Sometimes, all it takes is a simple math error, or a small miscalculation, or any of a million different things (or nothing we've done at all) to kick a blood sugar way high or send it crashing way low.
When your blood sugar gets low, your body sends out a handful of counter-regulatory hormones (unless you struggle with hypoglycemia unawareness). These hormones work in a few different ways to try and raise blood sugar and reduce the effectiveness of insulin. A couple of these hormones, such as glucagon (typically missing in people with type 1 diabetes) and epinephrine (or adrenaline), act fast and are out of our system relatively quickly. The other two, cortisol and growth hormone, act slowly and are in our bodies for many hours.
This is one reason why a low blood sugar at any point in the day can cause high blood sugars later. Those counter-regulatory hormones raise your blood sugar and make your insulin a bit less effective.
Exactly opposite to what I just said, I've also heard that a low blood sugar at any point in the day can make it more likely for another low blood sugar that day. Something about exhausted glucose stores.
Confused? Me too.
Did you know that as your blood sugar gets higher you become more resistant to your insulin? We know it takes more insulin to correct a really high blood sugar than it does to correct a moderately high blood sugar, but when you're really high, it takes even more than your correction factor says it should. It's so darn complicated sometimes!
It's very hard to be reasonable right in the thick of things. When I'm low, I'll gladly deal with a high later just to escape the low in one piece. Same thing for a high — I feel like I'll gladly deal with a low in a few hours just to get some relief from the high blood sugar.
All of this background contributes to what I'd actually like to talk about for this column, which is how it sometimes seems to take days to stabilize after a rough ride on the blood sugar roller coaster.
Do you know what a "Newton's Cradle" is? It is a series of usually 5 metal balls suspended, in a line, by a couple of strings or wires. When you lift up one of the balls on the end and let it drop back into line, the force transfers through the metal balls, causing the ball on the other end of the line to swing up and out. The balls continue this click-clacky, pendulum-like swinging until there is no more energy. Once the first ball is set into motion, it takes a while for things to stabilize and settle back into position.
In may ways, I feel like that symbolizes how my blood sugars take a while to stabilize into a semi-predictable pattern. Even though I do all of the right things and follow all of the rules, I have all of these extra factors mixed in there that need time to wash out of my system.
It is frustrating, because it is hard to be patient when these swings and highs and lows are disruptive.
I once heard a doctor speak at a local support group. He said — and I love how he put it — that the goal of diabetes management is to stay as close to target as possible and AVOID LOWS! His point about lows was all about our safety, of course, but also about how low blood sugars introduce a bunch of new variables into the mix and make life difficult for a day or more.
When I think about those lows causing highs, which in turn trick me into causing more lows, the cycle is hard to break out of! If you've lived with diabetes for any amount of time, you know that we can't avoid all lows. But we can try our best, and we can be informed about what happens when we experience a low, which will hopefully help us break out of the cycle.
So — let's all try to stay as close to target as possible and AVOID LOWS!
dLife's Daily Living columnists are not all medical experts, but everyday people living with diabetes and sharing their personal experiences. While their method of diabetes management may work for them, everyone is different. Please consult with your diabetes care team to find out what will work best for you.
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