Low Blood Sugar: View From the Bottom of the Well
by kerri morrone
Lows are always described in clinical terms - "The typical threshold for hypoglycemia is 70 mg/dl (3.9 mmol/l) and symptoms include shakiness, sweating, and disorientation." But "under 70 mg/dl" doesn't describe how a low can feel . . . as though my body has betrayed me and won't move as I have asked, like I was a robot who had been over-oiled. Those words don't even scratch the surface of how it feels.
Sometimes, the same number on my meter can feel completely different in my body. I've had moments when I've been in mid-conversation with my fiance, chatting away intelligently about a story idea or wedding plan, only to feel the twinge of a headache creeping in from behind my eyes. My mouth starts to tingle a small bit, and the edges of my temper become tousled.
I'll reach absently for my meter - "I feel a little weird. I'm just going to test really quick" - and prick my finger without missing a beat in the conversation, even though the words are hitting my ear and spinning, like a marble in a drain, before dropping into my consciousness. I finish my thought or listen intently to his, and the meter counts down and the result flashes up: 49 mg/dl (2.6 mmol/L).
Even if I didn't feel too bad before, seeing the low result brings the symptoms flooding to the surface. But being low in the middle of the day also includes the sounds of the voices in my office, or the strong hands of my fiance on my shoulders, or the white noise of humanity streaming in live through my windows. I'm not alone; I'm accounted for.
It's when those lows visit in the early morning hours, when the rest of the world seems to be asleep, that a thread pulls loose on my composure.
Recently, I had a low blood sugar in the prickly cold hours of the early morning, around 4 am. It's like waking up in stages: my eyes flutter open and I take note of the fact that my forehead is damp with sweat, my hair stuck to the pillow and my body overheated. I was trapped inside, screaming "Wake up, Kerri! Wake up now," but my body refused to respond. All it let me do was toss aside the blankets in an effort to release the heat. I sank back into a fitful sleep.
About twenty minutes later, I woke up again. This time, all I did was dart my hand over to the bedside table and switch on the lamp. My shirt was melted against me; my face was cold with sweat. My meter case was open and lying next to me, but I couldn't remember testing. Did I test already? I start to wonder but sleep reaches out and claims me while my questions yell up from the bottom of the well.
Almost half an hour later, I wake up again. Without giving my body time to second-guess my actions, I reach out for the meter. The comfort of this familiar action takes over, and I load up a strip and prick my finger. Watching through my low lens, I grab the bottle of juice from the bedside table and open it, but can't bring myself to take a sip without seeing the result. It appears after five seconds: 49 mg/dl (2.7 mmol/l). I drain the sport bottle of grape juice in a few, desperate gulps, careful, even in my low stupor, not to stain the sheets.
Collapsing back onto the pillow, I realize it's wet with my cold sweat. Even though I want nothing more than to let my head sink into the softness, I force myself to flip it over so I'm nestled against the drier side. Strange, robotic movements that bring me comfort when my numbers aren't friendly.
"It's okay. You're okay." My fiance puts his hand on my shoulder to comfort me.
And I lay there, at the bottom of the well but slowly coming back up to the surface. Wishing I could tell him "I know," but instead these tears fell out and my mouth wouldn't make the words.
A low blood sugar is complicated.
Diabetes, as a whole, is complicated.
And my fears related to diabetes are complicated, too.
I read about the diabetes-related retinopathy, the neuropathy, and the ways that diabetes can weaken my heart. These complications don't seem real sometimes, like threats in the distance, as I sit here in my twenties and in very good health. But they need to be regarded with a healthy amount of fear and respect in efforts to make the later decades of my life just as healthy as the first few.
In stark contrast, the complication of a low blood sugar is immediate. It is something that I prepare to face every day, from the tube of cake gel in my purse to the glucose tabs in my glove compartment to the bottle of grape juice as a permanent fixture on my bedside table. I have had the benefit of a very high tolerance for extremely low numbers, but every year that increases my hypoglycemic unawareness, leaving me numb to symptoms of my lows until I'm close to 50 m/dl. They sneak up on me as I exercise to keep fit, as I edit articles at my office, and as I sleep beneath a mountain of blankets.
Low blood sugar is that monster in my diabetes closet, the one that lurks in the corner of my mind, never completely asleep. And I'm prepared to battle this foe at any moment, armed with juice, technology, and a steely determination to survive.
