How do Hypoglycemia and Hyperglycemia FEEL?

@ClaudnDaye
I also wanted to mention, low BGs are not always the same. For me it can be only one symptom, a combination of a few symptoms, or many of the symptoms I listed.

Sometimes I get very tired. If I desperately want to go to sleep, that’s a good sign I need sugar. But other times I am not tired at all.

That’s what can make it tricky. It can be a big list of possible signs, but just not always consistent.

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Worst sign a bad low is in progress: big flashbulb spot in the center of my vision, like I’ve glanced at the sun or had a camera flash go off in my face. That usually means I’ve hit 50 or below. Often I get that effect before anything else when it’s going down fast. Then my knees start to lock up and unbelievably intense gnawing hunger–Eat Now Or Die!–starts. Confusion? Definitely. Like even though I have the hunger thing I can’t figure out what to eat. Just want to sit down and shut my eyes. Cone vision. Yuck.

Hyper I don’t feel very much unless it’s pushing into the 300s, which rarely happens. Nausea, headache, tiredness but less acute than hypo. More like a mild hangover. Gets worse if prolonged.

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Things I’ve noticed:

  • Low symptoms:

    • Brain fog and light headed
    • Quivering (internally, like having the chills)
    • Crabby and anxious
    • Hyper sensitive - no tolerance for normal things like music, joking (which I normally love)
    • Difficulty walking
    • Just want to be left alone!
  • The faster my BG is dropping, the more I feel the symptoms

  • If my BG has been on the higher side for a bit (when sick), I’ll feel the next lows much earlier.

High symptoms for me are like a general malaise … how @drbbennett explained it, like an annoying hangover. :face_with_head_bandage:

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I know when I was a teen, once my mom in the morning asked me if I had been low the night before. I said yes, why? Turns out I had had some frozen yogurt and then left the entire thing sitting on the counter. Oops. Yes, confusion is definitely a symptom—I also used to over-treat like crazy when waking up (I never had a parent waking me up, since no CGM then and besides, I was 10 when diagnosed and always seemed to wake up on my own from lows, so they didn’t worry about it) since I’d basically be like a half-asleep sugar zombie wandering into the kitchen. SUGARRRR.

Otherwise when I’m awake:

Low:
hunger (for me, an unexpected sudden uptick in hunger is a very reliable indicator of quickly dropping blood sugars at any absolute level, so even from 250 to 150 would feel that. when really low, it’s more intense and suddenly I want to eat ALL THE THINGS)
sweaty
pale
shaky
fast heart rate (which can make me feel like I’m anxious, even if I wasn’t)
confusion/can’t think well
drunk-ish feeling
light-headed
irritable/cranky
tunnel vision (very severe low only)

High:
thirsty
need to pee (my immediate thought whenever I both am thirsty and need to pee at the same time is I must be high; sometimes not the case though)
slightly sugar-y taste in my mouth (not ketones—something else)
tired/sleepy
headaches sometimes
flushed cheeks
sometimes very chatty (my mom used to notice this one, combined with the red cheeks)
sometimes hungry if caused by lack of insulin
if high overnight, it feels like a mild hangover when I wake up from the dehydration

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Low:
trembling
some weird hunger feeling
below ~2.5 mmol/l (45 mg/dl): excessive sweating

High:
Like @drbbennett I don’t feel hypers unless they’re very high, above 18 mmol/l or so.
Symptoms include:
tiredness
thirsty
lots of peeing

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When I am low, this is what I feel:

  • Shortness of breath
  • Trembling, shaking
  • Not thinking straight
  • Really tired or really energized
  • Angry, mood swings

When I am high, it’s really hard to feel. My parents can tell when I am high because they say that I speak faster, I can be a bit flushed, I am more disorganized. When I am really high, like above 250, I am tired, but more like energy-sapping kind of tired, rather than sleepy. I have a bit of a hard time concentrating. I typically don’t notice it unless I already know I am high.

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For me, lows feel like there is a Dementor (Harry Potter) or Black Rider (Lord of the Rings) in the room. There is an invisible evil presence sucking happiness and hope out of the room.

It is very hard to put the feeling into words, but it is the most horrible thing ever.

I also get many other symptoms people have mentioned, especially with more severe hypos.

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i don’t always feel a low coming on until i am in the 40s; at which point my husband panics and wants to shove every bit of sugar that we have in the house down my throat. he becomes in a complete sense of panic; and we’ve been together for 25 yrs. you’d think he’d know better by now :wink: .

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I just read this

I try to avoid hypo’s that is for me, decreasing rapidly with quite a big of IOB. This below is news to me:

"3. Lows are horrendous for overall control of BG. When BG’s dip below 70, our bodies alarm us to get some sugar into the system. One way our bodies do that is by releasing hormones that cause us to have intense hunger. (This is why I try to avoid lows when I’m in public – I’ve learned the hard way that people will look at you strangely when you finish an entire box of cereal in one sitting.) "

I thought that non diabetic BG may often be in the 60’s 70’s range.

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The premise of this article is ridiculous. At 100 my alarm would be constantly going off, and to silence it I would probably overeat and stay high.

Instead of the silly idea of setting your low alarm at 100, how about looking at the arrows once in a while? It amazes me that a medical student doesn’t know how to use his CGM.

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For me, lows feel like:

  • Lack of coordination (noticable when trying to type, unlock a door, etc.)
  • Sense of weakness all through my muscles
  • Legs get wobbly if dropping fast or very low
  • Tingling or numb lips and mouth (very unpleasant to me)
  • Visual distortions (blind spots, seeing everything through a red hue, not able to focus)
  • Sometimes intense hunger that I can’t ignroe even when trying
  • Confusion and lack of sense of time for severe lows

Sometimes when I’m low for hours on end overnight, I’ll wake up to my entire body feeling tingly and my vision being like looking through static. I really have never gotten strong symptoms of shaking or sweating when low other than on rare occasions.

For highs, I feel:

  • Dehydrated and thirsty (mouth feels dry even after just drinking)
  • Having to pee a lot
  • Extreme fatigue, like I want to lie down this instant and nap
  • If the high is from lack of insulin, then also nausea

I didn’t use to feel highs until they were upwards of 18 mmol/L or 300 mg/dl for a couple hours, but since going low-carb and having many days where I don’t go above 8 mmol/L for any length of time, I’ve noticed that 10-11 mmol/L now feels high to me.

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His premise isn’t silly imho. If you have your alarm set to 70 and you are busy (as doctors tend to be) you don’t have the time to be checking your CGM every few minutes to correct when you hit that golden number that you correct at, so by the time you notice, you may already either be low, or nearly low.

If, instead, you set the alarm higher, you can go about your business and wait for the alarm to sound at 100, which will then alert you to look, and correct as necessary (if necessary).

I know personally this has resulted in a drastic drop in our severe lows with Liam during the night. By sounding of at 100, I can wake up, correct, and go back to sleep before he ever went low.

If you live around 100 (which we don’t), I can see how it may be a pain, though, and probably not for you.

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I understand your situation Harold, but this medical student is not a young child, he is an adult (hopefully!). As an adult aiming to keep his Bg in range he should be able to glance at his Bg once every 15 or 20 minutes. Hopefully with his control his swings won’t be so dramatic that he would have to check more often.

So I still think his methodology for a well controlled adult is silly.

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What if he’s in surgery? Some of those take hours. Should he stop and check every 10 - 15 minutes? Doctors are sometimes in surgery for many many hours at a time…I don’t know how realistic it would be for him to stop if he’s got someone cut open to go push a button on his CGM ever few minutes (that would require re-washing his hands, etc.,)

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The advantages of a watch are becoming more apparent.

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I’m just not sure I agree with the premise that it’s silly in general…even for adults. I would think if I was an adult, I’d prefer (possibly) to set my BG alarm higher so that I didn’t have to watch the CGM all…the…time. As a non-diabetic, though, I can’t say. I just know that by setting it to 100, you’re being alerted early enough to take action to prevent a low. Maybe this doctor doesn’t have a great A1C and he’s roller-coastering a lot. I’d think that especially during surgeries, I’d want to set it higher just so that I have that alert early. Nothing would suck worse than forgetting to watch the all-powerful CGM (or watch), and falling low, and having that result in some medical malpractice suit by cutting someone’s (fill in a body part here) as he’s passing out in this, already stressful, situation.

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Who would you rather have doing surgery on you–a well controlled diabetic with blood sugar at 90, or an out of control diabetic with a blood sugar north of 250?

It is a doctor’s responsibility to make sure his Bg is in range if he is diabetic. Even if it means glancing at a watch every half an hour.

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I’d prefer a doctor who knows their BG at all times and/or has a system that works for them. I don’t care how much they roller-coaster or if they’re a flatliner…I just want them healthy when they have me cut open. If that means setting an alarm higher, then I’m all for it. :smiley:

Sounds like that’s what this doctor’s doing by setting his alarm higher. It may not be what YOU would do…but it works! And he’s achieving your stated goal above.

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Lately I’ve been setting low alarm to 100 for sleep so I can catch it early and fix it easily. During the day I set it lower since I check it so often.

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Confusion is absolutely a symptom for me, but it’s not confusion like not understanding the way confusion… is. I’m demonstrating confusion with this very bad response.

For me, it’s the inability to focus my thinking. It can start off just scattered, but it progresses to an overwhelming flood of thoughts that are absolutely useless and incredibly distracting. I always tell my family how alarming it is to see my brain actually abandon the rest of me and distract me from the necessary task at hand. I can have the antidote right there in my hand, but if I’m continuing to drop, especially in a chaotic environment, I still need someone to help me make the connection that I actually need to eat it.

I once had a Johns Hopkins doctor tell me that there’s an actual breakdown for symptoms at different blood sugar levels. I believe it started in the 70s, and the symptoms started with shaking and maybe a little sweating. Now, obviously, every diabetic will have their own unique version of things, but I remember her list was pretty spot on for me. I also have a whole rack of symptoms that were not listed, so maybe you start with some simple observations of him and try to capture what you see at those numbers…

As far as nighttime lows, those are really, very tricky. I used to keep small bags of Welch’s fruit snacks next to the bed, but I had a few lows where I couldn’t figure out how to open them. I do think it’s a powerful combination of the effects of a low blood sugar on TOP of the being between asleep and awake. Just out of curiosity, do you turn on the light??

My symptoms of lows are (in descending order): shakiness, sweating, becoming pale, panicky feelings/speech, inability to focus or remain on task, depressive thoughts (yes, and thank goodness these are in such short spurts!), weakness, loss of coordination (feeling like I can’t walk right), numbness in lips, numbness in face and throat, absolutely awful chemical/burnt onion taste, and black squares in vision (inability to look at things).

My symptoms of highs are (in ascending order): tightness or tingly feeling in skin (ketones??), tightness in jaw, cotton mouth, crankiness or irritability, headache, lethargy, and nausea.

I hope none of that was scary… I don’t want to scare you. :confused:

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