How to stay calm during a low and how often do you have one

How do you react when you are rapidly dropping or low?
I tend to freak out. Any ideas on how to stay calm? How often do you have a low?

Hey Lil MaMa:

I had a nasty and unexplained one in the middle of the night last night. I keep glucose tablets and/or glucose liquid always within reach - on my nightstand, in our cars, in my briefcase, in my luggage, etc. I know exactly by how many points each tablet or bottle of liquid raises me. I ingest accordingly and then wait it out. Its a horrible and uncomfortable experience, and I fight the urge to eat everything in sight, but I ultimately know that if I wait it out I will return to my target range.

Dex 4 sells tablets in 1g and 4g increments, as well as 60ml bottles. Once you know the impact of each dose, key is just to let it work and test every 15 minutes afterwards. I now have confidence in how it works, and giving me this level of control is what ultimately helped me get over panicking over a low.

Hope this helps and good luck!


I look at it the same way I do my asthma when an attack hits because I already know what will happen if I freak will make things worse so staying calm is very important also keeping candy or juice handy.also it’s important to know the warnings that your body give so that you have time to head it off at the pass.dealing with T1 or T2 is a lot but I see it as a way to make sure your always putting yourself hang in there and take it one day at a time

Adrenaline release is a natural part of the body's hypo response at least for many of us. Yes it can be disconcerting!!! The first hypo symptom I learned how to recognize was holding out my hand in front of me and see if it is shaking due to the adrenaline. Today it is not always the first hypo symptom - I am more likely to sense that I am fuzzy-headed before the adrenaline hits. This might be me becoming more attuned to hypo symptoms but I think the adrenaline response to hypos is nowhere near as reliable or strong as it was when I was very young.

You might read about folks who were say driving when they went hypo and got in an accident and you wonder "why didn't they stop before they got so low?". The answer too often is, the adrenaline release makes it very very unnatural to stop.

I find the hardest part of treating lows is the waiting to come back up. And those lows that happen while there is IOB and you are low plus still heading down are scary, too. When I have a bad low I treat it and, depending on how bad it is, I will either set a timer for 15-20 minutes and wait it out, or else I'll treat with a ton of glucose and then bolus for any over-treatment that I think I've done (I only do this if I know I'm crashing hard). I keep glucose tablets everywhere and I also have a phone (landline or cell phone) that I keep on my nightstand. I keep glucagon, but in reality I don't think I'd be able to use it if I needed it, unless I was micro-dosing during an illness or something.

I have memories of very bad lows as a kid - passing out in front of my family, not waking up in the morning, collapsing in the middle of my high school hallway, knowing but being unable to communicate that something was horribly wrong while my mom was out running errands - and so I do have a certain amount of fear around lows. But, after 23 years, I don't get scared of every single one. I think the most important thing is to be prepared, even over-prepared, and not ignore a low in its early stages. Also (and I am horrible about this) letting someone know that you are having a low if you are having a particularly bad one (where you feel like you might pass out).

I have at least several lows a week, but I only have one or two "bad" lows a year, I'd say ("bad" being where I'm extremely low or almost pass out). I don't currently have a CGM so don't get any warning of dropping BG unless I happen to test or feel the drop. Not sure if my feelings towards lows will change when I get a Dexcom in the near future.

I used to do the same thing when I was a kid - I'd sometimes hold out my hand and ask a friend if it was shaking (I couldn't see if it was, myself). I had hypo unawareness even as a kid, though, so I often had lows hit with no warning. As an adult I'm actually better able to detect them because I pay close attention to how my body feels. Even with that, though, I tend to feel lows at about 3.1 (55 mg/dl) with very vague symptosm like feeling really tired or my concentration being slightly off. No shaking or sweating or panicky feeling at all. It's very easy to miss if I'm not paying attention. I also don't feel highs much, and can easily test and find myself at 14 (250 mg/dl) with no symptoms. It's one reason I'm hoping a CGM will really help me - it will let me know if I'm high or low rather than me just happening to discover the next time I test or waiting until I'm way, way out of range to start to feel symptoms.

I haven't kept track of my lows but I would say at least a few per week that are mild and I head them off at the pass. My dex is set for 80, at which point I can decide if I need a glucose tab or some food. For a bad low I don't measure anything, sometimes don't even waste time to test- I can usually tell from symptoms but if dex has alerted me and I'm not sure I will test. I just take glucose tabs and or drink juice/glucose drinks and then monitor my symptoms to make sure I'm not dropping more which has happened.

Bad lows are awful. I tend to say to myself: you will be ok, you will take glucose tabs etc. and it will be alright, although I'm not religious I sometimes say a prayer too, and this keeps me calm as well as if I'm home one of my cats who seems sensitive to my lows is often there to help me through it. My first reaction is fear/oh **** here we go again, the anxiety is actually a symptom of the low although one of my typical symptoms is feeling bad tempered, that or anxious.

If it's bad enough I tell someone I may need help. I have glucose tabs/candy/drinks all over, in my purse, in my car, at work, in my coat pockets and a whole diabetes shelf with everything right by my bed. I can often feel a sinking low in the 120's but then I will monitor and see what happens or if I think I'm going to drop a lot due to whatever I start a little glucose going first. My goal is to never get to the bad hypo territory if possible.

I just had a low on Christmas, felt weird and tested and was surprised to see 27, tested again to double check, 23! I took a couple deep breaths, sat down, and asked my husband to bring me a couple glucose gel packs. I didn’t feel faint but since he was home I figured I’d sit down just in case and let him help me out. Had I been alone I would have been more freaked out but seeing those numbers on my meter was not too fun for sure. Once I got the gels down I reassured myself my BG would go up, even if I did pass out. I’m new to insulin but I’d say figure out what product works best for you and like Christopher said keep it with you always. Then treat and breathe:)

Yeah, it's normal to get's your body's way of telling you to eat now! But it's also common to overtreat, which causes more problems later. I've finally figured out that it helps to hold and swish the chewed-up candy or juice in my mouth for 2-3 minutes before swallowing, which gives it a head start by seeping in through your mouth membranes and under your tongue. There's the 15/15 rule...15 grams of simple carb, wait 15 minutes, and if still low 15 more grams and repeat. Give it a try next time and I hope it helps.

Lots of wisdom here. But the 15/15 role is incoherent, it's basically just two pretty numbers. It *is* a good idea to wait an interval of time, like 15 minutes, to give carbs a chance to stabilize your BGs. But the notion that 15 grams of carbs is the right amount in any hypo scenario, for any person, is utterly incoherent.

A better approach is to try to assess your personal carb to BG raise ratio, e.g. how much does a 4g glucose tab raise your BG, and therefore how many do you want to take to get back to your desired BG levels? Of course, if you're counteracting injected insulin and dropping rather than stable at a low number, that has to factor in, too.

And agreed, it's hard to avoid the munchies when you're low. Sometimes I'll munch and dose insulin, sometimes I'll munch on low carb things like almonds, but neither of those is optimal, the former because you risk rebound hypos, the latter because protein and fat will slow the absorption of carbs into your system.

Ironically, I had a pretty bad low last night. I was 14.5 (261) after dinner (which I measured, grr, but it was somewhat high carb and I was high before eating, so not totally unexpected). I corrected that at 9:00 and went to bed around 11:00 - my bad for not testing at that point. I woke up out of a dead sleep at 12:30 and knew immediately that I was low. Tested at 2.2 (40) and still had almost a unit of insulin on board so I think I was headed down even further. I ate a TON of carbs, but kept track of what I was eating. About 25 minutes later tested at 5.2 (94), bolused for 50 grams of carbs, and went to bed. Woke up in the morning at 5.6 (101) so, that time at least, it worked out well. I've been going insanely high after meals a lot (like significantly higher than I was last night) and then crashing fast when I correct, so I think I need to start pre-bolusing at least half an hour before eating...

Keep glucose tablets on or nearby at all times. when you get or feel low, check your blood and take a tab or two..or however many needed. If you can't check for whatever reason and you feel low, take a tab and wait a bit, if you still feel low then take another, and so on.

I used to panic with every low until I came to my senses and started keeping glucose tabs with me...and my meter. Now I have no reason to worry because I am always prepared.

Well, now I only worry a bit at night because I have yet to get a CGM. That will make sleeping much more peaceful.

I totally agree that you need to find out what your ratio is for how much you need to raise your BG. But for many people, 15g raises BG roughly 50 points. If she is uncomfortably low and the adrenaline is pumping, she is probably 60-ish or lower, so the 15/15 rule is just an easy one to remember especially if feeling loopy. If I'm only at 72 or something, I'll just pop 2 Mentos or a few Skittles and that's enough to get me back up to 90-ish.

I hear you, and agreed 15g carbs is not a terrible starting point, even if it's rather arbitrary.

The really important thing I didn't realize when I was first diagnosed is that it's key to take fast-acting carbs and as little fat, protein, and fiber as possible, because all of those will slow the speed with which the carbs affect the blood glucose.

if you are prepared and learn to recognize your bodies warning signs, then the anxiety should lessen. You could always set an alarm on your CGM or if you don't use one, like me, you learn your body warning signs. It might seem weird but i get dry mouth and almost chapped lips feeling when i go below 40. When i notice this i can go for some OJ. It also helps to keep glucose handy at work, in the car, etc.... Another big component to low blood sugar is the mental in-ability to process thoughts, almost like you are immediately drunk, that is why it helps to keep the process simple and to have a course of action mapped out. If i am home, straight to fridge for juice, if i am at work, right desk drawer for the glucose tabs. Then breathe, then check my sugar. I have been as low as 16 and have felt totally normal with a blood glucose reading of 29. Everybody is different, you just have to learn what your body is telling you and that comes with time.

Remember to breathe, not panic, have a plan, and most importantly enjoy those sweets guilt free for once.

I have lows with various frequency; usually one or two a week and sometimes more in clusters, like this week as I'm traveling. I don't really panic. I just go into response mode: Test and take glucose tablets, test again in 1/2 hour, etc. Oddly enough I do better when I'm alone, because I just do what I need to do. When I'm around people I get distracted and it's more difficult to go on automatic pilot. I don't eat sweets (no sugar for 20 years) and I find glucose tablets act the most quickly.I have them in my purse so they are always with me and in my nightstand by the bed. I am lucky that I have never gotten the munchies, so I don't have the desire to eat mindlessly or over-treat.

Most of all I remain confident that I will be ok, so the element of panic is removed. I had one bad low before I understood how to use insulin and went unconscious but my liver kicked in and then I could manage it myself, though it felt like moving through molasses. Since then I've been down as low as 25 and while I was definitely altered I was able to function to deal with it. So I act but don't feel fear or anxiety. In general though I'm good in emergencies. Little series of crises....not so

It makes a newbie like me feel better Zoe and Marky to see those low numbers and hear how you deal with them. Even though I was in the 20s and still functioning it did scare me, I feel better hearing about other people’s experiences.

I've measured in my 20s a few times in the dozen years I've been diabetic (I'm not confident enough in our meters to conclude I was actually in my 20s, though I suppose technically I could just as well have been lower rather than higher). Pretty intense experiences--tunnel vision, very impaired brain--but at least for me, still able to function. The worst is on the way back up, because when I pass 50 or so on the way back up is when my body seems to realize I was brutally low and then the cortisol, adrenaline surges and I get shaky, sweaty, and miserable. It is reassuring, somehow, to read about others' experiencing similar things.

I just eat the carbs and watch an episode of my favorite show, then continue on with my life.

Yes that’s true for me too niccolo, going up was worse. Had a lot of palpations and felt crummy for quite awhile.