How each diabetes moment tips into the next.

Scott K. JohnsonBy Scott Johnson

August 2007 — It never fails to amaze me how I can be knocked over by a sneaky low blood sugar late in the day that is caused by a series of decisions I made earlier.

It starts when I wake up, check my blood sugar, and make my first diabetes-related decisions of the day. It's as if I'm knocking over the first of an elaborate scheme of dominoes that weave in and out of my awareness throughout the day.

The constant audible "click" of the dominoes tipping into the next one is always there. It becomes background noise after a while. I stop paying attention to it.

The long string of dominoes is sometimes right there in front of me, especially when I have to do anything diabetes-related. But other times it seems as if the action of the dominoes is somewhere over the horizon of my day – I can't see it, but know it's still running its course.

When it is in that middle ground - somewhere between me less aware of it and me watching the show - I sometimes choose to ignore it. I decide to focus instead on whatever task is currently wresting for my attention, maybe an important project at work, something with my kids, or maybe I'm just enjoying some music or movie.

Then I'm blindsided by an emergency – a low blood sugar.

It seems to happen most when I'm trying to wind down my day. Maybe I'm going out to dinner with the family, or settling in after a busy day at work. Suddenly the dominoes are rushing at me from all sides.

Faster than I can blink, I have to stop whatever I'm doing to deal with a low blood sugar. Funny how having to deal with a low blood sugar can put things into perspective! The kids have to wait, dinner can't come fast enough, and so much for that music or movie. Priority number one is getting some food into my mouth, and nothing else matters.

Once the situation has been handled, (whether by a rational dose of glucose tabs, or the irrational destruction of a box of Cap'n Crunch) I usually try to understand "why." What caused the low?

The whole idea is to figure out if there was something I could have done to prevent the low. Was it some miscalculation hours ago? Or a long chain of events that started with something early in the day?

Sometimes I am able to figure it out. Other times I have to write the experience off to the "what the heck?!" fairy. Either way it is a frustrating experience. Anytime I have to drop what I am doing to deal with diabetes makes me a little angry.

Can the timing of my insulin and meals be such that a minor miscalculation at breakfast is masked because of the timing of my snacks meals? A sneaky low that hides behind the fact that I'm eating again before it can get me?

It sometimes makes me stop and think.

I'll need to pay closer attention to those dominoes.

Talk about it in the forum today.

Visit Scott's blog.

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.


Last Modified Date: June 12, 2013

All content on is created and reviewed in compliance with our editorial policy.

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