The Type 1 Traveller Ch 5: Hypos

In Matt's Musings, Travelling with Type 1 diabetes
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Another post about the joys (?) of making this journey with diabetes.

Diabetes is a funny old thing. Before you have it you see it as one of those dark, life changing medical conditions. Something to be feared and avoided at all costs (not that you have much say with Type 1 diabetes). When you actually get it, it arrives much as you feared and your world gets turned upside down. Then slowly over time it becomes very normal. The concern gets less and less and then before you know it you have these blessed days when you actually forget you have it.

But the cruel thing is that as soon as you have one of those days it seems it goes completely haywire again and suddenly you seem to be cursing and swearing at all things blood sugar related. Angry that you lost control, angry that you can’t find decent food, angry that you feel vulnerable and dependent on some externally managed medical regime that use to be so purely and unconsciously effortless.

And there is the rub. There is the most deeply annoying and ever present element. The fact that you never previously had to apply any cognitive effort what so ever to the job of managing your blood sugar levels. But NOW…..it is like a quiet mind chatter that is on constant rotate.

“What’s my waking BSL? What should I have for breakfast? What insulin do I need for this breakfast? What are we doing again today? Are we walking? Are we sitting on a bus? How much energy will I use? What food can I get later on? Do I have food in my bag? Did I eat my lolly stash yesterday? Am I feeling OK?……..”

I have fallen into a groove on this journey and it has become just like at home. Though China has thrown a few challenges. First the food – on many fronts. One mans noodles seem to be perfect for me then the next man’s noodles send my sugars through the roof. I found the perfect balance of intake and insulin so I could eat these dreamy, white, doughy, meat filled steamed buns. Only to eat one from a different part of town and my sugars went all bad. I have put my no/low carb intake on hold because otherwise I would starve in this part of China. After one particularly bad roller coaster of a day recently I swore I would just cut out carbs completely again but I could not find a single thing I could have eaten for breakfast lunch or dinner. And as brave as I am culinarily  I don’t fancy trying those unidentifiable, nondescript meat skewers in a land where they eat dogs…..

So the sense of vulnerability has reared it’s ugly head once again. None worse than the other day up in a town called Kangding in the Tibetan Plateau highlands of the Sichuan Province. We had been up high at the small town Mel mentioned – Tagong – which was COLD and at a breath catching height of 3700m above sea level. We had dropped back down to Kangding (2600m) which was noticeably easier on the lungs but the cold seemed to follow us down. I don’t know what it was but Kangding seemed more bitter and biting than Tagong. Maybe it was damper or windier I don’t know. Whatever it was – the cold had teeth. Sleet drifted down occasionally and the steep hills around us were frosted after every passing cloud. The wind crept through our layers and everything seemed darker. We set off to find dinner at the one restaurant at the other end of town that the kids promised they would eat at.

So there is the five of us – trudging through town, necks buried in the collars of upturned coats. Hoods over our heads so that when you need to talk to someone you have to turn your whole body, robot like, to face them. We tried a new restaurant but then quickly gave up on the Chinese-only menu knowing the girls would not even go near a food they couldn’t identify. We walked on, trudging, trudging – only to arrive at the shuttered, closed steel face of our destination. We turned and started walking back, the dark growing, the kids walking slower and lagging further behind. I knew my sugars were dropping – burning energy just to stay warm – but with all my senses a little dulled by the cold I didn’t notice the usual signs of going hypoglycaemic.

Going hypo is a funny thing. There are different kinds of hypos. There are slow exercise induced hypos that you can feel coming on and you can avert easily. There are horrible insulin induced ones where you overshoot and get this horrible fast onset wooziness that you need to combat by eating (sometimes lots of food) but they make me feel like I have been hit by a bus. Then there are ones like the one I has having on the streets of Kangding. I couldn’t feel it coming because of the cold. I was concentrating on the kids being safe. I was focused on where to eat dinner. I was racking my brain for WHAT we were going to eat. I was trying to stay warm. I was worried about the kids being warm. Then suddenly I couldn’t think at all. I turned to Mel and just said “I have to eat NOW.”

I raced across the street to a little supermarket and headed for the fruit juice aisle. Sweet drinks are the best antidote. Glucose lollies are good as they get digested fast and the sugars go to work. More complex foods like chocolate and sweet biscuits are OK but they release their sugar slowly. But the quickest fix is a sweet drink. I can feel the sugars entering my system and my mind clearing. Imagine a thirsty cartoon character like Tom or Gerry – as they drink you can see them filling with fluid from the feet upwards. That’s the feeling I get.

But I walked in and stood in the aisle filled from wall to wall with juice boxes. I looked left, I looked right. I tried to interpret the pictures (all the writing was in Chinese). Nothing made sense. I couldn’t even choose a fruit juice when my mind was screaming “Just pick one!!!”

That’s the point when I turned to Mel and said “I can’t think straight.”

I know some diabetics can suffer severe mood swings when low but I have luckily been spared that (maybe I should check that with my family though). So when I can’t think straight I know that things are bad.

Mel opened a juice, and before I was at the counter I had squeezed it dry. Slowly but surely the fog seemed to clear a little so I could gulp down more sweet food before we wandered slowly back to our hotel. I checked my sugars as soon as we got back and I was 3.2. Thats AFTER a fair dose of sugar so I don’t really want to know what I was when standing, dumb and confused on the side of a cold, dark street in a Chinese town.

Aahh, hypo stories. Everyone has them. Not sure why I am writing about it. Maybe just to share with other diabetics about to travel to let them know that when they do it will all be just like home. Nothing worse, nothing better. Just the same. And that all around the world, in every single country we have been to – no matter how seemingly remote or developing – there always seems to be a little shop nearby with a heavenly, strangely familiar aisle filled from top to bottom with life saving little packets of fruit juice.

All you have to do is reach out and pick one…..

2 Comments

  1. Can’t imagine what it is like for you, Matt. Scary just reading your narrative. But, I reckon anyone with Diabetes reading your thoughts will get the sense that it will totalise you if you let it. You don’t. Interesting that people with acute onset of anxiety or depression report similar inability to concentrate: very much a physiological experience at a cellular level in the brain.

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