Tough time

The other day I was at work and had a real bad low. I cannot feel my lows but my supervisor found me stumbling around like a dork and worked with several other people to get me some juice and help me back to my senses. It took two bottles of orange juice and a bag of m&ms to get me to 50.

I've been so nervous since then I have been having a very hard time taking insulin to cover my meals. I'm on a pump so I just let it run with the regular basal dose. My numbers have been in the high 300-500 range for the past few days. When I see it, I get so mad at myself, I know it's bad to be that high ONE time, and here it's been several days, but I just can't get myself to do any better. Even today I said "okay I am going to do a really good job today" but then, there I go, by the end of the day I am 458.

I'm not sure this is the right place to post this, but I just need some emotional support right now. D:

I don't think you need someone to tell you how dangerous it is for you to be taking basal insulin but not correcting and covering for your meals.

What are you afraid of? What happened the other day to cause that dramatic hypo? Like, maybe you took too much insulin or you took your bolus but then didn't eat breakfast or lunch for some reason. Are you afraid that you'll get your insulin dose wrong and have another low? Who taught you how to count carbohydrates and calculate your insulin accordingly? Do you need a refresher course?

Are you depressed?

Are you able to look into getting a CGMS? I have trouble with not always knowing when I am low, although I do not get as "crazy" or "spaced out" as I did years ago, being able to have my DexCom buzz me has become very reassuring. While you should not treat based on the readings of either the DexCom or Medtronic CGMS, using one can give you a heads up that your sugars may be changing and allow you to prevent such a large swing in either direction, both of which (high or low) can cause serious trouble.
And your fear of bolusing to cover carbs is valid. That type of low wipes me (you?) out! While to others our behavior when in the clutches of a serious low causing us to act in a manner that if posted on the net would overwhelm any website with hits (chime in here people, how many of us have not behaved in a manner that would scare the pants off of the President's Secret Service detail when we are really low and then to get our sugar up we have to polish off the entire 12 pack of REAL soda)can really affect the stability of any diabetic newly diagnosed or one who has been dealing with insulin injections forever.
It sounds to me from your post that you are aware of your need to work on being more in control of your diabetes. Maybe your goal would be to find a diabetic educator that understands the pump and can relate to your lifestyle. Maybe it is time to change carb ratios? Vary ratios during the day because of activity? Maybe using more square and dual wave bolus would help to prevent severe lows?
Somewhere there is a solution for you, it's just a matter of finding it! Good luck!

I agree that if you know what caused the low, the you can work on avoiding it without the fear. Any idea what it was?

Scary stuff.

Hey i dont think your basal will cover a meal simply because a basal is meant to keep a normal sugar in check so if u r eating carbs then your basal is pretty much worthless compared to your bolus so just keep an eye on your sugar when you inject the bolus. You should talk to your doctor about setting you up on a dexcom monitor its a machine that tests your blood sugar every 5 minutes u r connected to a little sensor and it tells you exactly what u need to know and which direction your sugar is headed whether its up or down and how fast its going up or down.

Lows like that are really scary, especially if you can't figure out what caused them. As others have said, do try to find the reason, but I know from experience that bad lows can come seemingly with no "cause", which makes them that much scarier.

How many times a day are you testing? It would be better to bolus for your food/corrections and test every hour or even every half hour, if you need to, rather than not bolusing at all. Maybe a few days of testing much more often than usual will help you to feel more comfortable.

Really embarrassing to be that out of it.

Have you ever been DKA? If you haven't, trust me that's far worse than a low. You know you're courting disaster not taking insulin other than bolus. Please think about why you're punishing yourself with damaging highs. Is it the low at work, or is it something else?

Great suggestions to go back to the basics to feel more in control so you won't fear lows or be dangerously high.

If you don't trust your pump, then go back to MDI temporarily.

You are going to get low BGs, and you are going to get high BGs. And, even if you want to discover the "why," it is often not possible. The weather can change my BG, for pete's sake!

I had a similar experience last Friday. I will start by saying I do not feel lows most of the time and can function pretty well even at 30; have done that many times. Last Friday, I unusually knew I was getting low. I tested and was 37. Drank 8 oz of apple juice. 15 minutes later, still feel nasty, test again and I am 32. Eat some Skittles; wait, test, now I am at 27. So, I get up to get a Coke (good hint here: if you are really low and having trouble raising the BG, regular Coke works really fast, due to carbonation). Couple of people stopped me to ask if I felt alright. It still took me over an hour, with all that treatment to get to 47. I ate my lunch and took a bolus. Went up to 145, by was 102 by dinner.

I can be blaise about this, however. After 50 years, I have had a lot of lows and have learned to take them in stride. That one bothered me, though because it was so intense--not my everyday low!

Try to look at this kind of thing as an inevitable part of the disease; it may help. You can do yourself more damage than that low would have caused if you let your BGs remain so high. Have you spoken with your doctor?

I'm so sorry that this happened to you. I had a severe low one day at work and one of my co-workers sat with me until I was ok. It really scared her though (and me too). So I totally get why you're afraid. I'm hypo unaware also most of the time and that adds to the fear I know.

What's worked for me to help get over (somewhat) my very real fear of lows is to always be as prepared as I can. I log everything in a notebook (carbs, bg readings, bolus and basal insulin injected, exercise, stress, emotions, monthly female cycle) so that if something like this happens, I can look at my log to see if I can find out why. Most of the time I can. If I know why, I can try to fix it.

For example, I had a couple of fast lows at work both times one hour after eating lunch late...once at 2p.m. and once at 3p.m. My I:C ratio was working fine as long as I ate from noonish to 1 but any later than that and it was too much insulin. So I changed my "late" lunchtime I:C ratio and it hasn't happened again, thankfully.

I also keep regular coke and gatorade in my office within reach so I don't have to get up. I keep a glucagon kit in my purse and within reach at work. I also use a Dexcom cgm as some others here have suggested. I can tell if I'm trending down and many times can completely avoid lows now by popping a few jellybeans to bump it back up.

To combat the fear, my suggestion to you is to bring your blood sugar down in stages by first trying for a target of maybe 150 to build your confidence. That's not an ideal level as we all know but it's better than 300-500 and you can edge it down gradually over a few days building confidence as you go.

Don't be afraid to seek help if you need it. We're here and I'm sure your diabetes educator would gladly help you also.

After 20 years with Diabetes, Its so difficult to deal with the fear to inject myself insulin. The anxiety sensation is horrible. These last 6 months my insulin needs changed dramatically. Some days I need a lot insulin and other days almost zero. Its a horrible sensation but I have to live with it. Right now I am trying to be in the (120-150), instead of (70 - 90).
Last night, without rapid insulin, I drank 2 orange juices, 2 slices of bread and a lot of manies. My BG was 68 2 hours later,hehe. No exercise in 2 days. Pretty weird

I am sorry. If it's any help, I know how you feel. I've had a few instances where I was so scared of going low that I didn't bolus. I know, I know. BAD. But that fear is just so real, especially in the workplace. I don't tell a lot of colleagues that I'm T1 and I have a hard time asking for help from people. I am trying to get better because I know I'm just hurting myself, but.....

Some things that have helped:

1. I keep tons of fast-acting carbs on hand in my office at work. And I always stash some tabs down my bra just in case I need them in the middle of a meeting (easy to step out and chomp them down). I keep juice boxes, gatorade, candy, etc. Having this stuff close by has helped me avoid many scary situations.

2. I test frequently and religiously. On more than one occasion, I have done a test before going into a meeting and found that I was dropping. I don't use a CGMS; personally, I would rather just pay a bit more for test strips because (for me) the CGMS wasn't accurate enough to trust it. I trust my meter more (even with its +/- 20% accuracy).

3. Meetings always scare me because it's the one time I REALLY don't want to drop. If I am lower than 90 going into a meeting, I have 15-20g of fast-acting carbs. At most, this will raise me to about 130-140, which I am ok with if I have to lead a meeting or something.

You have to start bolusing. Being that high is dangerous. You know that.

Do you know what caused the low to begin with? You may never figure out what caused it and that's ok. We all have it happen. A low here and there is far better than the alternative.

I’ve had t1 for over 20 years and have freaked plenty of people out with low bgs so I totally understand where you are at! Lows are embarrassing and scary and when I feel that way I take a step back for perspective- for example I’ know people who have seizures . I’d rather get a low any day considering I wouldn’t make as big of a scene :slight_smile: I like what people have said in reply to your post- work your way back down slowly and PLEASE get a cgm! I just saw on the Minimed website that they are coming out with a machine that you set by your bed at night
That will be loud enough to wake you up. Looks like it will be great! Also keep sugar with you and a stash in your car , desk, and bedside table. It’ll cause less of a scene :slight_smile: and hang in there

It is healthy to have a fear of lows and a fear of highs. They both can be harmful. And the fears help drive us to behave in safe manners. But sometimes those fears can overwhelm us, become obsessive and our emotions will end up causing us to stop acting in a balanced manner. We will "feel" like certain things are more dangerous and risky (like lows) and we will feel safer running high. But in your mind, you know that is not true.

It can be really hard to get back a balance in your life. You may feel a great deal of stress and anxiety when your blood sugar gets to lower values (like 200) even though you actually know that is still pretty darn high.

I'd like to suggest that you try something. Life is all about taking managed risks and there are dangers all around. And facing up to those lows is about taking a managed risk. I ask that you just make one small step towards lowering your blood sugar safely and work to overcome some of the feelings you have. If you stopped bolusing, then bolus half your usual amount for dinner and get the idea that you can still bolus and be safe. It may be stressful, but it is only half and you know it won't bring you down fully. Once you have bolused, you should feel less stress the next time.

Then do that for all your meals, step by step. With time, and exposing yourself to the conditions and required actions that give you stress, you can start to get things back together. Just take this a single step at a time, recognize this is about your feelings, take a single "safe" step and expose yourself to doing the right actions that you know that you need to do and most of all repeatedly do the things that you fear and your overblown fear will fade and you can get your life back.

If you do this, you will work through this. I have faith in you.

Wow, excellent advice :-) I am going to save this for myself. Sometimes my fear of lows (or highs) gets me into bad patterns that I have trouble breaking, if only for a short period of time.

Edgar, do you have an endocrinologist or even a diabetes educator? I'm thinking that it would be wise to sit down with someone and go over what's happening. Maybe someone with fresh eyes can see some ways to help you get things under control.

Good advice bsc, it's exactly what I was going to suggest. Just try blousing a portion, try 10% at first, then 50%, then 75% and you'll see that it can be done. It's hard and can be very overwhelming, I know. I've been as low as 27 and still not able to feel it. Another suggestion is to try and find just one person at work you can confide in. I found Regan, she's understanding and knows to watch for the warning signals of a low and can treat me if needed. It's a wonderful "safe " feeling. I also try and think like the other people. I would feel horrible if my co worker had something happen to them, not know what to do and then find out there was a simple solution that I could have done to help! Good luck