Nausea with Lows and Diabetes Woes

June 12, 2024

It’s always amazed me how many little things can go wrong with the human body. So many complex systems work together so harmoniously that we often take it for granted. It’s very similar to a car – many things are working hard to get me from point A to point B, and I get very frustrated when it doesn’t work as it should. One tiny piece goes out of alignment, and hours of time and likely hundreds of dollars later, it’ll be back to usual. Unfortunately, it’s less simple when it comes to the human body, as we cannot take ourselves apart and back together again.

Symptoms Changing Over Time (Rude)
When you first learn about diabetes, they talk about symptoms of lows to help you identify and treat them early in hopes of preventing severe lows. Usually, the symptoms include:

  1. Hunger – I’m talking about a ravaging hunger like you’ve never felt before where you’re likely to eat everything in your fridge if you’re not careful.
  2. Shakiness – Often, you’ll feel like your hands are shaking, but others may not notice.
  3. Heart Racing – Another common symptom that can also add to anxiety, which you may already have about the low blood sugar you’re having.
  4. Feeling weak – Your brain is starving for glucose, so you may find it difficult to do normal tasks like walking.
  5. Confusion or Difficulty Concentrating – See above, and if you get too confused, you are already very low!

These are all frustrating, but in my experience, hunger was the main driver of my actions when I was low for a long time. The older I got, and therefore the longer I had been living with diabetes, the more I noticed my symptoms with lows and highs change. When I was about 20 years in, I noticed that my blood sugar dropped quickly or I had a low, my lips and tongue would start feeling very tingly. This really freaked me out the first couple of times, but it turns out it is considered a “normal” symptom of low glucose. Then, my partner and I decided to do what many adults do: have children.

Pregnancy brought all kinds of new and intense feelings to my body, and it has truly never been the same since. Since I spent most of the first trimester low, which is normal when you don’t have diabetes, I began to feel “normal” at 60-65 mg/dL. My medical team wanted this, so I figured I should listen to them and hopefully reduce risks for everyone involved. I also spent about 20 weeks feeling nauseated almost all the time. This is super counterproductive to my literal survival and made it very challenging to treat lows.

Ever since then, my first symptom of low blood sugar is almost always nausea. It took me a while to realize it, but often, I will start feeling nauseated and think, “Huh, did I eat something weird?” and look down at my CGM, and it shows a straight arrow down. This did happen occasionally pre-pregnancy. If I had eaten a full meal, then I had a low and therefore had to add food to an already full stomach, but now I feel nauseated about 80% of the time with lows and rapid drops in glucose.

Enter Fear of Hypoglycemia
Why is this so annoying? Let me count the ways…I have had some very low glucose levels in the past, including down to 24 mg/dL when pregnant and 17 mg/dL as a child. It didn’t bother me that much; I wasn’t afraid because I knew I could go very low without losing consciousness and that I would be okay. But as an adult with a fully formed frontal lobe and a parent of children who depend on me, my fear of hypoglycemia has skyrocketed. If it weren’t so unpleasant to manage my low symptoms, I’m not sure what my level of fear of hypoglycemia would be.

But as it is, sometimes I have to find a sugary soda to get glucose into my body, sometimes I have to take glucagon, and sometimes I will only eat fruit snacks or cereal. The added layer of feeling like I’m going to vomit and needing to get carbohydrates into my body really adds a lot of stress to me and my family. Add to this having an intense low with only my kids around, and BAM, you get someone wanting to keep their blood sugars above 70 mg/dL more than wanting to keep them below 300 mg/dL. Not that I like either end of that spectrum.

The Diabetes Hangover
Another lovely surprise about diabetes over time is that as your body ages, you don’t bounce back as quickly as you did when you were younger. Sure, we hear that about things like injuries, but I never thought about it relating to diabetes-specific things like highs and lows. And those nights when you have to treat a low or wake up to a very high blood sugar because your infusion set went bad and you and your partner both slept through your alarms make for a very unpleasant hangover feeling the next morning.

I’m not sure if it’s worse than an actual hangover, but I gotta tell you, it’s not pleasant for anyone involved. I’m so grumpy these days and honestly find it very difficult to function as a normal human being. I have had to call off work a handful of times due to experiences like this, and I hate it more than anything. It feels like diabetes is “winning,” and I am definitely “losing.” As someone who grew up with diabetes since the age of two, I always prided myself in not letting diabetes stop me from doing anything. And in the big picture, it definitely hasn’t. But on those few days, it sucks to admit that my body needs rest and recovery.

There are many, many other things on my diabetes woe list, but I will say that diabetes keeps you on your toes and will teach you that no matter what you plan, life (or diabetes) may have other plans. It has helped me be more flexible, resourceful, and creative in problem-solving. But it would be cool if you could chill a bit more diabetes, okay? Thanks. 😊


Written and clinically reviewed by Marissa Town, RN, BSN, CDCES