Beyond the Sweeter Things in Life

Summer 2018 was mostly lackluster. Busy, above all else, but mostly lackluster. While most of my peers spent their time traveling or lazing around with family and friends, I chose to spend my time in Durham, North Carolina and fill my time to the brim with summer classes, volunteering, and a full-time job. Of course, it was a necessary evil. Choosing a pre-health track with two majors and a minor meant staying focused and getting ahead. And it truly wasn’t that bad at all – the class was interesting, the weather was nice, and my job was fun.

But a few weeks after the start of classes, I began to feel a little funny. I began having dizzy spells, weird dreams, excessive fatigue, and a dry mouth accompanied by a constant insatiable thirst. Days went by, and I continuously brushed off my symptoms as the beginning of a cold. I remember going to the gym after work one day, warming up by starting on the squat rack. Everything was routine and familiar - one, two, three sets down. With a few reps left in my last set, I began getting extremely foggy-headed. My heart rate began to accelerate and I broke out into cold sweats, but decided to push through until the end. I was entirely convinced that the feelings of discomfort would pass until the moment when I squatted down and was completely unable to get back up. I dropped my weights and stepped back. In that moment, everything around me seemed to be going in slow motion. I felt like I had trouble breathing, images started blurring together, and I lost complete control over my emotions. For no apparent reason, I suddenly felt too weak to be at the gym, and found myself confused as to where I was and what I had just been doing. It wasn’t until I went into Student Health later that week that I discovered that I was pre-diabetic and hypoglycemic, and that my scary experience at the gym was the result of a hypoglycemic episode.

I was purely surprised and confused. I was a healthy young woman who exercised regularly, barely drank alcohol, and controlled her diet (apart from the occasional Friday night Domino’s, of course). Exactly what does this all mean? What is hypoglycemia? How could this have happened? And what could have possibly brought it on so suddenly?

Pre-diabetes is a condition in which blood sugar levels are high, but not high enough to be diabetes. As the name suggests, it often precedes diabetes, acting as a warning sign that indicates something in your body is not quite right. Both diabetes and pre-diabetes revolve around insulin – a hormone needed to convert food into energy. But despite this commonality, both also vary immensely in how they affect people. For some, diabetes may allow the pancreas to produce some insulin, but not enough to properly nourish or be absorbed by the body.  can cause autoimmune complications that prevent the pancreas from producing insulin altogether. My case was more of the latter.

Hypoglycemia, on the other hand, occurs when there is too much insulin in the blood, but not enough sugar. It’s medically defined by blood sugar levels below 70-80 milligrams per deciliter, and can lead to seizures and loss of consciousness in severe, untreated circumstances. My blood sugar tends to naturally drop to 75-85 mg/dL at the beginning of a crash, causing symptoms such as shakiness, sweating, anxiety, confusion, blurry vision, and muscle weakness. Thankfully, drops in blood sugar are usually a quick fix, requiring just 15-20 grams of glucose or simple carbohydrates. This can be easily satisfied using glucose tablets, 2-4 ounces of juice, a tablespoon of honey, or (my personal favorite), a nice fat spoonful of peanut butter.

After an in-depth explanation of all of the aforementioned, my physician gave me a sympathetic look. She agreed with me – I was at a healthy weight for my age and gender, and it was very apparent that I took my overall health and fitness very seriously. “But sometimes,” she continued, “it all boils down to your genetics.”

And she had a point. Before officially receiving a diagnosis, my mom had mentioned diabetes as a possible explanation for my symptoms; it ran rampant on all sides of my family. Although I tried brushing off the possibility at the time, it definitely accounted for my seemingly random and unexpected conditions. However, receiving my diagnosis was somewhat of a consolation. It allowed me to educate myself, begin changing my lifestyle, and have at least some degree of closure as to why I constantly felt the way I did.

Although I constantly forced myself to remain positive, I was completely unaware of how difficult it would be to correctly manage and understand my two conditions. Even when I think I’m doing everything right - monitoring all of my macros and nutrition information, planning all of my meals and snacks, checking my blood sugar, and exercising at the right pace - I still have sudden onsets of dizziness, confusion, and anxiety due to hypoglycemic episodes. I always had to be cognizant of treating without over treating; too little carbs or sugar won’t raise my blood sugar enough to resolve my symptoms, and too much will cause it to spike up.

I found the whole ordeal to be incredibly frustrating. Time of day, mood, and external stress can hugely influence my symptoms, all three of which are intrinsically affected by a college student lifestyle. Eating out became nearly impossible, and alcohol consumption became essentially out of the question. Alcohol increases my chances of having a delayed low blood sugar reaction hours after consumption, making drinking on a night out relatively dangerous. For example, say I ~indulged~ in a shot or two at a pregame. There’s a decent to high chance that I would feel normal immediately following, giving me the false impression that I have the green light to drink more. Hours (and potentially many more drinks) later, I could have a huge crash, which would be perfectly okay IF I was in the state to catch it and take care of it. However, if I were drunk, it would severely impair my ability to constantly monitor and assess the state of my blood sugar and/or presence of any warning symptoms. I barely drank or went out to begin with, but the addition of this added risk pretty much takes away the option altogether.

My worry and anxiousness began spiraling out of control. As a sorority member at a school notorious for its “work hard, play hard” mentality, I was SO convinced that going out and drinking were an essential part of the college narrative. How was I going to make excuses for why I wasn’t going out? Would going out sober even be worth it? I don’t want to be that person that flashes her medical issues or uses it as a reason to justify anything, but I also don’t want to put myself in uncomfortable or unsafe situations as a result. My hypoglycemic episodes don’t make exceptions for classes, meetings, parties, or exams; they can come at any time or in any place. It took a lot of reflection and self-care to come to the conclusion that my health is my absolute top priority, and realize that I was ready to fight, push forward, and plod along.

As I’ve learned, so much of diabetes management is about trial and error; a simple meal or snack that might keep my blood sugar normal one day may cause me to spike or crash the next. Nonetheless, I’ve managed to find a glistening silver lining in the midst of all of this medical hoopla: cooking. A few months ago today, I barely knew how to make scrambled eggs without burning the house down. I’ve always wanted to learn how to cook, but it was hard to justify finding time in my schedule to experiment when on-campus eateries were so readily accessible. Don’t get me wrong – Duke dining is absolutely incredible. But while the food is often healthy and delicious, they often include unknown types and amounts of sauces, sugars, and oils that make it nearly impossible for me to keep track of exactly what I’m putting into my body. In order to remedy this (cause a girl’s gotta eat), I’ve started teaching myself how to meal prep and cook. I was pleasantly surprised to discover that it wasn’t nearly as hard or tedious as I expected, and I’ve found so much comfort and security in knowing that I’m taking care of my health.

I share this story with you not to gain sympathy or solidarity, but rather to hold myself accountable. I’ve always been one to preach about wholeheartedly accepting both the good and the bad in order to sustain personal growth. Yet even as a passionate supporter and advocate of all things health related, I am constantly reminding myself to be patient and understanding – now more than ever. I’ve finally decided to take control over my health by acknowledging it as an indispensable part of my identity. Sure, I’m still learning the ropes. And no, I may not have my ish together just yet. But acceptance is a beautiful thing.

Regardless of who you are or what you may be going through, listen to your body. Care for yourself. Every day, re-evaluate where you stand and find some time to recharge your body and refuel your mind. When your body says something, listen to it. When your mind is burnt out, respect that. The biggest thing I’ve learned throughout the past month is that you can either work with or against yourself; whatever mindset or mentality you have in navigating the adversities in your life is entirely up to you.

By Sabrina Maciariello 

Duke Student, wellness columnist and peanut butter junkie, constantly on a journey to understand and be understood.