I Passed Out

December 24, 2012. Christmas Eve day.

I felt blessed to get in a couple hours of basketball, even on a holiday.  We played hard. I had a lot of fun and wore myself out quickly. Blood sugars were pretty normal for most of the session, with a slight spike as I was finishing.

We got cleaned up and headed out to lunch — a normal routine I have with a few buddies at the gym. Before leaving I tested my blood sugar again and was surprised by a very high reading. So high that it didn’t fit the pattern, but I didn’t think twice about it.  I took a correction bolus and my lunch bolus, wanting to give my insulin a head start on my meal. Especially since I was so high.

About forty minutes later I had my food in front of me and started eating.  I got halfway through my sandwich (a grilled cheese, of course) and a wave of nausea hit me hard. I got up and headed to the bathroom, convinced I was going to lose my lunch.

I felt off as I walked to the bathroom. By the time I got to the front hallway I lost all logic and couldn’t read the signs to figure out which bathroom was which.  Stumbling through the hall and bouncing off of the walls, I pushed through the front door of the restaurant and reached for an outside wall.

That’s all I remember.

I woke to the sound of approaching sirens and my friends calling my name. I was sitting against the outside wall. There was a glass of orange juice. I drank it and asked for another. Coming back now. Help was on the way.

I was embarrassed and confused but knew it was low blood sugar. I was back enough to test myself; 69 mg/dl.

View from inside an ambulance

Ever seen an ambulance from the inside?

A fire truck and a police car pulled in, sirens blaring.  They asked about my blood sugar reading and gave me a tube of glucose gel.  The ambulance pulled up and I was able to get up and climb aboard.

They tested me a couple more times and I was coming back up.  I was fully back now and able to answer all of the questions (name, (new) address, doctor, etc).

I had another glass of juice and some glucose tabs while I sat with them.

A bit later my friends drove me home and I tried to understand what happened.  Was that high reading inaccurate? Possible, I guess. I also think my insulin was accelerated by the recent exercise and started working much faster than normal. Maybe it was a combination of both? Who knows.

What really rattles me is that I didn’t have any warning. By the time the nausea hit me, it was already too late. This low ran me over before I had a chance to see it coming. The CGM had no chance either, and it’s usually a little bit wonky right after exercise anyway.

Until this event, I’ve had no trouble with hypoglycemia unawareness. Time (and frequent testing) will tell if it’s something I need to watch out for.  Heck, we all need to watch out for it, right?

This is the first time I’ve needed help with a low while awake since Jr. high school (1987?).

I thought I was doing everything right. Only the benefit of hindsight shows what I did wrong. I should have double-checked that high reading, and I should have waited on my insulin. The speed and ferocity the price of my mistake exacted on me is terrifying.

After a week of sitting on this experience, I’m feeling a bit better.  But I’d by lying if I said I wasn’t psychologically shaken by this event. I’m a mess, mentally, and my wife won’t let me out of her sight if she can help it.

I need to share that this can happen. Diabetes is dangerous. If this can happen to me it can happen to any of us. If you think you’re exempt from the dangers of low blood sugars, if you think you’re so on top of everything that it will never happen, I have news for you…

Please be careful out there. The tiger is always on the prowl, sometimes just because he’s in the mood for a snack.

Can you have a pet tiger? Sure. So long as you feed it well, groom it, and never turn your back on it, you can co-exist with a tiger in your living room. But if you neglect the tiger, starve it, turn your back on it, the tiger will pounce on you and tear you to shreds. Diabetes is the tiger. Feed it right. Take care of it right. And the two of you will live just fine together.” — Wil Dubois, Taming the Tiger


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94 thoughts on “I Passed Out

  1. Hey my name is alex, ive been type one diabetic for around 9 years. Some diabetics(i happen to be one of these) when they do physical activity it actually inceases bloodsugar, sometimes even alot. My endo explained to me though this is caused by increased adrenaline. She also told me these spikes should not be corrected unless they last for more then 30 minutes without begining to go down after the activity, because theyll drop on their own. So may this is what hppened to you? I remember back in hs when i wrestled my bg would b 400 after practice

  2. So what is this called? This happens to my husband when he excersise but we don’t have a diagnosis. He is a type 2 diabetic.

    • Hi Susy,
      In my case, it was low blood sugar or hypoglycemia. Exercise usually accelerates and amplifies some types of diabetes medications, which means we have to be very aware of how they work and where our blood sugars are before, during, and after exercising.

      It may be a good idea for your husband to talk with his doctor about this happening. There are often many options available to help.

  3. Scott thank you for sharing your experience. It was very important for me that some people experienced the same couse last night i passed out the same way you did. It was just a normal day, i just did my usual things and go out for 10km run in the evening. After that everything was fine i was speaking with my mother ate my meal and thats the last thing i remembered… After that i was woken up on the ground in my room by ambulance doctors, they injectes some glucoses and i was stabilazed. The scary part that for a while i dont remembered shit what i was doing all day, or how everything happend. Even now i dont remember the moment when passing my passing out started, its really scary couse it was very sudden, i was living with first class diabetes for more than seven years and never experienced such horid thing before. Againthank you for sharing this it is very nice to know that you are not alone. And sorry for bad english i am From Lithuania, english is not my native tongue.

    • Hi Algimantas!

      Thank YOU for visiting and sharing your story. I’m so sorry that you had to experience that as well. It is so scary and really made me question my ability to take care of myself. But diabetes is hard, and we are doing the best we can. And the closer we are to our target ranges, the less room for error or weirdness we have.

      I’m glad you are alright. Please be sure to get extra rest today and watch out for more lows over the next few days.

      (by the way, your English is excellent!)

  4. So sorry to hear you had this awful experience. Don’t blame yourself Scott. Don’t feel embarrassed about what happened. Think of all the other moments (years) you are well aware of your diabetes and how you do whatever lies in your possibility to do things right. We’re only human, right? Don’t let this episode take over. You are still here and you are a mentor to so many out there who share the same condition. You are right when you say Diabetes is serious and dangerous, but we cannot live in fear all day. We have the right to go out and do things we enjoy, just like other people do. I’m proud of you. Be proud of yourself Scott!

  5. Glad you are OK-so scary! I have never had that happen where I passed out but I did encounter a similar situation where adrenaline kicked my blood sugar up high after exercising and I bolused for the high, which once the adrenaline wore off, my blood sugar like yours plummeted. I have learned over the years to not bolus for a high after exercising and give it a little time to see if it comes down on it’s own. Thanks for sharing your story!

  6. My goodness, this sounds awful. I had a similar experience last year and nothing comes close to the fear. It makes me realize the battles people with hypo unawareness go through so regularly.

    I am so glad you came through it and could put it all into words for others so well.

    Thank you for sharing, and stay well.


  7. Hi Scott. I can see that you posted this a long time ago, but wanted to share something that might help you next time. After your workout, your insulin sensitivity is greatly improved. It takes much less insulin for the uptake of carbs. Your body can actually process some of the carbs after your workout without insulin. I workout late in the evenings, and have a reduced basal pattern I choose after my workout that lasts for 8 hours. I also use a reduced bolus for the carbs after my workout. When you bolused for your correction and your meal, and did it early before eating, you probably didn’t need as much. There are a couple articles on my blog about this if you want more info. Glad you were ok.

  8. I was diagnosed as a type 1 when I was around 10 years old. Im now 31 and had my first loss of consciousness from a severe low only a few years ago. I too thought I had a good enough recognition of when I was getting that low. Its a real eye opener when something like that happens and definitely makes one re-think a few things. It really reaffirms the seriousness of this disease.

  9. OMG, Scott. I would have handled the after-workout situation exactly the same way. So scary that a hypo can hit that fast & hard!! So glad to hear you’re OK.

  10. Can’t tell you how many times I’ve corrected a high then wondered if I shouldn’t have double checked my number first. So glad you’re alright, Scott!

  11. I’m sending this story to my son Chris who attends college- sometimes I think he ‘knows it all’ and doesn’t think it will happen to him. As a parent, I worry constantly but have to hold back on telling him – you know, that ‘nagging mom’ out there is me!

  12. Whoa! Glad you are okay. I’ve had instances like that where the insulin kicks in during a meal and drops the sugar, even though I’m stuffing my face. (Or I end up 60 very soon after a meal.) It’s very bizarre.

  13. Wow, Scott! This is terrifying. I really appreciate you sharing this as I’m one of those that’s “never had a low that I couldn’t treat myself”. A good reminder that there’s a first time for everything. So glad you’re okay!

  14. I’m so scared of something like this happening to me. It’s so weird when diabetes attacks like that. Hey, that sounds like a reality show “When Diabetes Attacks!”
    Honestly, I’m glad you’re okay and I’m so glad that you had friends there than knew what to do. It’s so, so scary to deal with stuff like that. Much like my recent episode of DKA from a wonky pump site. We aren’t meant to be a vital organ, so even when we do our best, stuff happens.

  15. wow, Scott………
    a similar episode happened to me while I was grocery shopping once.
    after feeling like the bottom fell out and after I had downed a sunny delight juice bottle from the dairy dept. and beginning to rip open a package of sugar wafer cookies off the shelf, I remember telling a random shopper “I am diabetic , I need to sit down”
    Next thing you know I guess I was
    walking outside into the brisk March air, with my unpaid groceries still in the cart I was pushing in front of me.
    Someone I knew saw me wandering around, and asked if I needed help.
    No responce from me, apparently.Just a blank stare.
    Soon, a checkout lady came outside and escorted me into an office and immediately started to help me drink a glass of orange juice. (along with staff members standing around in a 1/2 circle, like they were observing an alien)
    I absolutely was not prepared for such a low.
    It was MY dumb fault for “just running in to the store for milk” after bolusing for lunch, planning to eat in the car as soon as I was done.
    This happened several years ago, but it is still a scary memory.

  16. SKJ! Wow, that’s scary — I’m so glad you’re okay. I’m really glad you shared this, because not only will it make any of us, your readers, feel better if this happens to us (we can think back to “Oh, SKJ went through this once too!”)…but also, reminds us, especially me, that even after a lifetime of low BGs I’ve been able to treat myself, there could always be one that sneaks up on me.

    So glad you’re okay. XOXOOOX.

  17. Glad it ended as well as it did. How terrifying! I’ve never had a low like that in my nearly 3 years in this D world, but I won’t be turning my back on that tiger.

  18. Hopefully this isn’t what you get for posting a comment on a related topic 😉

    You’ve touched on so many things that, for me anyway, can be difficult to admit.
    I don’t have many low lows that require other people’s help. But when I do, I do feel embarrassed. Which sucks.

    I wonder what happened, what I did wrong. Would checking twice have avoided the situation? I’d never know either. Not understanding where I went wrong is difficult for me to understand, let alone for the Type Awesomes who ended up being part of the situation.

    I’m very thankful the ambulance didn’t need to leave with you in it! Thanks for posting, Scott.

  19. Thank you for this post, a very good and necessary reminder that diabetes is so unpredictable. Glad you had friends with you and that you were able to recover with the help of some wonderful people. Take care!

  20. Wow, just found your blog today — how terrifying. My partner works out regularly and (and is on a pump) — and I worry about just this type of thing. He’s never had a situation like this where he’s passed out, and I’m absolutely terrified of the day when it happens. Thanks for sharing this type of stuff. Keeps us all alert.

  21. I am completely speechless. I know we all work hard to be confident in taking care of diabetes, but the reality is that things can happen that are just beyond our control. Things we never even see coming. And they can really turn our world upside down. I’m sorry diabetes hit you with one of those things. And I’m so so thankful that you made it through okay. Huge hugs to you, my friend!!

  22. ¡Scarymente! I’m glad you’re okay. I’ve had lows sneaking up on me recently, too, and they’re kinda freaking me out. We’ll stay safe, right? Right!!

  23. Glad you came back to us and everything is alright now! This is so very powerful and scary at the same time Scott!, It is an eye opener. Thank you for sharing this! Reminds me of the time I gave my 7 year old his bed time injection (long lasting levemir). The only thing was, I made the mistake of drawing up and injecting him with fast acting Novolog at bedtime, the wrong insulin. His number was already good, something like 110, he was tired and full belly, he had a very long fun day. I didn’t realize what I had done til the plunger was already pushed down. When the needle was in I flashed back to our red pouch – yes his fast acting is in a red pouch. It flashed before my eyes and I knew what had just happened. We, my wife and I started to treat him right away – It could have ended up DEADLY if I had only assumed to have given him the right insulin without recollection. It was scary, very scary. I had to keep him up for another 5 hours and shove food and glucose, sugar and juice, gel, glazed donut and ice cream into him, he was so tired and dropping quick, we were all tired. His number went down to 29 and back and forth to 54 back down, back down every 20 minutes for – 4,5 hours – later his number started to come back up and hit 112, I knew he would be ok then – we needed to add more insulin, just a little to keep him from going to high after 4.5 hours of struggle time. It was very exhausting and scary for all of us here- We don’t have any history of Type 1 Diabetes and we don’t know what anyone with it T1D goes through except for what we do with and for our children to keep them alive. Type 1 Diabetes is very dangerous and can be very scary at times, It can also be deadly. Alot of us parents scare every day with the highs and lows, we check my son 15 times a day 24/7 to make sure we catch everything – he gets 6 injection min. per day also. It is more difficult with a young child or infant – they, not all children can tell you they feel low or they need something or something is wrong..trial and error my friend. Glad your still with us! Thank you for the SHARE!

  24. I’m so glad you’re OK and so sorry you had to go through this, Scott.

    I’ve always thought that the most dangerous person with Type 1 is someone who thinks that this will never happen to them. No matter how hard we work at this, no matter how many pumps and CGMs we have, no matter how perfect we eat, we are vulnerable. I give thanks for my family and friends who watch over me. But I am vulnerable and your story is a good reminder of this.

  25. sorry this happened Scott, and glad your ok now! a few weeks ago i was fixing my dinner, i peeled a couple of those easy peel cutie oranges, not long after that i tested my bg for my bolus, and it was sky high 270. i was pretty sure this couldn’t be right as my bg’s were running pretty good for most of the day and my dexcom wasn’t reading that high either. i remembered i just peeled the oranges and washed my hands and re-tested, and good thing i did question it and remember the oranges and didn’t bolus for the 270! i always make sure i wash my hands now before i test. good lesson learned.

  26. Oh my friend … I am so sorry this happened to you. And like George said, I’m wicked glad that there were people there to take care of you when you needed it most. Only George didn’t say wicked.

  27. Nausea is new symptom of a low for me and it started about a year ago. I felt sick, checked my bg, and I was low. Weird.

    I am so sorry this happened dude but thank you so much for telling this story. I know it was not easy for you. And I am so thankful for the people that came to your aid.

  28. Scott, sorry to hear about this. It always seems to get us when we least expect it, right? The view from inside the ambulance is no fun at all. Glad you’re okay.

  29. Your story and others posted here are the constant reminders that although we are basically able to manage diabetes when this are boring and status quo, but when we work at living life to the max, we need to take things so cautiously. My son in 11 y/o (dx at age 3). We have had our share of highs and lows and it seems like we can never relax. So glad you are alright and there were not long term sequel. Thanks for sharing.

  30. I know you and your personality so this freaks me out. You’re so “ON” with your ‘betes. This can happen to any of us. It all made sense. All of your decisions and the way you went about it is exactly what I probably would have done.
    I’m glad you shared, I hope it doesn’t happen again. LOVE YOU TOO MUCH!

  31. Glad You are OK.
    I’ve read that eg. karate can cause Your BG to rise, adrenaline effect or something.

    My son went low in autumn because he had accidentally injected long acting twice. He got memory loss for couple of hours when the longacting started kicking in (was like a broken LP). What was scary too was that he could have been mistaken as a recovered hypo though he was totally messed up. he got an ambulance ride and spent the night at hospital. I was so relieved his memory normalized.
    He first got pens with timers and is now on pump. No nighttime hypos anymore (earlier two which were treated with glucagen injections). It is quite a shaking situation and two persons so the other one can keep the cramping patient still.

  32. Very scary! But how do you know when to retest? I recently had the opposite experience. My numbers came up 83 before lunch so I cut back on my correction factor and only shot my carb ratio insulin – and an hour later I was 250. At least that is less dangerous. Glad that you weren’t hurt.

  33. Glad to hear everything ended up ok. That’s scary stuff. Just remember though sometimes we do everything right and diabetes still does what it wants anyways. Don’t be to hard on yourself, unfortunately these things just happen no matter how hard we try for no good reason.

  34. Oh Scott, for mercy sake!!! I think one of the most difficult part of living with db is accepting that some questions will never be answered. And that’s hard. Very hard.
    I guess there is some gratitude of offer re the fact that you did not crack your head open when you fell, or you weren’t driving. But still…………..
    Stay strong, my friend.

  35. We’ve had the Diabetes Monster sneak in a few times with the girls… it shakes your confidence and does make you want to rethink how you handled things. Just please remember that you are AMAZING and don’t let it get you down.

  36. So very sorry this happened to you! I have seen false high readings on my son’s meter before! It is a scary disease! So glad you are ok! Sending thoughts and prayers!

  37. I am so glad you are OK and that you shared this story! What a scary thing. 69 is not even that low–was it the action of your BG dropping so quickly (because of the correction bolus and exercise) that knocked you out? Would you usually even feel any hypo symptoms at 69?

    Sorry so many questions. You’re like a lemon I’m squeezing for every last bit of juice–even thought you’ve already listed all of the factors and concluded that you can’t know exactly what was really happening.

    • Don’t apologize, Katy, the questions are good. Unfortunately, I’m a bit short on the answers. 🙂

      69 is not that low for me either (though I usually do feel symptoms there). I would guess that my liver kicked out some glucose, which is why I woke up.

  38. DUDE! Just dude! I’m so very glad you are okay. And if I lived closer, I might find myself helping your wife watch you. In a completely uncreepy way, I swear.

    Take it easy out there, brother! LY/MI!

  39. I’m so thankful for you’re doing OK. Thanks for sharing your story, i’m sure it was tough to put together a scary event like that! Makes me shiver just reading it – i’ve been so close to being in similar situations. Your story so well illustrates and drives home the point that screwing things can happen, even if you are doing things as you “should” be.
    Be nice dear Tiger! This was not your day.

  40. So glad you were around people you knew and that everything ended up OK…and well, I remember being in your wife’s place.

  41. Eep. Glad your friends were there to help. I get nauseous when I’m low sometimes, but not often, so it can take a bit for me to realize what’s happening. I’ve passes out too, not thinking it might be because I’m low… So been there, done that, and I know how much it sucks. Glad you’re ok, my friend 🙂

  42. Oh, my friend. Hugs, thoughts, and prayers to you and your wife…I fully understand the emotions left to ponder in the wake of a low like that. When my daughter was super little (age 2-3 yrs) she had “bad lows” like this frequently. For us, I don’t think it was a matter of not being aware — it was more due to the fact that she couldn’t really communicate effectively yet, let alone verbalize what she was feeling when her symptoms began. I also had a learning curve to deal with as well…I needed to figure out the non-verbal cues that signaled danger. She used to pass out all the time, and it paralyzed my heart with fear for a really long time.

    So happy you were with people who knew to get you some OJ and call for help. So glad you weren’t driving. So glad for a million “what ifs” that weren’t.

    Happy 2013…every day is a gift, indeed!

  43. so sorry, scott! gosh, what a beast this thing is. i was so shaken up when i passed out last year. it takes time to process for sure, leaving you frazzled cos you do so much right and yet The Tiger just goes wild sometimes. oy. Big hugs to you!

  44. wow Scott – Thank God and OJ that you are alright. Im sorry you went through this but I am so thankful you shared it. Even when we think we do everything right things can go wrong even for those who always seem to do everything right. I love the tiger quote and might have to check out Wil’s book.

  45. so glad you are ok…((HUGS))…. I think the older I get combined with how long I’ve had D makes me more anxious about something like this happening…love ya!

  46. Oh Scott, I’ve been there and it is terrifying! Thank goodness you’re ok now. We are unfortunately reminded by incidents such as this to treat insulin with tremendous respect. It is very humbling, and I have learned to respect it, and doublecheck the highs, and if anything feels off, to just check, and check again if you need to. At least you are ok now, and perhaps a little more wary. Hindsight is a good, if not harsh, teacher.

  47. Scott, I was just having this exact thought the other day. I was looking at my glucagon shots thinking they needed to be refilled. While I’ve NEVER needed them before, you never know when you will need them. Glad that you are still here to tell the story, but how terrifying for you. Glad you had friends around who knew what to do in such an event.

  48. Wow. That’s so scary. I’m so glad you shared this, though. I think there’s always this part of me that feels like I’ve failed or done something wrong when Ave has a bad low. She rarely (never) feels them. Scares this shiz out if me! But hearing that it can happen for no real reason from someone who experiences it… It helps. And that quote is brilliance!! Glad you’re feeling better!

  49. So scary. That’s only happened to me once .. But luckily I was home (woke up with a glass of OJ in my hand) and woke up before the ambulance was called. But still scary and scarring nonetheless. So glad you’re ok!

  50. Scott- I am so sorry this happened to you! I want to punch that damn diabetes Tiger for hurting you and for continually threatening us all! I know you’re still wrapping your head around what happened, but thank you for sharing your experience with us – And for reminding us that the tiger is on the prowl. Love you, brother!

  51. Sorry you had to experience that Scott. It can be a vicious tiger for sure. Stay safe. I will share if you don’t mind. I’m having a terrible time right now with worry. You are in my prayers buddy!

  52. Scott. Holy smokes! So sorry that happened to you. I know what you mean when you say, “I’d by lying if I said I wasn’t psychologically shaken by this event.” I’ve felt that way before after a low that I didn’t remember. It just sucks.
    Dam diabetes.

  53. Holy scary! Its a great thing that you had friends around…this is a perfect reminder for me and others, to always double check what may not seem right!