Driving on Empty: How Changing a Tire Can Lower Blood Sugar

During a recent trip to visit my sister and brother-in-law I hit a piece of metal on the interstate and my front left tire was ruined. Changing the tire wasn’t a difficult process, but it used energy that was not accounted for in my calculations of exercise, insulin and food intake.

After arriving at my sister’s I took 20 units of regular insulin, my normal lunch dose, and ate lunch with my sister and her husband. An hour after lunch I checked my blood glucose level. It was a little high, 192, but I had just eaten so I expected a fairly high number.

I decided to get a new tire at the local discount store. It took about an hour to get the new tire and I was feeling fine. There was no warning of any kind that I might be operating on the lower edge of an adequate blood glucose level.

Soon I was looking for the shortest way from the parking lot to my sister’s house. I was still unaware of any problem, but I felt somewhat intimidated by the traffic and was focusing all my attention toward staying in my lane and stopping when the lights turned red. I lost track of where I was and found myself trying very hard to watch the traffic and take a glance at the passing buildings to get a clue of where I was. All my attention was focused on surviving in the heavy traffic. I was not aware that something was amiss other than the fact that I was having a terrible time driving. It felt like the part of my brain that could solve problems was not operating and all I could do was try to keep up.

At this point I had candy in my pocket, three boxes of juice within easy reach and two full sugar Coca-Colas behind the seat. There was no lack of a solution. But at this point I wasn’t even able to understand that I had a low blood glucose level. My entire world was now driving that truck and not hitting anyone or getting hit.

My next memory was of someone talking to me. I was restrained on a board or something, and a male voice was saying, “Mr. Blakely, Mr. Blakely, can you hear me?”

I opened my eyes and seemed to be in a small space with this person looking down and speaking to me. “Mr. Blakely, how do you feel? Are you hurt? Are you comfortable?”

I began to realize what had happened and a feeling of remorse and shame swept over me. I closed my eyes and shook (actually, tried to shake) my head.

“Mr. Blakely, you’ve been in a small accident and we are taking you to the hospital. Do you understand?” He moved the oxygen mask to allow me to answer.

“Did I hit someone?” I asked.

“I don’t think so. Whatever happened didn’t cause any damage that I saw,” he replied.

The ambulance was hurrying toward the hospital with the siren whooping. Soon the ambulance stopped and the back doors opened. People were rushing about, telling one another what needed to be done. A woman appeared by my right side and started by saying, “Mr. Blakely, Mr. Blakely, how are you?”

“I’m fine, nothing hurts,” I replied.

My mind had cleared pretty well by now and I was still struggling with a lot of shame at allowing myself to get into this mess. How had I missed the symptoms? What had happened that distracted me? My blood glucose had been fine when I left my sister’s house. How could this have happened?

The questions from the nurse beside me continued, “Do you take any medications besides insulin? What are they? Can you name them? Do you have any other problems beside diabetes? How do you feel? What is today? What is your name?” They sure wanted to know an awful lot!

After I was wheeled into the emergency room someone came over to check the glucose the hospital was giving me intravenously. They said my blood glucose level was 140. Hah! It may have been 140 on the way up to 400, I thought. Actually my blood glucose dipped into the 40s within the next hour. The emergency room doctor brought me a couple of juices and some graham crackers and things began to look better.

By 6:30 p.m. they said I could get dressed. A thoughtful nurse brought me a paper scrub shirt. Mine was soaking wet with perspiration. Of course they insisted that I ride to the car in a wheelchair. My sister had come about an hour earlier. A policeman checked my paperwork, we found my wallet and they gave me all the hospital paperwork saying, “Eat more snacks and check your blood glucose level more often.”

What a day! I have been insulin dependent for 17 years and have never had to be taken to the emergency room before. I have had low blood glucose incidents and, I fear, I’ll have a few more. Driving back from Atlanta I checked before I left and I checked after two hours of driving. Perhaps I can avoid further incidents by working harder at watching the numbers.

One more thing: I was wearing a medical emergency information bracelet. I was told by the policeman and the ambulance crew that the bracelet gave them something to go on. It was worth its weight in gold! If you don’t have one, get one! I dragged my feet for a long time. Luckily, I had it on.

I share this with the rest of you for a reason. Hopefully someone will learn something from it. Because I am a responsible citizen, I want to be in control of myself and my vehicle. And because of this incident, I will be even more vigilant about avoiding hypos in the future.

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