Saturday, February 20, 2016

I'm So High Right Now, Part 3 of ??? AKA: So When DO I Worry?

I spent a lot of the last post explaining about the day-to-day high blood sugar realities. And also reassuring people that they needn't worry about these. And it's true. There's a reason low BG gets all the hype, it's because when your sugar is dropping you can go from 80 mg/dL to dead in under an hour (probably. I would double check that science, for sure).

High blood sugars aren't immediately dangerous, but they are eventually deadly. High blood sugar leads to lots of fun long-term health complications, like diabetic neuropathy, eye damage, kidney damage, Alzheimer's...yeah, yeah, you know how to use Google so I'm sure you can figure this out on your own. The more high BGs, the more likely my chance of picking up these super-cool conditions. So, if you spend a lot of time with me or another diabetic and you notice that their BGs are consistently really high? Or they don't seem to really react when they have a high BG, or make comments or share that they haven't been taking care of themselves properly? Maybe they share with you that they sometimes let their BG run high on purpose in order to lose weight? Yeah, that's when you probably want to step in. Do what you gotta do, because that is dangerous. If you like having that person around you, and you think you might want it to be long-term, nothing says "I care about you" like, "let's discuss your personal private information AKA your blood sugar levels even though you probably don't want to AT ALL."

Lots of super-high BGs, like read: no insulin at all, can lead to a fun condition called diabetic ketoacidosis (DKA). This is how many T1Ds (read: yours truly) were diagnosed. It's the step before the diabetic coma, where your body is so starved for glucose as an energy source (because all your glucose is floating around in your bloodstream rather than being ushered into your cells in order to fuel them) that it starts breaking down all your stored fat and protein (aka muscle) and desperately scrabbling to get to any last bits of glucose. Like in the olden days when they would burn the furniture to stay warm during the winter. Except then imagine they ran out of furniture and also started burning the walls, which not only defeats the purpose but also results in them all being in comas.

Sad side effect of this is that, when breaking down muscle to get glucose, there is a leftover acidic tail called a ketone. Suddenly you're producing those like crazy. Your body is full of acid!! Symptoms of DKA include sudden dramatic weight loss (burning up all your fat and muscle dude! You're becoming a bag of bones!), exhaustion (no good energy sources, sad), heartburn (your body is filling up with acid), dehydration, frequent urination (gotta get rid of all that acid!!), craving sugar (because even though you're full of it floating around, none of it is actually getting to where it should go so you're actually starving for it), and eventually a coma. If you see any of these symptoms in people around you, especially the coma, I would say it's time to worry. Totally your call though.

Bottom line is that, discussing someone's BG with them can be tricky. It's private. It feels embarrassing to have a high blood sugar, even when no one around you understands what the numbers mean or is judging you at all. I judge myself. I don't want to talk about it. There's also really not too much to say about it, since all that can be done is to drink water, apply insulin and/or exercise, and wait. So weigh that when you bring it up. And also remember that, unless you are dealing with your own child who is diabetic and they are under 18 years of age,  you never, never, never need to worry about whether or not they "should" or "can" be eating whatever the heck it is they're eating. There's only one thing a diabetic can't eat, and that's poison (stole that from an internet meme. So tech savvy). So don't be getting on anyone's case when they're just trying to binge on ice cream okay?? Ummmm....I mean....responsibly enjoy a small cookie, okay??

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