Balancing the Highs & Lows
The truth about blood sugar
Highs and lows happen when we’re talking blood sugar.
Treat LOW blood sugar with a fast source of sugar, such as juice, raisins, fruit leather, sugar pop, or maple syrup (I'm Canadian).
Hyperglycemia: Getting High
When someone with diabetes is talking about getting high it’s not so fun. Having blood go extra sweet is called hyperglycemia in the textbook. There’s nothing hyper about it, except that your blood fills up with extra sugar that has nowhere to go.
Symptoms for one end of the blood sugar spectrum include:
Excessive thirst
Excessive urination
Nausea
Vomiting
Drowsiness
Acetone (fruity) breath
Flushed skin
These don’t happen all at once and vary from person to person. The first two are the tell-tale signs that the blood sugar is up. These symptoms are often similar to the ones experienced with the initial onset of diabetes.
If left too long in the hyperglycemic condition, for example if I didn’t take any insulin, ketoacidosis (DKA) would soon result, also known as the buildup of acid (ketones) in the blood. If blood sugar has been high too long and the body starts trying to burn muscle and fat for fuel, producing acid (ketones) that build up in the body, spilling into the urine. This is what happens to people when starving.
This is what it’s like, misspelling intentionally included.
Hypoglycemia: Getting Low
Also known as an insulin “reaction” or “shock,” low blood sugar, a “hypo” or in the medical textbook, hypoglycemia.
Most of the time it can simply be treated by eating a source of sugar, such as juice, pop, candy or sugar straight up.
Some of the symptoms that are usually associated with low blood sugar are:
Excessive hunger
Headache
Mood changes
Confusion
Tingling of lips and tongue
Sweating
Nervousness
Slurred speech
Unreasonable behaviour
This list is by no means exhaustive and has been compiled from my experience and through speaking with others who have diabetes.
I feel it in my stomach; it’s a frantic, weak feeling. I just know. I become irritable for no apparent reason. Later, I become panicky and I want food like there’s no stopping me. Another way to say this I get unreasonably "hangry."
But hangry for me is more serious than it is for you. Angry hungry. I need food NOW—it’s panic. My body knows this.
I know this sounds scary, but it's the exception to the rule—there are so many days when things work out, and balance is mostly achieved.
What is strange about low blood sugar is that all somebody needs to treat it is a fast source of sugar, such as juice, raisins, fruit leather, sugar pop, or maple syrup (I'm Canadian). If a person is unconscious, however, eating might be a problem. At this point it’s either call the ambulance so the paramedic can set up an IV with sugar and water or an injection of glucagon, the pancreatic hormone that releases glycogen (stored sugar) from the liver.
Stash quick snacks with sugar everywhere you go. In your pockets, at work, at the gym in your locker, around the house, beside your bed.
It’s a good idea.
Going low is a reality for someone with diabetes, but it can be especially tough for other people who are around when it happens. This is a good reason to tell close friends and family that you have diabetes, so they know what to do if you go low. If you have a sugar supply on you, it’s less likely to become a more serious problem.
What's the Goal?
Essentially, then, the goal for people with diabetes is to avoid getting both low and high and maintain the idyllic blood sugar range between 4 and 8 millimoles per litre. Time in range is the percentage you can stay in this range. It’s a lot easier said than done.
Highs and lows happen and it’s part of living with diabetes. Nobody’s perfect. Doctors cannot expect patients to be perfect.
Doing your best is all anyone can ask.