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I'm 21 years old. As much as I like to consider myself an adult, I know I've barely lived. Yes, I've been in love, traveled to multiple countries, held a steady job, and seen the sunrise. But I haven't held my own child in my arms, said "I Do" in a white dress, walked across the university commencement stage, or owned my own home.

I have spent the last four years of my life fighting against my health though. A fight that has beaten me down, bruised and broken me both physically and emotionally. A fight that I'm ready to give up on.

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I was grocery shopping when the phone rang. I didn't feel the vibration in my coat pocket; the call went to voicemail. As I was checking out, I checked my phone. Two messages. One from my mom and one from the doctor's office.

"Hi, Miss Guerin. This is G from Dr. K's office. Your lab results are back. I'd like to talk to you. Please call me back at..."

My heart sank. I've heard those words too many times. At 21 years old, I shouldn't be hearing those words!!! If your lab results are fine, they don't call and ask for a return phone call. They tell you that everything is fine or that the results are in the mail. You're not important if you're healthy.

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I don't usually see a lot of symptoms with high blood sugars. There are stages to the highs for me. Anything between goal and 200, I feel fairly normal. Above 200, I start seeing a few symptoms but nothing noticeable. When I hit above 260, I start seeing a lot more. The nausea sometimes sets in. I get headaches. I'll get antsy in the pit of my stomach. And above 400, the nausea almost always leads to throwing up (luckily I've only experienced this a few times in my history of diabetes).

My Accutane dosage was increased last week, which sent my blood sugars into another tailspin. Where I was seeing quite a few lows and lower need for insulin, I'm back to bumping up the boluses and shifting the basal levels of Lantus. It's frustrating. But worse, I believe I'm seeing a different kind of high symptom that I absolutely despise.

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Tuesday night and Wednesday morning, I had two bad lows. First was a 32, second hit 39. Both without warning and without any telling symptoms beforehand. I treated them and came up fine.

But last night, I started dinner at 108 (I'd been holding steady around there since 4pm despite a carb heavy meal). Within an hour and a half of a full-on Mexican meal, I was 90. I'd even delayed the bolus until about half an hour after finishing since Mexican food usually takes awhile to absorb (something about corn tortillas and high fat).

I didn't want to treat the 90 yet in case the food was going to start hitting. So I went to Wal-Mart with the guy I'm dating...keeping a careful watch over the way I was feeling. Generally, just weak. The effects of too much insulin and not enough glucose.

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The most recent heat wave may have passed, but summer is still in full swing -- which means heat-related health alerts. While these issues are not directly related to diabetes, diabetes can confound a heat-related health issue, making it harder to recognize and treat. Heat-related symptoms can mimic sugar-related symptoms and vice-versa, so it is in our best interests to know our normal ranges and reactions to the greatest degree possible.

The most basic heat issue is hydration. For some of us, dehydration will cause our blood glucose levels to drop; for others, it will cause those readings to rise. For some of us, the physical stress of dehydration will, at one point or another, trigger an adrenaline response and its associated glycogen release, leading to u-shaped curves (think "Dawn Phenomenon").

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I have been exhausted lately. More than my usual fatigue. I constantly feel like curling into bed and sleeping for ages. I can't get out of bed in the morning. I'm just so persistently tired.

I'm sleeping enough each night and I'm trying to maintain a regular schedule. I'm getting my blood sugars down (my average has dropped over 10 points in the past weeks!). I'm trying to take it easy as much as possible.

But I can't seem to shake the heavy eyelids and drained thoughts for longer than a few hours at a time. So I went back to the drawing board again trying to figure out what I could change or add to give myself some more energy. And I decided on more protein.

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Everything seems to be all over the place lately. Despite catching up on school work and actually de-stressing this week, my blood sugars are bouncing like rubber balls in an airplane bin. My averages are up, yet I'm having rashes of severe lows. And by severe, I don't mean symptoms. I mean numbers and hypoglycemic unawareness.

Like last Thursday night, I cooked chili for a friend. Ate a giant bowl with cornbread, bolused for what I expected was way too little, and went on my way. Only to feel an urge to test a few hours later. No symptoms, just something in my brain saying that I should bite the bullet to test. And that urging left me staring at a 37. How?

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Being a tightly controlled diabetic can sometimes mean lots of low blood sugars. They usually aren't convenient. And they are never that fun. Although getting to eat whatever you want is a definite perk. But it doesn't make up for the shaking, sweating, slurring, and slowness.

All those lows really add up over the years. Some are definitely more memorable than others. The times we push too hard. Or the times where we just can't take it anymore. So many stories locked away. Of things that we've done or been through while low. Here are a few of mine. Got any good ones of your own?

• Take English finals.

• Go on dates...

• and get interrupted at the most inopportune times.

• Deny, deny, deny. "I'm not low, I'm not low...okay, I'm not THAT low."

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There are times in my health world that it seems everything goes wrong all at once. Every symptom or side effect possible decides to rear their ugly and intrusive heads all at once. Stress tends to make it all worse, throwing my blood sugars, my sleeping habits, and my hormones out of an already teetering balance.

These past ten days or so have been an onslaugt of Dr. Murphy's Law (I say Dr. because it's strictly health related). The Accutane is giving me off and on side effects like back pain, insomnia, crazy dreams, fatigue, itchy skin, headaches, and so on. My blood sugars are trending low with the increase in stress and exercise. And the rest of my body seems to be following suit in the craziness.

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Ever since I can remember, I've always treated lows with high carb liquids or LifeSavers until I could get something better. It's what works for me. Cokes if I'm out or juice boxes if I'm home. It curbs the symptoms fast. It's easy. And it's something that I always want when low.

I don't like glucose tabs, although I do use them on occasion. But they aren't my preferred treatment. Mainly because I can get picky when I'm low, so having something I know I'll want is better than not liking the treatment. Let's not make a bad situation worse.

If it's not a meal time, I don't usually follow the Coke or juice with anything else. Unless it's bad. Then I like cookies or crackers. My favorites: Nilla wafers, Ritz or Saltine crackers, and chocolate Teddy Grahams. Those are usually my night low choices. And I always overtreat with them.

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