12.4.15

The Haphazard Art Of Hypoglycemic Decision Making

Low Blood Sugar Decision Making

Maybe you’ve heard the adage: HALT. Take precautions when Hungry, Angry, Lonely, or Tired, especially when it’s decision making time (this skill is sufficiently difficult by itself for me, not withstanding additional emotions). Let’s add another L to the acronym: Low. Trying to do much of anything while hypoglycemic is already a challenge, but oftentimes the tiniest decisions turn tortuous.

How important is this understanding? Well, important enough to write a blog about it. Looking back, I think things would have just been easier if used the thinking plan I use now, “Okay, Ryan you are low. I know this feels like something really important that you should do right now, but this will be simpler in 1o minutes. Find some food.” Remind yourself of the past experiences where things were never as bad as they seemed when you were low. Really though, it’s never that bad.

To make good decisions, I need a realistic perspective of what’s really happening right now. I need the facts. When I go low, my perspective usually accounts for only my needs, often needs based on fear. Not a compassionate place to operate from. You find me a person who can find their way into the other person’s shoes when they’re low and I’ll call them diabetic Buddha (or PWD Buddha).

So, here are the specific items I put off 15 minutes while the blood sugar is coming back:

  • Reading: unless of course you enjoy reading each page 3 times to comprehend it.
  • Text messaging: even an emoji can’t cover up the “low” tone.
  • Emails: even reading emails can be tough here, but if you really need to answer… See below.
  • Important conversations: just not a good idea.
  • Relationship contemplation: what did I say earlier about fear?
  • Shopping: This activity promotes panic attacks most efficiently.

Soooo, what happens when we absolutely must make a decision before we’re back to being us? Try to imagine what normal you would think about it. In my case, would normal me think it’s a good idea to get a coffee at 8:45PM because I need to focus more to study? No, normal me would have already downed that coffee at 8:15PM without thinking about getting one for 30 minutes.

(Additional Commentary: Turns out, counselors treating patients with depression tell patients to watch out for HALT states due to their capability of inducing depression relapses. For anyone who has entered the low blood sugar experience several hundred times, you’ve heard the doldrums of negative thinking, too.)

Former co-founder of DiabetesDailyGrind, Ryan's mission is to motivate others with diabetes to live their own authentic life. Most days, when not in the hospital during his medical residency, you can find him on the bike, surfboard, or yoga mat. He believes in the power of clean eating, and loves his Dexcom.

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