Now, here’s an issue that I haven’t written about, and a theory that NancyTW and I discussed a few days ago. It has to do with a specific element of severe hypoglycemia. While I’d venture to say that many, if not most, of us T1s have had serious lows, how often do they occur more than once in a single day? Often, we experience a rebound of higher blood sugar after an extreme low, and that was the case with me on one occasion about four years ago, when I had three harsh hypos within the span of about 18 hours.

Even with such a miserable day to look back on, I can’t attribute the events to being brittle. The ingredients were all present for a classic loss of control: it was a midsummer weekend; we had a house full of guests; I was having fun playing baseball out in the yard; NancyTW was busy entertaining her share of the crowd, and couldn’t be looking out for signs of hypoglycemia; there was the grille to start, drinks to distribute, and jokes, conversations, and small-talk. On top of that, we were already deep into the stress of preparing to relocate from New England to Florida.

With my attention drawn in so many divergent directions, self-testing took on less importance, and we all know what that means. Had I devoted myself every couple of hours to taking a minute for a test, the problems of the day might have been averted. It was my own negligence, not “brittality,” that led me to walk right off Blood Sugar Cliff.

The first insulin reaction occurred during the baseball game, and someone went into the house to alert NancyTW. A glass or two of OJ, a few minutes of rest, and I was fine. My liver, however, had already taken the precaution of opening the glycogen floodgates, and later on I dealt with the onslaught of hyperglycemia in the way any red-blooded American boy who puts his brain away on weekends would -- I Humalogged it.

After burgers, and my memory isn’t crystal clear at this point, we probably started right in on Game 2 of the doubleheader out in the yard. So again, through nobody’s fault but my own, I slipped quietly into the day’s second hypo. Again, more OJ brought me around. Again, I rested away the symptoms. Again, more glycogen filled my innards from my liver.

Again, more Humalog for the nasty rebound.

Now, none of this is going to get my name printed in the Mensa Bulletin. But there’s more. After getting back to normal sugarwise, or so I thought, we went to bed late that night after our company left. My next fuzzy memory is of a paramedic doing paramedical things to keep me from falling any deeper into the hole I had spent an entire day digging for myself. NancyTW had tried her best to bring me out of the nighttime low, risking loss of the finger she used to apply blue cake frosting to my gums. But I was having none of it, instead convulsing uncontrollably on the bed like Linda Blair in The Exorcist.

Nancy recalls me sitting upright at one point, still far from conscious, making ghastly sounds as I labored to inhale. I was not responding well to any attempts to revive me. The EMT had initially seen my blue lips, not knowing about the frosting, and thought to himself that I was a goner. (When someone says, “till you're blue in the face,” the connotation is not good.)

Eventually, the cake gel found an on-ramp to my bloodstream, and I slowly emerged from the hypo-stranglehold, to a degree of hypoclarity, and eventually to that happy place where the hypo-hangover begins and the regrets soon take over.

If you’ve read the Lord of the Rings trilogy, this third low was the Nazgûl of insulin reactions. The paramedic said something to Nancy about a “grand mal seizure,” and today she and I think that even though I was given glucagon, my liver was fresh out of glycogen after having already been called upon earlier that day to come to my rescue.

Is this possible? Based on what I’ve read, yes. Simply put, if the liver has a store of sugar, it seems likely that the supply could become depleted, at least for a time. This is what I believe happened to me after three reactions in the span of just hours. I think the emergency back-up glycogen supply was bone dry, like a sponge that had been thoroughly rung out.

But I don’t have a medical degree, and there may be many other factors that I am not considering here. Any comments or pertinent thoughts you’d like to share are welcome.

In the years since then, I have been fortunate enough to avoid such a severe repeat performance. Bad lows happen infrequently now, and I try always to keep my focus on blood sugar first, and peripheral activities second.

It would have been quick and easy to blame brittle diabetes for my wrongheaded lack of control on that sorry day. I could have gotten up the next morning, shaken off the cobwebs, and forgotten all about it, never bothering to figure out why it happened or how to avoid it next time. But if I’m using the term “brittle” to describe woefully inadequate control simply to feel better about myself, then I have to address another important issue: does feeling better about myself help me ward off the short and long term complications of diabetes if my sugars continue to rise and fall drastically out of control? I say no, it does not.

So I don’t call my diabetes brittle. My sugar swings like a pendulum just like everyone else’s does from time to time, but I gain nothing by denying the reality of my own human error. Nothing will continue to keep me out of the hypo penalty box better than a disciplined attitude toward strict control.

The only thing brittle that long ago day was my way of thinking.

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EXTRA, EXTRA!! Be sure to check out this super Feature Story interview given to Diabetes1.org by our great friend Kelly Kunik of Diabetesalisciousness.

Have a great weekend, everyone.