Running on Empty
Avoiding a low while behind the wheel.
By Kerri Sparling
January 2006 — So I have a speeding problem. Not the kind that involves checkered flags and squealing tires, but more the kind that has me offering up the phrase, "Officer, I had no idea I was speed ... what? I was going how fast?" Inject here a mingled sense of embarrassment and pride.
But I like to drive. And I like to drive a little bit too fast. But I am a careful driver, despite the lead foot issue. I always wear my seatbelt. I never drive after having anything alcoholic to drink. And I always test my blood sugar before I get behind the wheel.
Seatbelt on? Check. Purse contents strewn about the passenger seat as a result of tossing the purse haphazardly? Check. Glucose tabs stowed in the center console? Check. Random, used test strips stashed under the driver's seat? Most likely: Check.
There's a certain threshold that I, personally, need to be at to be comfortable in the driver's seat. If the meter rings in at anything less than 100 mg/dl (5.56 mmol/l), I snack before driving. The opposite applies on the higher end of the spectrum: anything higher than 180 mg/dl (10.00 mmol/l), it's bolus time. For me to buckle in behind the wheel of my VW Jetta, I need to be able to focus on the road. I've noticed that my reaction time is much slower if I am above or below my threshold range.
The dangers of driving with low blood sugar have been compared to those of driving under the influence. When I was a little girl, carrying around my pink wallet with Tinkerbell's smiling face on the outside flap, I had a card inside stating that I was a diabetic. It also stated the following: "If I seem drunk or intoxicated, please allow me to test my blood sugar, as I may be experiencing low blood sugar." A seven-year-old with her license looming more than nine years away, I showed that card to everyone in my family. They laughed, but we had no idea at the time how right that card was. Low blood sugar can numb out your brain and slur your words. It can cause your hands to shake and your vision to wane a small bit, in addition to dramatically decreasing reaction time.
It can be extremely dangerous.
I can admit to having driven a few times, out of necessity and not desire, while experiencing low blood sugar. I've felt the clammy sweat on the back of my neck and the radio seemed too loud no matter how low I turn the volume. And I will also admit to having tested my blood sugar while driving. My ability to unzip the testing kit, insert the strip, prick my finger, and navigate my fingertip to the test strip without looking down at all is uncanny. After almost 20 years with diabetes, to test is to breathe; it's instinctual.
There have been times when I've clocked in at 62 mg/dl (3.44 mmol/l). Or 53 mg/dl (2.94 mmol/l). Or lower. Usually I have an arsenal of glucose tabs in the glove compartment, because they tolerate both blistering heat and crippling cold. Their chalkiness is enough to calm my adrenaline and ready me for the 5 – 10-minute wait while my blood sugar rises.
It took some time before I realized that glucose tabs were The Ones. I used to keep a bottle of juice in the car, but one snowy February afternoon had me struggling to open the bottle while I sat in traffic on I-95, only to find the contents frozen solid. With the heat turned up and concentrated from one vent, I spent almost ten minutes thawing the juice so I could steal a few sips. No more juice from there on in. I switched to keeping a candy bar in the center console, but a day at the beach turned out to be anything but once I realized that my reaction couldn't be treated with the molten pool of chocolate that the candy bar had become while my car sat in the parking lot. Glucose tabs, my friends. They can stand it all.
So I may have a bit of a speeding problem. I may have a car littered with used test strips. And there may be that little stain on the console where the chocolate bar melted. But I do my best to make sure that the safety of me and my passengers is never compromised as a result of my "tank" being empty.
Visit Kerri's website.
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.
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