A friend of mine I’ve known for years has a problem with lows. He’s had diabetes for a almost three decades, and many scary low experiences. He’s crashed a car, been pulled out of the water while surfing, and almost had a hotel room door beaten down by concerned co-workers. All of these were because of bad lows.
He’s hypo unaware and pursues extremely tight control, both of which contribute to these particulary bad lows. He’s on a Dexcom now, and that helps, but it doesn’t catch all of them. I’ve been out with him and seen his face change as he heads toward a low. I see the sweat appear on his brow and his words start to slur. I bring him a coke, no ice, without being conspicuous in case he’s embarrassed, but he refuses it. Only when he’s on the brink of passing out does he get something to treat his low, and he only accepts help from an extremely short list of people in his inner circle. It’s not healthy and it’s not safe. And it’s even scarier because he has a young daughter.
People talk about this person. They worry about him and his daughter. They shake their heads and they don’t understand why he runs so low – they can’t understand why he’d put himself in danger just about every day. To be honest, I don’t really understand it either. I’m the type of person who’d rather run a little higher while driving/surfing/traveling for the sake of safety.
But then I heard about another person who has this problem, at a diabetes conference. I heard about a man with the same issues as my friend. He ran low all the time, to the point of passing out frequently and putting himself and others in danger. He nearly lost his marriage to the problem. But he and his wife went to counseling with someone who specializes in diabetes mental health and he was clinically diagnosed with a special phobia: a deep fear of hyperglycemia.
This man was so afraid of having a blood sugar over 120mg/dL that he equated the feeling of a high with “fire alarms and bells screaming in his head” for him to get out of the danger zone. He said a high blood sugar caused him so much anxiety that he’d do anything to avoid them – even run dangerously low. For him, a high blood sugar felt as bad as trapped in a jail cell, and the discomfort pushed him to unreasonably tight control. As soon as I heard his story, I wondered if my friend suffered from the same issue of hyperglycemia phobia.
Most of us fear lows more than highs – they cause an acute issue that demands immediate attention. Highs can languish and be uncomfortable, but running higher can provide peace of mind that you won’t bottom out during an activity. But there may be sub-set of people with diabetes for whom a high blood sugar feels like the ultimate failure. Things that knock directly at self-esteem and self-worth can cause anxiety. If those feelings of anxiety are caused every time you have a blood sugar out of range, it would be very possible to develop a “phobia” of high blood sugars. And any phobia can cause people to think and act irrationally – including putting themselves in danger.
I think more than anything, my friend needs some help digging out the reasons of why he runs so low. I don’t think anyone likes the way a low feels or the damage a bad one can cause to yourself or anyone around you. I also know it’s hard to ask for help sometimes, and diabetes can make you feel like you’re completely isolated and that no one will understand. It wasn’t that long ago that people didn’t really talk about the emotional side of this disease. There are more resources now – including mental health professionals that specialize in helping people with diabetes.
My hope is that my friend one day gets some help. As frustrating as it is for people around him to watch this self-destruction, nothing can be worse than what he’s putting himself through in his own head. That’s where the real work – and real healing – has to begin.