This post is about feelings, so I’ll miss out some facts. You can find facts on my intial ‘diabetic’ post
All you need to know is this:
Hypoglycaemia means ‘low blood sugar’; the glucose level in the blood has fallen so low that the brain-cells are not getting enough fuel. Without getting plenty glucose from the blood, brain cells just don’t work. Trust me.
Diabetics aren’t the only ones to suffer “hypos”, but we are by far the most common. Sure, symptoms can be startling – including fitting and coma – but mostly they are more mundane. One can “feel a hypo coming on”: usually we’ll have treated ourselves with some fast sugar before a stranger has noticed anything odd about us at all.
It’s different for everybody but when I’m going hypo, I feel a little pull of hunger. For most people this means ‘consider eating’; for me it means, ‘test your blood sugar, you need wine-gums’.
But this isn’t infallable. You don’t always, 100% notice the first pang of hunger – for instance, if concentrating really hard on something, like driving a car.
Because of this, we have to test our sugar before we drive. We should be “Five to Drive” (5mmol/l glucose in blood) which I believe the DVLA favour not only because it rhymes, but because it is actually higher than a lot of ‘normal’ drivers (normal being anywhere about 3.7-7 mmol/l), giving us some safety margin for the level to drop. We also have to park up for two-hourly retests. It is extremely unlikely that a diabetic following the rules will loose control and veer sideways off the road. This is why they give me a driving license (reviewed every three years).
Having made my fair share of mistakes involving hypos, these days I check every two hours not only when driving but also at work and at the climbing wall. I am not nearly so pedantic at home, which is when I often depend on just my ‘feeling’ to catch the lows.
So if I miss the hunger stage, it affects my thinking. Sometimes I get a feeling of mild disconnection – ‘there but not there’ – like in a dream. Sometimes I get ‘blodgy’ vision.
Other times I try to think and get stuck. It doesn’t have to be a complicated thought: often it is one of those little decisions we make evey two minutes without realising it. To sit down first, or to pick up the mug from the coffee table? Or if I’m talking, how to phrase my next sentence? In extremis, I change my mind so much that I just can’t get the words out.
On rare occasions even the indecision phase can be missed. If I wake at night and can’t sleep again, I need to test. Or perhaps I am concentrating too hard on a book and don’t notice until I start seeing blotches on the page where a few of the letters should be. Or if I am exercising and my sugar falls very fast: I might take a step and my leg muscles delay for a split-second before they tense to support that step. For that split-second I feel as though they are not going to catch me at all and I am about to hit the ground. Tummy-lurch.
We get used to hypos. Worryingly, the more hypos we have had recently, the more normal we feel when our sugar is low. Some poeple don’t get ‘signs’ at all: they are prone to switching from feeling ‘fine’ to ‘unconscious’ in a blink. To loose one’s hypo awareness must be a huge disability and ever since I heard of it, I pay attention to mine. I aim to pick a hypo up between 3 and 4mmol/l, though it’s lower if I’ve been exercising or concentrating and I am not doing regular tests.
So that’s it: I catch it, have sweets, carry on. If I am caught on the hop, I get flustered and things fly in all directions; sometimes, I am afraid, I can be a bit quiet or rude.
But it wasn’t always that easy.
Pregnant brain-cells take a big leap closer to hypo-unawareness. They seem to function remarkably on minimal blood sugar while in truth they are gagging for food.
Last time I was pregnant, I ignored some hypo warning signs because they were only mild and I was busy trying to get something else done. That was before I properly understood what I just explained: the hypo was more advanced than it felt and I blacked out. An ambulance was called. My one and only time.
But when I was first diagnosed I maintained a ‘normal,’ non-diabetic average blood sugar level by taking too much insulin and causing hypos several times a day. In retrospect this was silly, but I was quite proud of being a ‘good diabetic’ at the time. My GP told me that me levels were exceptional: he didn’t realise I hypod so much. I have lots of good ‘hypo’ stories from the early days. I’ve hypod climbing; I’ve missed my footing and fallen down in roads. I’ve woken dripping in sweat in the middle of the night. I’ve had embarrassing conversations that I have not remembered later.
While travelling in India, I hypod in a busy street and sat down while hubby went to find more sweets. When he came back, I had vanished. I have lost some time here: I don’t remember wandering off. But I do have a dream sequence of running along a dirt-track with a group of barefoot kids. I remember suddenly realising that I didn’t really know why I was following them, or where we were going, or why hubby wasn’t there. Luckily I hadn’t gone far. I said the name of the village and the kids pointed back the way we’d come. I can only think that my liver must have released some stored glucose, because I’d become lucid enough to get myself back.
The first time Mum saw me hypo, she tried to get me to eat one of those sugar sachets that you get on tables in cafes. I tried to explain that it wouldn’t work very well but my ability to form a reasoned argument got the better of me and I literally turned and banged my head against a brick wall instead. That was freaky.
Others have had worse: hypos make you slur and stagger; many’s the person labelled a ‘disruptive drunk’ who just needed a bag of jelly babies. Some people get suddenly violent. Hypoing diabetics have woken up in Police cells.
This sort of thing hasn’t happened to me, but when someone else has seen me hypo I always feel as though I have been inappropraitely drunk. I have lost control and feel exposed and ashamed. After all, I hope to be an example of a diabetic who ‘does things,’ not an example of a diabetic who can’t cope; who does unpredictable things; who makes people unsure.
But if you are a bit unsure of diabetics, let me tell you something: 99.9% of the time, you don’t need to be. We know how to look after ourselves; we carry sugar; we test. Often, we have lived with this for years and know our limits. It’s hardest when we’re first diagnosed; initially I was probably a danger to myself. But if you’ve doubts, then ask us. I love it when people ask me about it rather than making assumptions. It gives me a chance to explain.