Low and Slow, but sometimes fast, very fast – Understanding the not-so-silent crisis of hypoglycaemia

‘Behind the Veil…  Journeys in Chronic Healthcare with Dr Stan Landau and Team’

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In this second part of our mini symposium looking at the use and value of continuous glucose monitoring (CGM) in practice, we explore the ‘experience’ ofhypoglycaemia in people with diabetes.

“It was a typical Tuesday afternoon, and I had just finished a long day of meetings at work. The stress had left me feeling more tired than usual, but I brushed it off – just part of the job, I thought. Little did I know, my blood sugar was steadily dropping without me realizing it. I had been managing my type 1 diabetes for over five years, but hypoglycaemia was still something that crept up on me when I least expected it.

I was sitting at my desk when I first noticed something felt off. My hands, usually steady when typing, were starting to shake. I thought maybe I was just hungry, but as the minutes ticked by, the shakiness got worse. A wave of dizziness hit me next, followed by the cold sweats that are all too familiar. It was only then that I realized what was happening – my blood sugar was crashing!

I excused myself and went to the kitchen to grab some fruit juice, my usual go-to when I felt the first signs of hypoglycaemia. But it wasn’t just the physical symptoms that made this episode so unsettling. It was the mental fog that accompanied it, the inability to think clearly or focus on anything other than the overwhelming urge to get my blood sugar back up, quickly! I could feel my thoughts becoming disjointed, and I had to fight not to panic.

As I sipped the juice, I tried to remind myself that I had dealt with this countless times before. I knew the routine: drink the juice, wait 15 minutes, check my blood sugar again, and repeat if necessary. But it never really gets easier. Each time, I find myself wondering how low I might have gotten, how close I was to not realizing it in time. Would I have passed out? Would I have been able to take care of myself?

The thing about living with diabetes is that you’re constantly juggling the delicate balance of your blood glucose levels. It’s an ongoing cycle of checking, adjusting, planning meals, monitoring exercise, and trying to predict how your body will react. But even with all of that, there are still those moments when everything goes wrong. Sometimes it’s caused by something simple—maybe I took my insulin just a little too early or didn’t eat enough at lunch. Other times, it’s the result of stress or even the weather, which can throw my body off.

Did I miscalculate my insulin? Hypoglycaemia doesn’t always give you a warning, and it can happen at the most inopportune times. But I also knew that as long as I stayed vigilant, I could manage it. That’s the balancing act of living with diabetes—the awareness that a moment of inattention or a small mistake could lead to a physical crisis, but also the knowledge that you can usually fix it.

But what if I couldn’t fix it? That’s where the anxiety sometimes lingers. Hypoglycaemia can be dangerous, even life-threatening, if it’s severe enough. I’ve heard the stories of people who’ve experienced seizures or even lost consciousness. Some have even died. There’s always that silent fear hanging in the background, a quiet reminder of just how serious the condition can be. And in those moments, it can feel like your body is betraying you, no matter how much effort you put into managing your diabetes.

When I felt the dizziness subside and the shaking in my hands slow down, I knew I was out of the danger zone for now. I checked my blood sugar again, relieved to see it was rising. I’d caught it in time. But the feeling of vulnerability lingers, like a shadow that’s always a step behind. And that’s the strange thing about living with diabetes—sometimes, it’s not the physical symptoms that are the hardest to manage. It’s the mental and emotional toll of constantly being on guard, of knowing that one small slip-up can send your body into chaos.

Still, I carry on, because that’s what you do when you live with diabetes. You adapt. You learn from each experience, and you keep moving forward, even when it feels like the odds are stacked against you. The fear of hypoglycaemia might always be there, but I know I can face it, one step at a time.

This narrative is a reflection of both the physical and emotional challenges that people with diabetes face when dealing with hypoglycaemia. It touches on theunpredictability of blood glucose levels, the anxiety of managing them, and the resilience needed to navigate the daily realities of living with diabetes.