The digital clock on my bedside table said 2:11 this morning when I woke up. I had, in the midst of dreaming, tried to put off getting out of bed to correct a slow onset hypoglycemic episode – but deep down I knew there was no avoiding it. There hadn’t been any good cause for my blood sugar to drop. I had eaten a low-calorie salad for dinner with a piece of whole wheat bread and went to bed at 10 pm (early for me!) with a blood sugar of 110. I had not joined friends for a glass of white wine, or snacked. My conclusion? My basal insulin (basal insulin covers an individual’s requirement for insulin 24-7 without food) from 12 midnight onward was too high. I reached for my glucometer and checked in the dark. The blue light illuminated the screen and I counted down 5-4-3-2-1.
My blood sugar reading was 44 mg/dl. I threw off the covers (careful not to disturb my husband), clambered through the dark hall and as I flicked on the kitchen light, noticed my vision was more than a little spotty. I had run out of glucose tablets and Lucozade Sport – a glucose drink that I depend on for low blood sugars. It didn’t matter. At that moment – I had a delicious opportunity to eat something I normally wouldn’t. I opened the refrigerator door, and the cereal cabinet.
My choice? A large glass of non-fat milk and one of my daughter’s Health Valley Toaster Pastries. It’s not easy making choices when you about to lose consciousness so I believed I was doing pretty well under the circumstances!
I started to eat quickly and then gulped down the cold milk – immediately feeling more stable with each mouthful. Standing in the muted light of the kitchen I thought of many things: the beauty of a sleeping household, how our family dog who, poised between me and the counter, waiting patiently for fallen crumbs – was an unapologetic moocher, how my high carbohydrate snack might make for a terribly high blood sugar in the morning, and finally, if eating so furiously could have a poor effect on digestion.
In fact, I began to wonder how eating and drinking too fast might be harming me. Did I really have an excuse for gulping all of that food down in 5 minutes flat? Eating and drinking for hypoglycemia is usually classified as an emergency, but I questioned whether after all these years of eating, not for enjoyment but for practical matters, I had forgotten how to eat slowly. I also wondered if gulping down my food was helping me achieve the effect what I wanted.
I jotted down some notes on the kitchen counter, re-checked my blood sugar (82) took 3.8 units of insulin to counteract a high blood sugar (hyperglycemia) in response to the low blood sugar and the carbohydrates, and went back to bed at 3 am.
In the morning I began to do some research and the first article I found told me that eating too fast:
–Counter-acts losing weight and is a risk factor for insulin resistance and obesity (study from the BMJ): When the brain isn’t sent adequate messages about the fullness of the stomach, we eat more. It’s been reported that many of us eat too quickly or with the TV on, and that this is causing us to overeat. While this doesn’t apply to my hypoglycemic episodes – it does remind me I should slow down.
-Decreases the enjoyment of eating. I wonder how many people with diabetes no longer enjoy eating. I know that eating to compensate for too much insulin is no fun. Again, aside from hypoglycemia, do I really take notice of what I am eating at every meal?
-Results in poor digestion: Also called dyspepsia and common for people with diabetes. Why? Gastroparesis (a condition when the stomach takes too long to empty) is fairly common in people with diabetes because high blood sugars can damage the nerve which controls movement of food from the stomach to the digestive tract. This complication of diabetes is also called autonomic neuropathy and is often correctable. (Persons with high A1c’s are at a greater risk for this). For more information, see the NIDDK website or ask your doctor.
-Causes stress: With so many of us multitasking at work and at home with family matters, do we make time for eating or do we skip meals? Furthermore, it probably makes sense to relax when we do eat. Try not to skip breakfast lunch or dinner. You’ll over-compensate for the missed meal in the end.
-Dehumanizes us: At first, this point seemed melodramatic until I thought about it more carefully. In the end, I agree that eating without thinking does become mechanical.
While this list wasn’t completely what I was after – it did make me realize that even when our body signals us to get sugar into our bloodstream quickly – there are certainly some things all of us could be doing better when we need to correct hypoglycemia (and some of these points apply to eating for nutrition in general):
- Glucose. Always having glucose tablets or a glucose drink available on a bedside table for low blood sugars at night.
- Low fat snacks. Fat slows down food absorption. It might be fun to eat foods like chocolate, such as M&Ms when we have a low, but it is not the best remedy. Furthermore , it can cause unwanted calories and weight gain.
- Gulping! Having a hypoglycemic episode is scary, but if you have adequate sugars ready to be consumed and the low isn’t severe– take it slow. Try not to take in air, and chew the food slowly and in smaller pieces. It will be easier for the sugar molecules to enter the bloodstream.
- Over-correcting. There have been many times after hypoglycemia that I have felt sick to my stomach and have over-corrected the low. Be patient. According to most physicians utilize the 15/15 rule – eat 15 grams of carbohydrate and wait 15 minutes, then check again. Repeat if necessary. Sometimes this rule works well – other times it is not enough. As is the case for most people using insulin to manage diabetes – trial and error and instinct is often the best method.
- Standing up and eating to get it done more quickly – according to dietitians it is important to relax and sit down.
It’s hard being prepared for hypoglycemia without warning, even with the best intentions and care. Remembering the above points, however, (and I am certain that your diabetes educator, doctor and dietitian have more advice to offer – so check with them too) will ensure that you are better prepared and less inclined to suffer a post hypoglycemic high or an upset stomach.
In terms of eating well without regard to hypoglycemia, eating slowly (20 minutes-30 minutes at each meal) will ensure better digestion. It gives the body time to let you know you’ve had enough to eat, and allows the body to access all of the nutrients.
Originally published on diabetes24-7.com