Too Much of a Good Thing
How a fear of low blood sugar translates to extra calories.
By Scott Johnson
November 2009 — Would it be fair to say that we all hate low blood sugars?
I don't think it matters if you are someone living with diabetes, or have a loved one with diabetes. Low blood sugars are no good to any of us. There are a lot of reasons for this. First and foremost, low blood sugars are just dangerous. But there are many other ways that they cause trouble too, including adding lots and lots of extra calories.
I was talking with a friend of mine recently about lows. We were talking about some of the more vague and maybe abstract ways that lows interfere with our lives. We talked about safety, specifically in regards to driving or being in charge of our kids or other people's kids. We talked about embarrassment, and some of the crazy and awkward situations we've been in or heard about. We talked about relationships, and how lows can sometimes cause us to act out in ways that damage and hurt the ones we love.
We talked about the fear of lows, and how that causes many people to back off their insulin. In that way, fear of lows can be directly related to many high blood sugars. Fear of lows keeps a lot of us from working out too, or interrupts our workouts, meaning we are getting less exercise than we need.
Then he asked me a question that stopped me in my tracks. "How many extra calories do you think you've consumed in your lifetime just to treat low blood sugars?"
Wow. What a question.
I started thinking back on all of the lows where I remember just eating and eating and eating until I felt better. I started thinking about how I might eat four or five bowls of cereal and milk in one sitting when I'm low. I thought about how I would come out of my low, look at the evidence of how much I've eaten, and have to actually take more insulin to dampen the high that was surely coming.
I've eaten entire meals, or their caloric equivalent, because of a low. These are extra meals. Not replacement meals. I have never sat down for dinner, then not eaten because of how much I ate for the low two hours earlier. I think a non-diabetic person might skip that meal because they're just not hungry. But living with diabetes has created this huge disconnect for me between actual hunger and mealtimes. That contributes a lot to this problem I think.
I have eaten a LOT of extra calories in my life, just to treat lows. I won't blame all of my extra weight on lows and those extra calories. But I will say that I'm sure there are more than a few pounds of low blood sugar calories looking down over my beltline. Maybe they can watch my toes for me – I can't see them from up here.
What this comes down to is hidden weight gain. The caloric balance we live with is a cumulative thing. We don't get a "do over". The score doesn't reset on Monday morning. If you eat more calories than you burn, they get stored as fat.
I talked last article about trying to view low blood sugars as a medical event that needs to be treated with medicine rather than viewing them as an opportunity to indulge in some treats. I haven't made much progress there yet, but as I investigate my relationship with food, and explore these feelings when I'm low, I see that it is even more important if I don't want to gain a bunch of weight over my lifespan from low blood sugars.
Fast acting glucose is designed to quickly raise blood sugar (without needing to metabolize first) and help me feel better faster. When I eat food to treat my lows, that food has to digest and metabolize before it starts raising my blood sugar. It happens faster than you might think – but even the fastest food is much slower than fast acting glucose tabs, liquids or gels.
The faster my blood sugar comes up, the faster I feel better. When I feel better I am better able to reign in my crazy feeding frenzy urges. It makes perfect sense, logically. But I still struggle with it in practice.
I think this is an important piece for me, in the world of good health and diabetes management. I hate that diabetes makes food such a complicated thing for us, and low blood sugars just seem to muddy the waters in that complicated relationship.
I will keep working on it, and keep exploring the feelings and emotions. I feel like I'm making progress, a little bit at a time.
dLife's Viewpoints columnists are not all medical experts, but everyday people living with diabetes and sharing their personal experiences, most often at a set point in time. While their method of diabetes management may work for them, everyone is different. Please consult with your diabetes care team before acting on anything you read here to find out what will work best for you.
Anchovy Puffs Fresh and Natural Applesauce with a Twist Grilled Tuna with Herbed Mayonnaise Vanilla Ice Cream with Strawberry Sauce Nectarine Sundae with Raspberry topping Russian Cabbage Soup Old Fashioned Lemon Bars Waldorf Fruit Salad Pita Veggie Pizza Chicken and Peaches in a Spiced Orange Sauce
As I mentioned in an earlier post, one of the benefits that made it cost-effective for me to go with the real healthcare (HSA) plan rather than the phony (HRA) plan is that my company is now covering "preventative" medicines at $0 copay. The formulary for these, as stated by CVS/Caremark (my pharmacy benefits provider), covers all test strips, lancets, and control solutions. I dutifully get my doctor to write up prescriptions for all of my testing needs, submit...