T1D + T2D Perspectives on Hypoglycemia w/ Ginger + Taylor
Beyond Type 1 staff member, Ginger Vieira, and Type 2 Podcast Host and Advocate, Taylor Daniele, joined Beyond Type 2 to discuss their experiences with hypoglycemia from a Type 1 and Type 2 perspective, respectively. Read the condensed interview below and watch the video for the full discussion.
BT2: Thank you both for joining me today! Let’s talk about your unique experiences with hypoglycemia – Taylor, you live with Type 2 diabetes, and Ginger, you live with Type 1. Would you mind sharing your experiences?
Taylor: That’s actually how I discovered my Type 2 diagnosis, amongst other symptoms, I had fainted several times and decided to see a doctor. Both of my parents have Type 2 so I figured there was also a genetic aspect [to developing diabetes]. I recently joined the CGM crew with the Freestyle Libre 2 and saw many lows with the first two weeks of my sensor. I could see what was going on versus doing the finger prick and guessing and not knowing where I’m at during the day. I also noticed I was going low in the middle of the night and would wake up starving with my alarm going off. In hindsight, I recognized moments where even before I received my diagnosis, I’ve had low blood sugars and had no idea.
Ginger: I’ve been Type 1 since I was 13 and I certainly had lows as a teenager, but I wasn’t as attentive to my blood sugar management. I don’t remember having as many lows maybe because my blood sugars were definitely a little higher as a teenager. But, I’ve had a few scary lows and only one where I passed out. I’ve never had a seizure from a low and I’ve never needed someone else to give me emergency glucagon, but I have used it on myself. Like when I was eight and a half months pregnant and I had norovirus and I didn’t know it, I’d gotten it from Christmas dinner with this giant group of people. I started puking nonstop and had taken all this insulin for all the Christmas dinner I just ate that wasn’t being digested.
So, it was really helpful to have emergency glucagon for that because I knew that I had all this insulin in my bloodstream from food that was no longer being digested. Probably, the scariest low was when I was in my early 20s learning how to juggle training in powerlifting and managing my insulin doses, and I forgot to cut my insulin dose in half for the meal that I ate after my powerlifting workout. I crawled from my bedroom to my kitchen where I grabbed a thing of dry oatmeal off the counter and poured it in my mouth and then passed out on the carpet. I woke up a half-hour later and my blood sugar had come up because of the oatmeal; I’m sure my liver also helped. But those are the most dramatic lows that I’ve had and that’s what I think what people who don’t have diabetes think about as what low blood sugar is, but anyone on insulin and anyone in other stages of living with Type 2 diabetes too can experience lows, even minor ones because we’re trying to stay in that healthy range.
Let’s talk about treating low blood sugar. Ginger, you mentioned a glucagon kit and we’ve mentioned things like Gvoke, BAQSIMI, other traditional glucagon kits. Can you both talk about the education you did or did not receive about low blood sugar?
Taylor: This will probably give you a clue, but I have no idea what you just listed because my understanding was to drink some juice or some type of sugary drink. I usually, now I keep like the go packs of applesauce. Even when I was first diagnosed, my doctor said “here’s some metformin. You’re young. This will probably be all that you need. Cool. Here’s a pamphlet on all of it.”
I’ve just now started seeing an endocrinologist, and I didn’t know I was supposed to. My primary care doctor has always been the one helping me to treat diabetes. But even then, I wasn’t told to keep something like that on hand.
Ginger: I think doctors are good about making sure Type 1s have the old school emergency glucagon kit that’s very complicated to use and expires after a year. If you don’t know that, then you’ve got one that’s like five years old and, but you have to mix these two things, and then it comes with this humongous needle. The whole benefit of these newer emergency glucagon kits like the nasal glucagon Baqsimi and Gvoke is that you don’t have to mix anything and don’t come with a giant syringe, which can be intimidating for the people who are administering it for you. I have Baqsimi, but my doctor never mentioned it. I had to ask for the prescription, and fortunately, I didn’t get any arguing with like, “What’s that? Why do you need that?” I don’t think enough doctors know about these newer better types of emergency glucagon.
Nasal glucagon, originally, is thought of as someone’s using it on you if you’re having a seizure and you can’t eat. But let’s say you live alone, you would keep it in your nightstand so that if you woke up during a severe low, and the idea of trying to chew or get to the kitchen is not possible, you could at least just reach for the glucagon and give that to yourself. I could save my life or prevent seizures and hours of in bed, seizing.
Taylor, you mentioned how you woke up in the middle of the night, starving. Do you live alone? Is there someone close by who can help you when you experience hypoglycemia?
Taylor: My partner has access to my place, but he wouldn’t know I was dropping low if he wasn’t near me. Because I have the CGM too, I don’t have a way to put it on his phone to alert him if I’m having a hypoglycemic event. So, I must be aware of that kind of stuff. Fortunately, he was a medic in the military and knows how what to look out for when we’re together. Even my parents know what to do to help me because they have similar experiences. Still, I’ve taken it upon myself to try to prepare myself as much as I can.
Regarding prevention and preparedness, how do you both try to prevent hypoglycemia? Do you make any changes to your medication?
Taylor: I keep snacks everywhere, including my car, purse, and nightstand, and my partner will keep gummies or tabs with him as well. If we’re out, I also make sure to preview what we’re doing for the day so I can plan accordingly.
Ginger: I always wear this little purse when I’m walking my dog that has gummies in it. Also, because (rapid-acting) insulin stays in your system for three to four hours, I adjust my insulin dosages and time my exercises, including dog walks that can lower my blood sugar. That’s what works for me and my body, but everyone should talk with their healthcare team to find out what works for them.
Please talk to your healthcare provider about what you should do to prevent or prepare or even treat low blood sugars. For more information about hypoglycemia, click here.
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This content was made possible with support from Lilly Diabetes (Baqsimi), a Founding Partner of Beyond Type 2. Beyond Type 2 maintains full editorial control of all content published on our platforms.