The lesser of two evils – by Jenny Foster
Is there a lesser of the two evils? By the two evils of course I am referring to what us slaves-to-diabetes call the hypos and the hypers or the lows and the highs; those times when blood sugar levels decide to slip out of their comfort zone and give their owners a little kick up the bum!
I was asked the question just the other day by a friend who was unfamiliar with the difference between the effects of high blood sugar readings to those of a low reading. I contemplated my answer and discussed it with Ewan, my 10 yr old son who has Type 1, insulin pumper!
When Ewan was diagnosed 2.5 yrs ago the word ‘hypo’ sent shivers down my spine, it sounded so serious, deadly serious! When I was told by a nurse that Ewan could have several of these a day while we were getting used to his insulin regime, I was horrified!
I imagined him passing out on the street, or slipping unconscious during classes at school but the reality of a hypo was one of our few pleasant surprises during those early weeks. Ewan would say he felt shakey, his legs a bit like jelly, a blood check would confirm his sugars were a bit low, we would treat with jelly babies or Lucozade and 15 minutes later all would be fine!
When I first heard the word ‘hyper’ I immediately thought of the abbreviation for hyperactive, I never related it to hyperglycaemic, why should I? I’d never heard that word before. So again my mind played tricks on me and I pictured Ewan running around the house screaming and waving his arms around or having an uncontrollable fit of giggles when he should have been concentrating in maths … but again, how wrong I was!
Whilst the hypo had been my pleasant surprise, the hyper came as a nasty shock. Words like ketones, ketoacidosis and coma (yes coma!!) we’re branded around in abundance and with unnerving normality.
Now, we’ve experienced many of these highs and lows over the past few years and as a mum I definitely find one much easier to deal with than the other, but as the person with diabetes, Ewan is at odds with my conclusion.
The hypo is quick, his awareness is exceptional so treating and recovering from them is quick too. The treatment feels like I’m giving him a treat and no sooner has he felt the shakes then he’s back to doing whatever it was he was doing! For Ewan though this is a pain, the shakes feel awful and stop him from doing what he was doing. The jelly babies and lucozade ‘treat’ as a treatment is becoming boring and a little bit sickly and because of hypos he has to carry a bag everywhere he goes with sugary supplies that he can’t just eat and drink whenever he chooses – torture!
The hyper is hidden. His symptoms of high blood sugars are almost none existent and often surprise us when we are doing routine checks. That’s when I have to start using my brain… calculating temporary basel increases, adjusting ratios and setting alarms for endless re-tests and ketone tests while his sugars slowly return to acceptable levels, all the while the words ketoacidosis and coma reverberate around my head and the long-term side effects of high blood sugars gnaw at my conscience.
Ewan on the other hand is pretty oblivious, aside from the extra testing and correction boluses through his pump he pretty much carries on as normal and feels no different.
You can see why our conclusions are at odds with each other!
For me – hypos are in the now, recognise them, deal with them quickly and all will be fine. Ewan is 10, he lives in the now, hypos are a pain.
For me – hypers are hidden and they signal something is really wrong, put it right or suffer the consequences of possible long-term side effects and hospitalisation. Ewan doesn’t look at the future, he is 10, he lives in the now.
The lesser of two evils? Ask me and I’d tell you hypo, ask Ewan and he’d say hyper. The real answer is in the question though, they are both evil!