Nothing is more discouraging than a ride on the blood glucose (BG) roller coaster. 🎢 It’s a nasty one, and once you’re on, getting off is tricky. The BG roller coaster starts with a super low blood sugar, or a super high one. The ride gets going when that super low is treated by carb-overloading, or the super high gets treated with insulin overkill — sending your blood sugar rocketing in the opposite direction. Then, you treat that new soaring blood sugar with excess insulin, or the plummeting one with carbs-on-carbs-on-carbs to prevent swinging back to where you just were. And so, the vicious cycle begins again. ♼
The worst and most common trigger for that coaster ride is the super low blood sugar that gets treated with an over-abundance of carbs. 🍌🍩🍟🍮🥧 We’ve all been there: a quickly descending blood sugar that prompts you to eat every morsel of food in sight. “You only need 15 grams of carbs to treat a low,” says your doctor.
Sure, that may be the truth most of the time, but if you’ve ever felt your blood sugar at 55 mg/dL and still dropping rapidly from a bit too much insulin at your last meal, 15 grams of carbs just feels like a drop in the bucket. Your brain begs you to eat more! To the point where you simply can't control yourself. Even after your blood sugar is back up over 80 mg/dL, a severe enough low can leave you feeling shaky and weak for at least an hour (sometimes two) afterward.
So you eat, and eat, and eat. Sending yourself flying high, high, high. Then, you feel guilty for eating so much. So you take a whopping dose of insulin, sending you way back down. You get the picture: it's a messy one. So how can you prevent yourself from getting stuck in this nasty loop? Here are three tips you can use the next time your BG roller coaster beckons.
1. If you’ve got to have more carbs, acknowledge and account for what you’re going to eat.
Choose the carb-laden food you’re going to eat to give your brain a feeling of safety and satiety. Then, carefully calculate the insulin dose you’ll need for the carb content over the first 30 grams of carbs. The truth is that some low blood sugars do need more than 15 grams of carbs, especially the rapidly crashing ones. Because your glycogen stores (your body’s back-up glucose) need to be replenished, too.
Instead of going wild on carbs and then pretending you didn’t, acknowledge what you’re going to eat or what you're already eating (like a giant bowl of Honey Nut Chex cereal), calculate the carbs as best you can, and take insulin using your insulin-to-carbohydrate ratio provided by your healthcare team to cover the carbs above 30 grams.
That extra 15 grams of carbs gives you a little cushion; while you might end up a smidge higher than ideal, you won’t be sky high or take too much insulin that you risk going low again.
2. Write down what foods you will use (and not use) to treat low blood sugars.
Some people know there is no way they could only eat 10 fruit snack pieces to treat a low blood sugar. Others know they could easily resist eating all 30. Some people know they could eat a small bowl of Cheerios and not go back for more, while others know that one small bowl of Cheerios will quickly become 4 bowls.
What carbs are triggers for binge-eating during lows for you? Personally, I hate bananas. Eating a banana makes me want to chug water and not eat anything else ever again. For that reason, they are my go-to treatment for severe low blood sugars. There’s absolutely no way I’m going to overeat bananas, or even want to eat anything else. I also know that, for me, I will never run out of room in my belly for Honey Nut Chex.
If I’m having a severe low and my brain is begging for something full of quick-digesting, heavily processed carbs to bring me back to that feeling of “safety,” I give myself permission to eat one or two small bowls. And that's it. I have my game plan in advance; no more than two. Then, I already know to take a good dose of insulin for the excess carbs to prevent flying high in the other direction. This is my plan. These are my triggers.
Think about what foods are triggers for binge-eating during low blood sugars for you, and what foods you have more control over. Once you've got your designated foods, use them to come up with a surefire game plan you can use, even when you are zombie-low.
3. Forgive yourself for “causing” the super low or super high, and move on!
In the daily game of diabetes management, it’s so easy to blame yourself for those super low or super high blood sugars. We often know exactly what caused them — that extra slice of pizza or the sloppy job we did measuring out the carbs at lunch. And too often, we go from blaming ourselves to thinking, “Well, I’ve already screwed up today, might as well give up trying for the rest of the day.”
The truth is, managing diabetes is not easy. Even when you have the best intentions! Like using an apple to prevent low blood sugars during yoga, only to find that you needed about half the carbs in that apple, and now you’re high. And there is no way we’re going to get it right every time. There are just too many variables in life!
When you find your blood sugar rocketing up and down, take a deep breath. Let yourself off the hook for making “a mistake,” and think rationally about how you’d like to handle the current blood sugar situation you’re facing. Know that you are not alone. You are not the only one on the BG roller coaster; there are others doing loop-de-loops, too. You will get off this coaster, and you'll move on! Like the diabadass you are.