Two years ago my daughter ran away from me in a store while I was suffering from low blood sugar. One minute she was beside me as I fumbled for glucose tablets and drank juice. The next minute she was gone. She was three years old at the time. Fortunately, I had the presence of mind while low to check the toy department first. That’s where I found her, on a shelf of an endcap and behind some toys.
My daughter, now five, has sensory processing issues that cause her anxiety in public places and it can be hard to engage her attention. I long for the day when I might explain to her that she should stay by my side until I recover from hypoglycemia or that she should ask for help from a stranger, but she is not there yet. She doesn’t understand the threat of a low blood sugar. We’ve talked about 911 and she knows that I need glucose when low, but she doesn’t have a frame of reference for me actually not being able to help myself because she’s always seen me recover. And in stressful situations, due to her particular special needs, she shuts down.
Being a parent and being a person with diabetes are not always conducive. My decisions about my care – short term and long term – affect the safety, security, happiness, and well-being of my children. A failure to eat the food I dosed for in a timely manner because I had to change a diaper and then clean up a messy highchair suddenly becomes a situation where my children are in danger of Mom passing out. A slip of the memory to dose insulin before a meal and I’m feeling too high and sick to play and I’m edgy and curt with my kids. But for me, it’s the weekly grocery shopping trip that represents the heart of parenting with diabetes.
I have a lot of low blood sugars at the supermarket despite my best precautions, like lowering my basal rate before I leave and snacking on glucose tablets as I stroll the aisles. Like so many activities in diabetes, the same management techniques don’t necessarily work for me every time. An ongoing joke in the online community is that Target must pump insulin through the air vents.
Shopping doesn’t count as intense activity, by any means, but the walking and cart-pushing are a calorie burn, nonetheless, and between my diabetes and the added responsibility of parenting young children, the act of grocery shopping continues to vex me.
As you can imagine, suffering a hypo while alone in public can be scary, but suffering from a hypo while alone in public with my kids is something else entirely. Two recent shopping trips illustrate the difference between my needs as a type 1 in a supermarket and my needs as a parent with type 1 in a supermarket.
Trip number 1 – alone. A particularly bad drop had me sitting on aisle 8 for over half an hour while I recovered. I had my Nightscout rig (cloud CGM software) reporting my Dexcom data back to my husband at home. I had my phone with me. I drank a juice I hadn’t paid for yet. I ate a snack from the shopping cart. Thirty minutes of sitting on aisle 8 looking to the outside world as though I really couldn’t pick a bag of rice. People walked past me. I could have grabbed any one of them and asked for help, but I was okay. It was scary, my low brain wondering “what if?” and feeling out of sorts. But I had someone who knew where I was and that I was hypoglycemic, I had access to food and drink, I was telling everyone on Facebook about being stranded by my low. I knew I would be all right soon though. I was following standard protocol: check, treat, and wait, hoping you don’t lose yourself.
Trip number 2 – alone with my daughter. A particularly bad drop again. She kept trying to run from me. I was panicked. I made her sit in time-out in front of a display and I ran to grab a bottle of juice from a nearby shelf. I was seeing spots. I tried to keep talking to her. I gauged her understanding of the situation. She didn’t comprehend why we couldn’t move on, so we argued. I ate a snack from the cart and drank the juice. She was antsy. I was frustrated. But mostly, I was terrified to lose her.
And that’s the difference. In one scenario, I’m able to maintain responsibility for myself even with a loss of control. It’s what we spend our lives with diabetes preparing to handle. In another scenario, my heart is beating outside of my body and I can’t hold on to it. My blood sugar affects the safety of the things I treasure most in the entire world.
There is no easy, predictable solution to blood glucose management. Highs and lows happen. Every time I visit my endo and her nurse (who does not have much knowledge about the particulars of type 1) asks if I’m having any lows, I say “yes, ever since diagnosis.” The goal of normoglycemia is a nirvana that we reach toward, of course. “Man’s reach should exceed his grasp, else what’s a heaven for,” right? To dismiss my parenting-with-diabetes dilemmas as the story of someone not tightly managed is to misunderstand the volatility of the disease. I’m tightly controlled, but this is the nature of type 1 diabetes. Keeping blood sugars in a healthy target range necessarily means that it’s easy to step just below the threshold into hypoglycemia.
I’d like to tell you that I’ve solved shopping-related low blood sugar (shopoglycemia?), but I haven’t. Each week marches on and the milk and coffee must be replenished. Sometimes the children can stay home with Daddy, but sometimes it’s important that I try with them again, that I continue living and parenting and gauging my little one’s ability to follow my directions. Diabetes does not stop me, but someday, when that long-promised cure comes, I’ll be running to the market. I might just race my kids there.