Fitness + Hypoglycemia with Liz Cambron, Ph.D.
Hypoglycemia (low blood sugar) can occur during or after a workout and to learn how people with type 2 diabetes address it in their lives, we reached out to one of our community members, Liz Cambron, Ph.D., a health coach and diabetes advocate, to share her story. Watch our full interview below or read the condensed version to learn Liz’s hypoglycemia + fitness tips. For more information about hypoglycemia and type 2 diabetes, click here.
BT2: Thanks for joining us, Liz! When were you diagnosed with type 2 diabetes?
Liz: I was first diagnosed in late 2014 when I had just started grad school. I had moved away for the first time, so it was a really big transition. But it was also a really big, stressful time in my life. While I was working out, I blacked out, and it happened a couple of times. But it wasn’t until I was working out really hard, and I ended up blacking out and hitting my head on my dining room table. So, I had to go to the doctor at that point just to make sure everything was okay, that I didn’t get a concussion. Thankfully, it wasn’t too bad. But that’s when they started doing lab work and found that I was pre-diabetic.
At that point, I’m like, “Okay, it’s still early on. I can do this if I eat right and healthy.” That’s what society tells you that if you just would’ve worked out more and ate healthier, you could prevent this. That’s the mentality I had at the time. Even though I would run a lot and work out a lot, I was still eventually diagnosed with type 2 diabetes. It wasn’t a complete surprise; about 90 percent of my family is diabetic and we’re Mexican-American. So, it’s very predominant in my family and in my culture. But it definitely was like an ego slap to know that I was the healthiest one in my family, but I was still developing this disease.
How did you handle your type 2 diagnosis in the beginning?
It was hard at the beginning because diabetes doesn’t care how old you are, how big or small you are, what your culture is. This is a very personal journey, and my diabetes journey is going to be different than yours or someone else’s. I didn’t want to, but I got advice from my family. They told me, “Well, you need to do this is eat more cinnamon, or don’t eat carbs, or don’t do this, or make sure you get this medication.” So, it was like a lot of noise getting thrown at me at the beginning. And fortunately, when I was diagnosed, I was sent to a diabetes educator. I was given a bunch of pamphlets, then was like, “Okay, good luck.” And that was really hard because trying to navigate this on your own is very different than helping my mom with her diabetes because she’s at a different level than I was.
The beginning of my diabetes journey was very fear-filled, fear of getting my foot amputated, fear of living on medications for the rest of my life, but also fear of the stigmas that now I’m just this lazy fat overweight person and that’s who I’m destined to be. So, why even try? It impacted my depression and anxiety, which also increases due to diabetes. It was hard to navigate that without the education I needed. I know what nutrition is from my background in biology and it’s different for a diabetic. Carbs aren’t just bread, they include fruit and watermelon’s my favorite fruit, but I can’t eat a whole watermelon anymore. Nutrition has been the most difficult to manage and I have been and am still working through emotional eating. My lifestyle was just not what it needed to be to live a healthier life. I was in grad school during this whole time, so my own health and my own journey were kind of on the back burner.
It wasn’t until probably maybe a year and a half ago, where I was finally put on insulin. It shouldn’t have been, but it was a low point for me because that’s where that original fear from the very beginning came in of, “Crap. I’m on insulin now. That means it’s getting worse. That means I’m just destined to be this unhealthy diabetes person.”
I took a step back and told myself my body either doesn’t make insulin or doesn’t use it properly. So, that means, when I work out, my muscles aren’t getting the blood sugars that they need to work because they’re working, they need fuel, and my body’s not giving it to it. So, my body needs insulin. It’s like my body’s a car. If there’s a piece that’s not working, you don’t hate the car, you just change the piece and get it to work again. When I switched that mindset, it really made such a big difference because it wasn’t me fighting my body. It was me working with my body. So, being on insulin and other medications really made a difference
Did your doctor ever talk to you about low blood sugar and hypoglycemia? What was your education around there?
It wasn’t until I was on Victoza. I was also on Lantus and Glipizide, and I just recently started Jardiance. And so, it wasn’t until I was on that one, that I was kind of explained a little bit more about hypoglycemia. For the most part, I never had any hypoglycemic events, so it wasn’t really a concern. But once I was on all four of these medications, that’s when they’re like, “Okay, there’s going to be some interactions. So, this is what you need to look for. And if that happens, let me know so we can adjust things as needed.” And so, once I got on all four, I had hypoglycemic events every day.
It was exhausting. I just always felt like I didn’t have energy because my body wasn’t getting fuel. And it got to the point where it was scary to be alone. I was afraid to drive to work and be by myself. My first hypoglycemic event on my own didn’t really click at first. I felt nauseous, sleepy and anxious – I thought I was having a panic attack. I didn’t even think of checking my blood sugar because I’ve had issues with low blood pressure. It wasn’t until a few more events that I realized I should start checking my blood sugar to rule out hypoglycemia.
How does your family support you in preparing for hypoglycemia-related emergencies?
I had to make sure to let those around me knew what to do [just in case of an emergency] and I always have a snack or a juice box. My fiancé, Jamie, made sure he knew what to look for and what to do. After my first hypoglycemic event, he said I looked pale and thought I was dying. But now, he understands why we have juice boxes and candy. I keep emergency contacts on my phone in the event I’m alone and paramedics need that information. I feel safer because of it.
I have emergency contacts on my phone in case anything happens in public, and I’m by myself, paramedics can help get my information. So, it feels almost like doomsday planning like, “Okay, I have to get all these things done and make sure I have all this stuff with me.” But I feel safer because of it.
It’s great that your fiancé and family are prepared. How low has your blood sugar dropped?
I think the lowest it’s gotten is probably about 2.2 mmol/L40 mg/dL. This past year and a half, I’ve really learned to listen to my body. So, I can catch when my blood sugars are going low. Knowing what hypoglycemia feels like for you is important.
I will always use a continuous glucose monitor (CGM). It has been amazing. And that’s really what also helped me fine-tune my medications. So, we know when my blood sugars go down, how they fluctuate throughout the day, after I eat before I eat. So, it’s really helped me learn kind of the daily rhythms of my blood sugar levels. But I scan pretty frequently. One, because it’s easy. But also, because I love how much data it gives you.
Before you work out, do you eat a snack before just to prepare for low blood sugar? Or at least how do you prepare for low blood sugars before your workouts?
Thankfully, I don’t really have hypoglycemic events as much after I work out. They usually go a little bit higher, because I think my muscles are still not getting all the sugars they need, so I’ll get a rush into the bloodstream. But I always prepare. I have like a pre-workout before that does have some carbs in it. So, that really helps. I personally don’t like eating before I work out because they’re usually high intense workouts.
It’s important for people to know when you get low blood sugar when you’re working out so they can help you when needed. Also consider eating a snack beforehand, even if it’s like half a bite of a banana. But have something to prepare. So, as I said, I always have juice boxes and I always make sure to eat after I work out too, to refuel my body.
When it comes to just general hypoglycemia awareness in the type 2 community, in your opinion, why is this such an important initiative to have? Why should we focus on hypoglycemia for people with type 2 diabetes?
It’s just assumed that type 2s just always have high blood sugar levels. And so, having that mentality really hinders diabetics from knowing what to do in an emergency of a low blood sugar level. It can be dangerous.
It can lead to passing out. It can lead to possible emergencies that can be preventable. So, having people understand, even if they never get a low blood sugar level in their life, it’s good to know what to do in case it does. Because it’s always better to have and not need than to need and not have.
This content was made possible with support from Baqsimi, a Founding Partner of Beyond Type 2.