As I opened my eyes, I noticed a team of paramedics standing over me. Then I heard a loud shout, “She is awake.” There was an IV in my right arm and Pope Paul VI was seated next to me.
No, this was not a dream. Rather, it was the result of my first blackout from hypoglycemia, which took place on a vacation trip to Vatican Square years ago.
Now I counsel Veterans at the Cleveland VA Medical Center to help them deal with hypoglycemia and diabetes. I am the program quality manager for Diabetes Self-Management Education and Support at the Northeast Ohio VA Health Care System.
I am pictured above with my son.
When I was diagnosed with diabetes as a high school sophomore, it was a shock. Luckily, there were amazing tools available. For example, I used one-step urine tests, long-acting insulin and a meal plan called, The Exchange List.
I set out to do everything correctly. I took my insulin and tested my urine. My exchange list hung on the refrigerator and my parents ensured I measured everything I ate. I even carried a mini copy in my purse.
I knew the signs and symptoms of hypoglycemia, specifically low blood-glucose. Two years after my diagnosis I experienced my first “LOW.”
Vatican on Italian itinerary
My grandparents, and my aunt and an uncle invited my older brother and me to join them on a three-week vacation to Italy. My aunt was a nurse and my parents felt it was a once in a lifetime opportunity, so they let me travel.
After a long journey with a diabetes fanny pack strapped to my waist, I ventured to Vatican Square with my family. Suddenly, I became confused and disoriented and fell to the ground.
I was experiencing severe hypoglycemia with no symptoms. Hypoglycemic unawareness. I was unable to communicate, but my Aunt told the Vatican’s first responders that I had diabetes and needed IV glucose.
Help came quickly. When I regained consciousness, there was an IV in my arm and Pope Paul VI was sitting next to me. A severe hypoglycemic event resulted in me and my family getting a private audience with the pope. I remember him giving me some hard candy, but cannot remember a word he spoke.
Teaching Veterans what she learned
Eventually, I updated my nutrition strategy, learned to carb count and dosed insulin based on what I ate. Now I teach these practices to Veterans with diabetes and hypoglycemia.
This is important because Veterans are aging, and about one in four has been diagnosed with diabetes.
I go over the drill with them:
- When were they diagnosed?
- What tools do they use to help them deal with it?
- What diet do they follow? Do they use an exchange list, calorie counting or a low-fat diet?
- Can they calculate the amount of carbohydrates in a standard portion of common foods?
- Do they know how to read a label?
- Can they determine a serving size?
- What is their blood glucose before meals?
- Are they taking a fixed dose of mealtime insulin?
- Do they have a sliding scale?
- Can they determine their carbohydrate-to-insulin ratio?
Know your diabetes-related numbers
Severe hypoglycemia is a problem. Numbers matter. I empower my patients to minimize their risk of hypoglycemia. It takes a team and it takes time to teach them their diabetes-related numbers.
Mary Julius is the program quality manager for Diabetes Self-Management Education and Support at the Northeast Ohio VA Health Care System.