Lows....Running the Train!

It is hard to accept that we need fuel like plants need the sun. Our cells use chemical energy to operate. The energy in the glucose is used catalythically to create new bindings between the atoms of molecules. Molecules that will operate our complicated inner machinery. Glucose also drives the operation of the cell membrane of nerve cells to conduct electrical charge. The list goes from muscles activity to chaining fat for energy storage to unchaining fat to release body heat.

The brain alone will consume 4g of glucose per hour. Add heart and other muscles, body heat and billions of bacteria in your gut and you will come to impressive figures for our hourly glucose consumption. This is why 48 mg/dl will get consumed very quickly. If your finger is at 48 mg/dl your brain will be lower because the consumption rate is very high in the brain. This is why numbers below 70 mg/dl will start to impact brain functionality. Especially the higher functions like our intellect can be slowed down. This definitely starts below 60 like two devils sitting on your shoulder: test and treat the low VS do what you really want to do. With time I have developed habbits to give the low the highest priority first. This goes so far to rest for 10 minutes to help the glucose to be absorbed. It pays out because I can continue sooner with my planned activities. It is a form of patience with yourself or even humbleness.

Part of the body's hypo response is a release of adrenaline. Combine this with lower cognitive ability and it's very easy to push yourself further and further before stopping.

Glad you made it through okay. I think it's situations like this that have caused the UK to adopt specific guidelines for people with diabetes who drive:


The UK has also told all people with diabetes who take insulin they must take the following precautions:

You must always carry your glucose meter and blood glucose strips with you. You must check your blood glucose before driving and every two hours whilst you are driving.
In each case if your blood glucose is 5.0mmol/l or less, take a snack. If it is less than 4.0mmol/l or you feel hypoglycaemic, do not drive.
If hypoglycaemia develops while driving, stop the vehicle as soon as possible..
You must switch off the engine, remove the keys from the ignition and move from the driver’s seat.
You must not start driving until 45 minutes after blood glucose has returned to normal. It takes up to 45 minutes for the brain to recover fully.
Always keep an emergency supply of fast-acting carbohydrate such as glucose tablets or sweets within easy reach in the vehicle.
You should carry personal identification to show that you have diabetes in case of injury in a road traffic accident.
Particular care should be taken during changes of insulin regimens, changes of lifestyle, exercise, travel and pregnancy.

I hope our government doesn't start getting this specific.

EDIT to add, I really hope no one ever tells me I have to "take a snack" when my BG is 90 [5mml/l] or that 72 [4mml/l] is hypoglycemic.

You and me both, Shadow Dragon! And I thought the U.S. was into controlling things that should be personal choice! "Take a snack" at 90! Stop driving at 72 and wait until "45 minutes after blood glucose has returned to normal!" Carry personal I.D. to show you have diabetes! Yikes! I agree with all of you that I was wrong in my actions, but this is ridiculous! Both that they are trying to regulate this legally and the guidelines themselves!

Great responses all!! I have learned to test and wait...There is a definite cognitive dissonance going on when we are low. As Holger said,( such a cute reference, BTW), those twin little imps on our shoulder are telling us, alternately, to "Treat Now, Sweetie. You can wait, my love.", in a mild, meek voice with blue birds singing in the background. The other one sings, "Keep on truckin', Baby" with the 1970's Eddie Kendricks disco hit pounding in the background. Now of course I want to jam. Yet, LOL, I have to turn off that radio devil and listen to Ms. Sunshine.
Seriously: If I was 48, I would get the glucose tabs, or Capri sun, or whatever I had in the car, poke in my mouth, crunch or sip, swallow, and Make myself waited 15-20 minutes before I tested again and put the key in the ignition.

Many Years ago, when I was young and cavalier about testing, I had a couple of hypo accidents where I hit parked cars . Fortunate turn of events:. In those cases, No one was hurt, both cars were already old, it was on private property; the damage was minimal,drivers were neither inflamed nor interested in calling the Cops (outstanding warrants?). I gave them a bit of ATM money and the issue was taken care of. But it let me know how unsafe it is to drive while low..and scared me so much..
Our responses are so off when we are low. Suppose You hit another car, or worse, a pedestrian while in this state?.. Please test and wait and re-test , Zoe. So thankful you made it home safely.. WHEW!!

God Bless,

So glad you are okay and nothing bad happened. Thank you for reminding all of us to not be in a hurry. And not to be stupid:-)

Guilty as charge, laddie! And it's not like I was late for an appointment or anything!

Thanks for the reminder of what could happen, Brunetta. On our Main Street people do have a habit of stepping out or pulling out into traffic. (California entitlement and bad rural drivers). And going up my curvy hill there are my friend the deer, who I would NOT want to hit!

Hi Zoe, this is one scary thread! (Appropriate right around Halloween time, I guess.) I go low when I go to our local Fitness Center. I put my Kindle in my purse, and if I have to take too many carbs to get normal (40 carbs last time I went), I sit there and read a while. It helps to be involved in a good book! I know this won't be an answer for many if anyone, but I think you have to develop a plan to handle lows when you're driving--your own life can be at stake, along with everyone else's on the road.

40 carbs, yikes! I needed four glucose tabs for this low of 29 (16 carbs). I knew there was a reason I didn't exercise! :) I mentioned that since I wrote this I thought: "I could have gone to the cafe next door for a cappuccino." But my next thought was, "I didn't have my kindle with me so I wouldn't want to just sit there with nothing to read." Good patience-inducer for us compulsive readers! I'll carry it with me.

Zoe - I’m glad to read that you’re OK. I’ve found very low BGs, say less than 50 mg/dl, can sometimes have a normal and wrongly persuasive feel to them. It’s as if I’m more alert and in full control of all my capacities. I feel cognitively stimulated. It’s like a hypo in stealth mode.

Now that my lows are less frequent, my unawareness of lows has disappeared. Do you have hypoglycemia unawareness?

One thing that I add to any low less than 50, is a full glass of water. It speeds the hypo treatment into the intestine and works a few minutes faster. I’ve even had excellent results treating a low with milk. Liquid is better if you have the choice.

What I’m trying to say is that hypos impair our judgement, much like alcohol will, but differently. I’ve had too many episodes like you describe. I’m completely sympathic but you need to change something to not let this happen and you seem painfully aware of this.

I’m happy this ended well and your sharing it here serves to remind a large group, even us long-timers, to treat lows very seriously.

I confess I've done it twice, and that's with a CGM screaming at me.

The second time was enough of a disaster I'm a good boy now. Never been in the 20's, but 40's are enough to put me in a bad way.

The second time I was on my commute to work (30-45 minutes, traffic permitting), and got my first low alarm from the G4 shortly after I hit the road. 30 minutes in, I was in the 40s, shaking and sweating, with mental fog creeping in. I stupidly kept thinking I'm 10-15 from work, I'll just sweat it out and down some juice at work.

After avoiding rear-ending another car by a whisker, I pulled over to a gas station and got a bottle of chocolate milk. Inhaled it, and say there for 30 minutes parked, in a daze, checking (fingerstick) twice, until I was back in the 70s. Felt well enough to drive again, but I was out-of-kilter all day.

Never again...

Yes, I am aware of my hypos, although what number I notice them at varies depending on what I'm doing. I knew I was low in the hardware store. I have never felt the "more alert" feeling; I definitely feel out of it, but I go into "I can do this" mode and try and shake off the vagueness. I like the phrase, "hypo in stealth mode!"

Yes, I posted both to remind others and to remind myself. I have a hefty ability to compartmentalize, which is sometimes very useful, sometimes dangerous. "Outing myself" here is useful to me as well as others, serving as a reminder to take better care.

I'll try and remember to add the water since you say that speeds it up a tad.

Wow Dave!! That was TOO scary.. I ALWAYS have something really high on the glycemic load in compartment on the drivers side door: glucose tabs, jelly beans, Capri Suns. Have made it an almost anal habit.

The other one sings, "Keep on truckin', Baby" with the 1970's Eddie Kendricks disco hit pounding in the background.
That's funny... mine covers Supertramp tunes.

Go figure...

Yeah, and the near-collision didn't snap me to hyper-aware clear-headedness like such things usually do. Rather, I was kind of like, "what just happened?" Only reflexes saved me.

I (almost) always have skittles in my car. This was the one time (never again!) I got lazy and didn't replenish right away.

Now I have a 2lb bag of them in the door pocket :-)

The severe hypos that I've had over the years all had a reptile-brain single-minded "I can do this" flavor that ended up in me passing out. It was during this phase of the hypo that I lost any awareness that I was actually low. I simply went into a moment-to-moment tunnel-vision survival mode.

Your observations about hypoglycemia will serve you well.

These challenges that we face are so under-appreciated by the public at large. Our attempts to convey this message adequately as we start diabetes month sometimes seem feeble to me. It's still good to try, I realize, but I think to really understand, one needs to experience a bad real hypo. And that's not something I wish on anyone!

Wow I don’t know how I missed this topic when it started. I love reading the responses & have been through the same myself, more than a few times. And when low bg effects you, of course your brain isn’t functioning right so it makes it even harder to get it together.

However the thing I do now is keep sugar packets in my car. I have always kept Capri Suns & OJ in my car, but most recently, like over the summer, I was advised to pick up a few extra sugar packets while at the table in restaurants or 7-11. I now keep them in the cup holder so I can see them. I replace them when they are gone. This way, if there’s a low BG episode, they are in sight and near by. One or two of them can usually get me even until I get home, or to a quick meal.

I like the term “running the train” …I usually use the phrase “behind the 8 ball” but I like this better! #RunningTheTrain

Thanks, Hakima. I don't eat sugar but like the idea of keeping my glucose tablets in plain site as a visual cue to TREAT!

I did it in my early days, but I realized I was a hazard to society! I might go 2 minutes or so if I'm stuck on the phone or other inconvenient thing, but no more than that because it just drops so dang fast. I have checked my BG in line at the grocery, during meetings, and have no problem pulling over while driving too. Any time I feel "funny". Lows can also make you feel frantic and even energized, so it's extra important to just stop what you're doing and test. Takes maybe 30 seconds to test and slam some Skittles. To help you feel better faster, try holding your chewed-up candy or juice in your mouth for a minute before swallowing. The sublingual effect can give the sugar a head start in your system.