Comment by GordonS | Hacker News Reader

Comment by GordonS | Hacker News Reader

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It isn't my intention to doubt Tinker, only to continue discourse here, but I was going to say something similar. I have reactive hypoglycemia and it is very, very obvious when my blood sugars are too low - it really is an absolutely horrible thing.

At first I start to feel a little bit "stupid", like my brain isn't functioning properly, and is working in slow motion. Talking is more difficult. Next I start to feel a bit weak/shaky/trembly. Next I start to feel anxiety/dread. Sometimes now I can get very aggressive (which isn't in my nature at all!). Then comes an incredible desire to eat sweet things - once you start eating, it can actually be difficult to stop! Depending on how bad things got, I might feel too confused to actually just go and eat something.

Now, all being well, I did eat something, and will start to feel a lot better within 10-15 minutes.

If I didn't eat something (because there wasn't anything available, or because the "stupid" feeling had given in to confusion, and I didn't know wtf was happening), everything ramps up - the anxiety becomes full on dread, the world seems to be caving in on me, and I literally feel like I'm going to die. The weakness feels like I need to lie down (a couple of times I have, but thankfully my partner was at home and found me). The "stupid" feeling gets much worse - my speech is slurred, and finding the right words to talk is very difficult - mostly what comes out it is "umm.. err.. what?.. uhh..".

T1D here, and you explained the experience of hypoglycemia very well. This is very close to what I get as well.

> Then comes an incredible desire to eat sweet things - once you start eating, it can actually be difficult to stop!

This sucks a lot with diabetes. The survival mechanism kicks in and tells you "eat something, anything, everything", which can subsequently cause your blood sugar to skyrocket, which you then have to correct with more insulin...it can send you on a blood sugar roller coaster than can ruin your entire day. Diabetes sucks.

Yeap. There were blood sugar test strips and lancets in every nook and cranny of the house. Yo-yoing all over the place and developed a phobia about going anywhere in-case "something happened."

My dad was using low blood sugar as an excuse and insulin as an enabler to eat crap, and gained a lot of weight.

He eventually got an insulin pump and cut down on simple carbs.

Diabetes, especially T1 diabetes, is so unbelievably mentally taxing. It's a constant source of cognitive load and stress, as your conscious brain is being forced to take on the functions of your pancreas. A lot of diabetics develop mental health issues and unhealthy habits as a result of it (which is what it sounds like happened to your dad).

For me, a CGM was the biggest game changer, by far. Second was cutting down to eating one (larger) meal per day.

I'm not diabetic but I know what low blood sugar feels like from both exercise depletion and long-term fasting.

If you're not diabetic and have low blood sugar from exertion, just stop what you're doing and drink some water and rest. Your body will handle it just fine. Carbs should be reserved for real emergencies.

So what is a good and healthy way to address the situation aside from eating something? Using an insulin pump?

Insulin lowers blood sugar, rather than raising it. For T1s, I would imagine an insulin pump would help prevent mistakes where you misjudge how much insulin you need - but I'm not a T1, so can't comment on real-world effectiveness.

In my particular situation, the best way to manage things has been to go keto - any more than around 5g of carbs causes me to have a hypo, presumably because my body over-compensates and releases too much insulin. I switched to keto a few years back, and my life has been so much easier since then - I went from having a hypo multiple times a day, to very rarely. It's been several months since my last one.

If I hypo (or in the more general case when a T1 takes too much insulin by mistake and hypos), the "healthier" option is to use glucose tablets or a glucogel tube (a measured dose of glycogen, often carried by T1s).

But when you're having a hypo, you don't always think clearly - it's fine if you catch it early enough, but otherwise it really is like you're under a magical compulsion to eat as much sugar as you can; I'm not sure there is another experience I can relate it to. And once you eat some carbs, it's 10-15 minutes before you even start to feel better - believe me, you can eat an obscene amount in that time!

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