, on the day when you have forgotten your meter at home, when one of your kids drank the last juice in the car, when you are out of cash, and when they are re-paving the parking lot at the supermarket.
It will happen on your first date with Mr. Perfect, when you want to impress your colleagues at a convention but they want to work through lunch, and usually on the day before you go to the doctor.
When do people get in the most trouble with hypoglycemia?
When they DENY that it will happen, that it IS happening, and that it WILL happen again!
Denial: It's not gonna happen
Sometimes you could have predicted it (the small restaurant portion at lunch, the boss' request that you stay and finish something before you go to dinner, your host forgot to put the turkey in so dinner was delayed), and sometimes it comes out of the blue. Stress – positive or negative - can cause changes in blood sugar.
Hypoglycemia, like many things in life, happens when you least expect it.
"I forgot my monitor at home."
"I used to keep food in my car but I don't have any now."
"I can always stop at a convenience store" (unless you're in a bad neighborhood or in the boondocks, )
"I have severe hypoglycemia sometimes at night and I have to crawl downstairs on my hands and knees to get food – but I don't like to keep it in my bedside table."
Is this denial? Diabetes fatigue? Depression?
When I give talks about the psychological aspects of hypoglycemia, I'll sometimes start with some questions:
"How many of you keep food in your car in case of hypoglycemia? (Or a snow storm, traffic jam, major accident on the freeway or earthquake?") I am amazed when I see how few hands go up.
Does it feel like one more lousy thing you have to do because you're diabetic – even though it makes sense to keep supplies in your car generally?
Are you superstitious? (If I prepare and act like it could happen, it will.)
If you did not have diabetes, would you keep food and water in your car for emergencies? What about your desk at work? You could keep things you don't like too much so you don't eat them up.
"It can't be happening now."
(in the security line at the airport, on my honeymoon, when I'm trying to finish these documents, at Disneyland)
Life happens when we least expect it. The longer you wait, the more difficult it may become for your brain to discipline itself to eat.
"I'll eat in a little while."
In a little while, you may be so "out of it" that you have to crawl to the refrigerator. Or, you may have passed out. TEST and EAT NOW.
It helps some people to think of watching for hypoglycemia as being like keeping up their virus protection on the computer. I use MacAfee. I love my MacAfee. When my red MacAfee "M" turns black, it is not working. Usually I need to shut down the computer and restart it. I NEVER download e-mail when my red MacAfee "M" is black. I ALWAYS fix the problem, even if it will take some time. It is not worth risking getting a virus, which could happen when my dear MacAfee is not working!
Humans are not computers. But, it helps some people to think of watching for hypoglycemia as their "virus protection!"
More about hypoglycemia
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