Being hypo-aware

It’s 5.26pm and I’m still in bed. There’s a bag of jelly babies that looks like it’s been mauled by some feral creature on the floor next to me and there are granola crumbs lining my bedsheets. My head is throbbing, as though I am recovering from some sort of bender.  But I haven’t been drinking.  At 10.34am, I had a hypo.

Hypo is a word I had never used before I was diagnosed with diabetes and hypoglycemia was something I had never heard of.  I now know it is when your blood sugar falls below 4mmol/l – a level too low for your body to function effectively.  Without treatment you can fall unconscious and it is a risk I face every time I inject myself with insulin.

The symptoms of hypoglycemia are listed as hunger, sweating, dizziness, tiredness, blurred vision, trembling or shakiness, going pale and experiencing palpitations. This is all true, but a medical list doesn’t really portray the reality.

Having a hypo is a little bit like being drunk, but without the giddiness of being at the party.  It’s like your body and brain have become disconnected and you have no control over either.

This morning, the first thing I noticed was that my little finger was shaking.  At first I put it down to a trapped nerve, but I was trying to write a message and realised my typing was more terrible than usual.  I could tell I wasn’t making sense but didn’t know why.  My heart started racing, I could feel my body burning up and I became increasingly confused and panicked.

I knew something was wrong and I should probably check my blood sugar, but my brain was already becoming too muddled to figure out how to do it.  In this addled state, I had to fumble with lancets, testing strips and squeeze a sample of blood to confirm what I already knew: I was having a hypo. With my body and brain becoming increasingly incapacitated, I then had to treat it.

It is ironic that most people with diabetes probably sleep within an arm’s distance of something sugary. I keep a bag of jelly babies in a drawer in my bedside table.  I started doing this after once suffering a hypo in my sleep.  I woke up so disorientated and had nothing sugary to hand, so I had to crawl out of bed and raid my kitchen. The next morning I found Minstrels strewn across the floor and a frozen garlic baguette in my laundry basket.  I have no memory of how this happened. I now know it’s important to have something sugary to hand at all times – whether that’s when you’re in bed, at home or at work.

To treat a hypo, you need to eat 15-20g of fast-acting carbohydrates.  My treatment of choice is jelly babies (five of them), but others use glucose tablets, sugary drinks like Coke or Lucozade or energy gels.  You then follow this up by eating slow-acting carbohydrates, like a cereal bar or a piece of fruit, and retest your blood sugar to check it’s gone back to normal.

This all sounds simple in theory, but in the chaos and confusion of a hypo having just five jelly babies doesn’t seem like enough.  I panic-eat and then my blood sugar goes too far the other way, which leaves me feeling the hangover. Despite having a hypo this morning, I am still experiencing the aftermath now.  I’ve been sleeping on and off all day and have had a pounding headache. My blood sugar is too high and I’m now afraid of giving myself too much insulin in the battle to get it right.

So why did this happen? I clearly got my sums wrong.  I woke up at 6am to find my blood sugar was a little bit high – 14.7mmol/l when it should be between 4-7mmol/l.  Wanting to start the day on the right track, I thought ‘I’ll give myself a correction dose now and when I wake up my blood sugar will be perfect’.  My intentions were good, but my execution apparently poor.

As I have written previously, I am trying to be much better with my diabetes control and with this comes an increased risk of having hypos.  Just one unit of insulin too much can push my blood sugar below that perfect 4mmol/l.  This means I need to get better at treating hypos and understanding the reasons I have them. I need to recognise the warning signs early, ensure I am prepared and resist the temptation to over-eat.

But, right now, I need to tidy my room and change my bedsheets. I don’t want to sleep in a bed of granola tonight.