Both yesterday and today I woke up with a similar blood glucose level, a little under 100, then a little over 100. I had the same breakfast and gave the same bolus. But yesterday I bolused as I sat down to eat and regretted not pre-bolusing because my blood sugar spiked pretty fast before settling back down to an acceptable pre-lunch level. Today I didn’t want to repeat that so I pre-bolused by about 8 minutes. Today there was no spike.

An hour after my bolus I was sitting on the metro, halfway to work and felt some mild telltale songs of a low. I glanced at my dexcom and was a bit surprised to see 51 with a straight down arrow. I grabbed a few glucose tablets and even as I munched them, started feeling worse. A bit panicky. I ate some more. My heart started pounding and I was sweating so I very awkwardly took off my scarf and then my jacket in the overcrowded train. I wasn’t counting the glucose tabs but I was slightly aware that it would be a good idea not to eat too many.

Sheer concentration helped me stand up to get off the metro at my station. But I couldn’t make my feet  take me where I needed them to. I sat on a bench on the platform. I wanted to cry. Not because I was scared. Not because I didn’t know what to do. Not because I didn’t think this low wouldn’t come back up. But because normally I have diabetes and in that moment, diabetes had me. I was no longer the one in control of the situation.

I’m not sure how I looked to the morning commuters but I must have sat there for about 15 minutes watching the trains go by and trying to catch my breath, control my shaking muscles and slow my heart rate. When I finally did get to my office, I checked the glucose tab tube and saw that I had eaten 8 of them. 40g of carb. I knew that would more than shoot me high, but I didn’t want to bolus right away either, given the ongoing shakes and fuzziness in my brain that made me think I was still low. I then realised that I hadn’t actually tested my blood sugar that whole time so I took out my meter. A shaky blood drop later and a 102 stared back at me. This was about an hour after I first noticed the symptoms of the low.

So I knew I was in the clear blood sugar-wise but it took until after lunch, almost 4 hours after starting to treat the low for the symptoms to disappear. All morning I was working in slow motion. My brain wouldn’t process complex information. My colleagues told me I was pale (which is saying something for this Irish-skinned girl!) and that my eyes looked a little vacant. I felt run over, flattened, defeated.

Most of the time I handle living with diabetes just fine. But today, diabetes got me. Really got me.

Has this ever happened to you?

You come home from work and the kids jump all over you eager to tell you about their day. You try to get a few words in with the babysitter before she leaves while your kids are still trying to butt in every few seconds. You finally give them a few minutes each but then you really need to get dinner going. While you start cooking you try to estimate both carb content and timing of the meal and take your bolus while trying to figure out why one of the kids is now crying. Tripping over some toys that weren’t there 2 minutes ago you finally get dinner on the table and sit down to eat. Things are calmer now at the table and you think how your blood sugar has been reasonably well behaved today and you really should have pre-bolused for this meal. But whatever, better late than never. So you do the math and bolus while hearing about who was sitting beside whom at lunchtime at school. Then 45 minutes later as the kids are getting into bed and wanting a last pee, a last drink of water and a last kiss, your Dexcom starts blaring and your first thought is “I can’t be under 55, if anything I under-bolused for that meal and my 2 week old Dex sensor must just be showing its age”. Then the symptoms hit. Hard. And both Dexcom and Libre are reading LOW. And only then you think “Did I… No, I couldn’t have…” Then you look in your pump history to find that yes indeed, you bolused twice for that meal, 23 minutes apart. Then you drink the rest of the orange juice in the house and sit down and wait to feel human again, thankful that your husband is now home from work.

Result of a double bolus.

Yeah, me neither. Until yesterday.

I’m pretty sure I haven’t made a mistake like that since going on the pump almost 14 years ago. I’m glad that my boluses are relatively small so that I only took 3.35u twice rather than much more. I’m also glad that I have a pump so there is actually a record of past boluses. I have now programmed my pump to alert me if I try to take more than 7u (basal rate included) within an hour.

Stay safe! Don’t double bolus!