# Type I Diabetes and mood



## Undine (Jan 19, 2008)

Hi, all. I've got a question/long rambling rant about type I diabetes, insulin mess-ups, and how it all affects one's mood.

My boyfriend was diagnosed with diabetes when he was about eight years old. The diagnosis didn't come as a surprise, since his father is also diabetic. He is insulin-shot-dependent, and when we first met I thought he dealt with it quite well. But then his doctor decided to start messing around with his insulin. He changed him to a type of "pen" (the brand name escapes me right now) that he would take twice a day. About two weeks after starting this, his mood began to go downhill. He began to show signs of depression and started getting a little mean, and his mood slowly but steadily deteriorated over about a year to the point where he was often severely depressed (didn't want to leave his house, literally did not care about anyone or anything, etc.) and would get completely nasty and enraged over the tiniest things, like my missing an exit on the highway, or even for no reason at all. When he told his doctor that he wanted his insulin changed (his sugar was also apparently a mess, though he didn't tell me how bad it was), his doctor told him he didn't know what to do with him anymore and referred him to a specialist.

The specialist told him that the insulin he'd been taking for over a year was for type II diabetes and should never have been prescribed for him, and that that was the cause of all his problems. He put him on a long-acting insulin that he takes once a day and a different kind that he only takes if/when he eats.

Right before he saw the specialist - back in September/October - we decided to take a break from our relationship because of his health. I couldn't take the constant abuse, and he was completely worn out. We recently decided to give it another try because we both really care about each other. He definitely seems changed from when we ended things - ex: I unknowingly positioned myself behind him in a store the other day, and he stepped back and sort of stumbled on my foot. Last year, this situation would have triggered a tsunami of black rage from him, but this time he just got a bit annoyed. So the lack of fury is a definite plus. But he's still not himself - whereas a normal person has ups and downs, he seems to be very level most of the time, with only slight ups and slight downs - a symptom, to me, that is very familiar to what I experienced when I went on antidepressants. He doesn't have that level of care that he used to, and it gets worse when he takes the fast-acting insulin. After taking it at dinner the other night, he was like a zombie within 30 minutes.

It's evident to me that there's still a lot of tweaking to be done with his insulin, it's just difficult to GET it done because he's on state insurance since he's still in college and, frankly, it sucks. I also suspect that he's sort of given up on ever acting like a normal human being again, but that could be my pessimism showing. I suppose I'm looking for any support, opinions, and advice that any friends of/family of/type I diabetics here can offer. Are these mood problems something that can be alleviated, if not cured, with the proper meds? Or is this something that he's going to be dealing with his whole life, no matter what? I'm quite worried about him, and I miss my boyfriend.


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## moore2me (Jan 19, 2008)

Undine said:


> Hi, all. I've got a question/long rambling rant about type I diabetes, insulin mess-ups, and how it all affects one's mood.
> 
> My boyfriend was diagnosed with diabetes when he was about eight years old. The diagnosis didn't come as a surprise, since his father is also diabetic. He is insulin-shot-dependent, and when we first met I thought he dealt with it quite well. But then his doctor decided to start messing around with his insulin. He changed him to a type of "pen" (the brand name escapes me right now) that he would take twice a day. About two weeks after starting this, his mood began to go downhill. He began to show signs of depression and started getting a little mean, and his mood slowly but steadily deteriorated over about a year to the point where he was often severely depressed (didn't want to leave his house, literally did not care about anyone or anything, etc.) and would get completely nasty and enraged over the tiniest things, like my missing an exit on the highway, or even for no reason at all. . . . . . . .
> 
> ...



Undine, I edited your post so to address the points I wanted to stress. First and most importantly, this sounds like how domestic violence gets started. Men who show initial symptoms of rage, losing their temper easily, or physically or verbally assaulting their girlfriend have the classic signs of becoming a violent abuser. Hundreds of thousands of women each year are hurt or killed by men who are acting out their rage on their wife. Such violence usually starts small and escalates as the relationship continues. I would strongly advise against a permanent relationship with a man who has these characteristics. And, it would not matter what kind of justification a man uses (or you use) to okay this behavior. It still is not okay. Being drunk is not an excuse for it. Being tired is not an excuse for it. Being mad is not an excuse for it. And, being medicated is not an excuse either.

You have not stated your age, but lets assume that someday you want to have children. You will need your husbands full support and cooperation to raise a family. Do you want to have to worry about his temper? His problems? Are you willing to give up your future kids if necessary because you have to take care of your boyfriend? What if he is violent toward your children?

My advice would be the guy is too much of a liability and will hurt you in several different ways in the future.


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## Undine (Jan 20, 2008)

moore2me said:


> Undine, I edited your post so to address the points I wanted to stress. First and most importantly, this sounds like how domestic violence gets started.
> 
> And, being medicated is not an excuse either.



My point was that now that he's switched insulin, this anger is no longer present... I suppose I should have specified that the specialist he saw told him that his mood swings - especially his anger - were the result of his condition being so completely uncontrolled. He did not have this issue before his doctor initially started messing with his insulin, and has not shown it since becoming adjusted to the new stuff. I never would have given him a second chance if there were any indication that this was still an issue, and if he does display any signs of it again I will be gone without question. But after a month and a half, nothing.

What I'm asking is this: is his condition going to make him (chemically) depressed for the rest of his life, or is there a possibility of controlling it with the correct insulin?


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## Isa (Jan 20, 2008)

M2M, under normal circumstances your advice would be sensible but there is an underlying medical issue present here. In some Type I diabetics quick mood changes such as this can be a very good indicator of low blood sugar. Or as in Undine’s case overall problems surrounding the new insulin prescription. I have experienced this firsthand with a good a friend, watching him become combative, which is so against his nature that I was actually confused and borderline afraid until his wife explained the situation to me. Once we went into action, the normal happy go-lucky guy returned. It was amazing to watch. Although it doesn’t happen very often anymore, all of his friends now know the warning signs that his blood sugar is dropping and we jump into action so things do not get to a more serious stage.


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## moore2me (Jan 20, 2008)

Undine said:


> Hi, all. I've got a question/long rambling rant about type I diabetes, insulin mess-ups, and how it all affects one's mood.
> 
> My boyfriend was diagnosed with diabetes when he was about eight years old. The diagnosis didn't come as a surprise, since his father is also diabetic. He is insulin-shot-dependent, and when we first met I thought he dealt with it quite well. But then his doctor decided to start messing around with his insulin. He changed him to a type of "pen" (the brand name escapes me right now) that he would take twice a day. About two weeks after starting this, his mood began to go downhill. He began to show signs of depression and started getting a little mean, and his mood slowly but steadily deteriorated over about a year to the point where he was often severely depressed (didn't want to leave his house, literally did not care about anyone or anything, etc.) and would get completely nasty and enraged over the tiniest things, like my missing an exit on the highway, or even for no reason at all. When he told his doctor that he wanted his insulin changed (his sugar was also apparently a mess, though he didn't tell me how bad it was), his doctor told him he didn't know what to do with him anymore and referred him to a specialist.
> 
> ...



I based my advice on the fact that violence by men toward women is never acceptable. Not when drunk, stoned, or chemically unbalanced. I continue to advice women to have a no tolerance policy toward domestic violence. 

Now as to Type I Diabetes, from what I understand, there are at least two possible sources of depression and/or abnormal mood swings. The first is based on hypoglycemia (or low blood sugar) and the second is a general depression from the diabetes itself. Both of these are discussed in the American Diabetic Association's website.

Hypoglycemia is more of an immediate, emergency situation. Chronic depression is a long term result of the disease or medications or both. Here is what the ADA says about hypoglycemia.

From http://www.diabetes.org/type-1-diabetes/hypoglycemia.jsp
Hypoglycemia (low blood sugar) in Type I diabetics
What are the symptoms of hypoglycemia?

The symptoms of hypoglycemia include: 
 Shakiness 
 Dizziness 
 Sweating 
 Hunger 
 Headache 
 Pale skin color 
 Sudden moodiness or behavior changes, such as crying for no apparent reason 
 Clumsy or jerky movements 
 Seizure 
 Difficulty paying attention, or confusion 
 Tingling sensations around the mouth 

*Hypoglycemia Unawareness* - And to make matters worse, some people have no symptoms of hypoglycemia. They may lose consciousness without ever knowing their blood glucose levels were dropping. This problem is called hypoglycemia unawareness.

Hypoglycemia unawareness tends to happen to people who have had diabetes for many years. Hypoglycemia unawareness does not happen to everyone. It is more likely in people who have neuropathy (nerve damage), people on tight glucose control, and people who take certain heart or high blood pressure medicines.

As the years go by, many people continue to have symptoms of hypoglycemia, but the symptoms change. In this case, someone may not recognize a reaction because it feels different. 

These changes are good reason to check your blood glucose often, and to alert your friends and family to your symptoms of hypoglycemia. Treat low or dropping sugar levels even if you feel fine. And tell your team if your blood glucose ever drops below 50 mg/dl without any symptoms.

As far as general depression in diabetics, it is discusssed in more details here
http://www.diabetes.org/type-1-diabetes/complications.jsp
and here From http://www.merck.com/mmpe/sec12/ch158/ch158b.html

I too am a diabetic, but a Type II. However, I have Type I's in my immediate family. My internal medicine doctor has told me that there is no reason that a diabetic these days cannot live a relatively normal life as long as they tightly control their blood sugars and follow the recommendations for diet, exercise, educated themselves, and have good management with a good doctor. Diabetes is like walking a tight rope in a circus - it can be done, it takes practice, skill, and perserverance. 

And as to your original question about the mood problem, sources indicate is can continue but the hypogycemic symptoms may change or may disappear. However, hypocyemia may still exist.


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## Green Eyed Fairy (Jan 20, 2008)

I was married to a Type I diabetic (onset when he was 12 years old). He took shots twice to three times a day for years. Now he has a an insulin pump that seems to have helped his sugar levels somewhat but still far from perfect.

He tends to want to fight over nothing when his sugar is high. He is childlike/confused when his sugar is low and I constantly had to worry that he would pass out at bad times and die. He had frequently scared and hit me when he was thrashing around in a low blood sugar incident- which he had frequently. It was one helluva an emotional roller coaster ride for me. It might have been worth it if he had appreciated all my efforts. 
I don't attribute all his bad moods and quirks to his diabetes. Some of his depression and need to fight seem to be linked to his troubled/abusive past. Add the the mix that he's also an alcoholic. He seemed to feel sorry for himself often and used it as an excuse to not "tow the line" when he should have been. Hard to tell sometimes...........glad it's over. 

Oh, and did I mention how expensive that illness is? How many bills can pile up? How many days of work he will miss? How many times he can end up in the hospital? How medical bankruptcy is an everyday issue? How insurance can deny coverage due to "pre-existing" illness - even employer supplied insurance? How the copays, deductibles and the 20% not covered can cripple a family? 

Over time, his constant up and downs, low blood sugar levels and alcoholism have added up to an organic brain breakdown. He will end up in a nursing home being spoon fed if he doesn't get his life/health under control. Or with no legs, sight or functional kidneys on dialysis three times a week just to live. He is now disabled and takes it all as a joke. I didn't want to spend another 14 years of my life with someone that planned on dumping everything on me and never cared what I went through for him. (Sorry if I sound bitter- I hope this doesn't become your life)

Take it from me....think long and hard about how much of your life you want to spend this way. Is it worth it in the end? Is the love you get from him enough to take the constant turmoil and abuse? Personally, I now feel quite drained from all of his "love".


I'm not sugar-coating a damn thing here Lady- nor should I. It's a hard fucking walk to live each and every day of your life. Make sure he's worth it.


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## moore2me (Jan 20, 2008)

Green Eyed Fairy said:


> I was married to a Type I diabetic (onset when he was 12 years old). He took shots twice to three times a day for years. Now he has a an insulin pump that seems to have helped his sugar levels somewhat but still far from perfect.
> 
> He tends to want to fight over nothing when his sugar is high. He is childlike/confused when his sugar is low and I constantly had to worry that he would pass out at bad times and die. He had frequently scared and hit me when he was thrashing around in a low blood sugar incident- which he had frequently. It was one helluva an emotional roller coaster ride for me. It might have been worth it if he had appreciated all my efforts.
> I don't attribute all his bad moods and quirks to his diabetes. Some of his depression and need to fight seem to be linked to his troubled/abusive past. Add the the mix that he's also an alcoholic. He seemed to feel sorry for himself often and used it as an excuse to not "tow the line" when he should have been. Hard to tell sometimes...........glad it's over.
> ...



Dear Green Eyed Fairy, 

I admire your courage to tell it like it is. No punches pulled. Too often young women (or young men) in love with someone fail to see how difficult the road up ahead will be to travel. Life is hard enough when you partner is helping you and cooperating. Life is harder when your partner has a chronic illness - but that cannot be helped and is part of living and most of us deal with those problems. But life with a partner who has a chronic illness and will not cooperate with their treatment or does not or will not help in dealing with the day to day nursing, healthcare, dietary restrictions, medication, is enough to destroy even the strongest marriage. Plus, add what you described - financial ruin, stress of hospitalizations, stress of seeing your loved on eaten alive by a wretched disease, and other things you did not mention.

Uncontrolled diabetes can lead to impotence, lack of sexual drive (also a side effect of anti-depressants), hard to control urinary functions, skin lesions, partial or total blindness, and some other nasty side effects. Plus, it will effectively eliminate the patient from many other life saving procedures such as heart surgery, back surgery, knee surgery, and complicate other medical procedures if they can find a doctor brave/foolish enough to risk it. 

My father was a type II diabetic, dad badly needed a heart bypass but could not have it due to his advanced diabetes. He had also lost 3/4 of his sight by the time he was 60. He could not wear hard shoes without pain, only bedroom shoes and just the sheets of a bed hurt his feet. Due to not being able to have heart repair, he died of a massive heart attack at age 64. As an added side note, my dad had excellent nursing care too - my mom is a registered nurse and had retired and was taking care of dad full time when he died.

Financial concerns - forget about getting health insurance. Most employers will hesistate to hire him as well because their health insurance could not stand the risk (unless they are a giant company like the federal or state goverenment). Medicaid and medicare are available but you have to qualify and be accepted for those programs.


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## Green Eyed Fairy (Jan 20, 2008)

Another thing I didn't add originally is how many jobs he lost due to so many days missed from work. He passed out at work often enough to be labeled a liability. 

He cannot drive at night due to impaired vision from many years/treatments of expensive eye surgery by a retinal specialist. He also has no periphereal vision left and seems to have "holes" when he looks straight ahead in broad daylight. No more can be done to correct his vision. I spent years writing the specialist monthly checks- and many other doctors/hospitals.
The fairy tale stops when you have children. He cannot adequately provide for our children. I am their main basis of support as in I provide the clothing, food, shelter, help with all the homework, care for them through all the illness, take them almost everywhere they go, get them out of bed and dressed every morning and bathe them and put them to bed every night. Mostly everything they have and do...I alone provide. Dad loves them but doesn't do helluva much for them when you take in the big picture. 
And yes, in later years, he started having sexual dysfunctionl problems. Viagra helped but you have to wait an hour after taking it to have sex. He was not far past the age of 30 when these problems occurred. I had just turned 30 myself......... It's taking care of a young man in an old man's body. 
Does this sound like a romantic future for any young woman?


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## D_A_Bunny (Jan 20, 2008)

Wow, where to begin? I agree with M2M about NEVER allowing anyone to abuse you. I also agree with GEF with all of the points that she has made.
In my case, I am the diabetic in the relationship. I have type 2 for about 5 years now. I was in denial for a very long time and did not properly care for myself. 
Last June I became very ill and needed surgery for an infection. I spent many days in the hospital and 2 months in a rehab facility. I came home still requiring nurse care and finally "healed" in mid Sept.
I learned a big lesson from that. It is not fair to put my loved ones through trauma for my illness. I have since changed radically in my thinking and have taken much better care of my health.
I am very thankful that my husband has always been there for me.
As for the sugar levels causing mood swings, it definitely does. Sometimes if my sugar is too high or too low I snap at my husband. A voice inside me tells me why and I try to tell him, but it doesn't always come out correctly. 
When I have calmed down I remember why it is so important for me to me a better health manager so that I don't abuse our relationship.
As the "sick" one, my advice to OP would be to listen to what all of the posters are saying and really think long and hard and discuss and decide if he will continue to care for his health. 
It is not his fault that his original doctor screwed up. But, if he decides that he will do whatever is necessary to be his very best, then maybe your love and relationship with him can help.
I wish you the best of luck.


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## Half Full (Jan 30, 2008)

Green Eyed Fairy said:


> I was married to a Type I diabetic (onset when he was 12 years old). He took shots twice to three times a day for years. Now he has a an insulin pump that seems to have helped his sugar levels somewhat but still far from perfect.
> 
> 
> Take it from me....think long and hard about how much of your life you want to spend this way. Is it worth it in the end? Is the love you get from him enough to take the constant turmoil and abuse? Personally, I now feel quite drained from all of his "love".
> ...



I know this was posted some time ago but my recent insomnia had me reading older threads. 

I don't want to minimize your experience in any way but I think you *are* painting a very negative and pretty misleading picture of diabetes, side effects and diabetic management and I say that because your SO's *alcoholisn* is a much greater issue here! 

When a diabetic drinks alcohol in excess it's next to impossible to maintain his blood glucose level with normal range plus an alcoholic usually isn't very compliant nor does he make his healthcare needs a priority. This indeed leads to all of the health and financial disasters you describe but it is more directly in relation to his alcoholism rather than his diabetes.

Hyperglycemia due to excessive alcohol intake is most likely responsible for all of the miserable and negative behavior you describe but diabetes, both type I and II are very manageable diseases and a *controlled, compliant* diabetic has a life expectancy comparable to that of a someone without the disease.

While every person with diabetes can have the occasional bought of hyperglycemia due to illness, stress, ect. and the concomitant side effects of uncontrolled diabetes such as mood swings or depression are then very real, the grave picture you are painting of your SO is *not* the normal course for a compliant controlled non-alcoholic diabetic.


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## Half Full (Jan 30, 2008)

Undine said:


> Hi, all. I've got a question/long rambling rant about type I diabetes, insulin mess-ups, and how it all affects one's mood.
> 
> My boyfriend was diagnosed with diabetes when he was about eight years old. The diagnosis didn't come as a surprise, since his father is also diabetic. He is insulin-shot-dependent, and when we first met I thought he dealt with it quite well. But then his doctor decided to start messing around with his insulin. He changed him to a type of "pen" (the brand name escapes me right now) that he would take twice a day. About two weeks after starting this, his mood began to go downhill. He began to show signs of depression and started getting a little mean, and his mood slowly but steadily deteriorated over about a year to the point where he was often severely depressed (didn't want to leave his house, literally did not care about anyone or anything, etc.) and would get completely nasty and enraged over the tiniest things, like my missing an exit on the highway, or even for no reason at all. When he told his doctor that he wanted his insulin changed (his sugar was also apparently a mess, though he didn't tell me how bad it was), his doctor told him he didn't know what to do with him anymore and referred him to a specialist.
> 
> ...



Student healthcare or not, with the dramatic side effects and personality changes you are describing I would make an appointment for him with an endocrinologist who can regulate his insulin more closely as soon as possible. 

Since you said that on his "original" insulin, he wasn't having all these changes and he had a normal affect and personality, I think he really needs a to see a specialist to get him back to his old self again.


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## Friday (Jan 30, 2008)

I have to agree with the diabetes + alcohol issue. I work in a large facility with several others besides myself that have diabetes. Of those among us that have type one and need strict control over their sugars, only one drinks with any regularity. He is the only one that hits horrible lows and becomes a combative asshole, not just at work but when he goes out with friends as well. He is currently on indefinite leave because he is so uncontrolled (and he HAS a pump) that he passed out and fell in front of a forklift that was just coming through the swinging doors. If the guy driving had not had excellent reflexes, he would be dead or seriously injured.

I don't know if your bf drinks Undine, but if he does that's the first thing that needs to stop.


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## Green Eyed Fairy (Jan 30, 2008)

Half Full said:


> I know this was posted some time ago but my recent insomnia had me reading older threads.
> 
> I don't want to minimize your experience in any way but I think you *are* painting a very negative and pretty misleading picture of diabetes, side effects and diabetic management and I say that because your SO's *alcoholisn* is a much greater issue here!
> 
> ...





I'm not arguing that alcoholism IS the biggest of issues here...however, he didn't drink the whole sixteen years. He did have many times of abstinence/sobriety though-out- some for as long as two years at a time. I did get a portrait of him without the drinking. I attribute the "organic brain breakdown" to the alcoholism (however the doctor did state it was a combination of both diabetes with the alcoholism that caused it) but did not see a marked improvement of his diabetic care, job performance, expenses, etc during the sober times. 
It IS an expensive illness- alcoholism or not. What I described of the expenses incurred have nothing to do with his alcoholism. He never drank before/at work- and never missed work due to hangovers. In fact, he frequently went to work feeling ill because he needed the job that provided the health insurance. 

I also concur that SOME diabetics, the ones that:
1. Care enough about it to properly monitor themselves, eat when they are supposed to, take their injections at the right times, eat a proper diet, etc..
2. Are aware of their limitations and are aware enough of their sugar levels to realize they are too high or low before even testing them (my ex wasn't capable of this- the dr stated it was because his levels were too erratic for him to have a proper awareness of changes on his own) 
3. Understand not to drink excessively. The doctor told my ex that ONE beer - (I remember having the dr clearly define "one beer" to my ex as a 12 oz. can of beer) with dinner is "okay". Drinking a six to twelve pack is not. 
4. Can take care of their own meal planning and gain an understanding of what foods drive blood sugars too high or know how to adjust insulin intake to their activity levels.

are all capable of a better lifestyle than the one my ex chooses to lead.


BTW, I have a friend from childhood that is married to a man that is a diabetic (Type I). He is a wonderful man that never seemed to miss a beat in taking proper care of his diabetes. I really like him and feel that my friend "lucked out" to get him (and vice versa for him because my friend is wonderful  )
She recently wrote and told me that he had to have surgery for heart problems. He is 40 years old. 
Diabetes DOES come with adverse effects. It is VERY hard for them to keep the blood sugar levels under constant control. I spent three years working for a company that drove people to dialysis three times a week- many of those people were diabetics (kidney damage is another side effect of diabetes)....some with lost limbs, eyesight or heart problems on top of it all. I noticed a trend of our passengers on dialysis dying frequently.
I was willing to "weather it all" because I believe that is what married people do- stand by no matter what health/financial problems arise. However, how much is a person to do when a person isn't willing to take care of themselves? It was a hard lesson learned for me


Oh, and I exaggerated nothing in what I have posted here- just for the record. Everyone's life will not necessarily be like mine has been but it is something that CAN happen. To say that it cannot is foolish, IMO. Case by case.... sure. Just never say never.


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## BLUEeyedBanshee (Feb 4, 2008)

I Can't speak at all about the highs of a blood sugar situation. However, I can speak as a reactive hypoglycemic that low blood sugar can cause you to be a completely different person.

Right now, I'm going through the motions of getting mine back under control. I've sort of let it slip since my celiac diagnosis and haven't been monitoring carb intake. It has caught up to me.

I can't concentrate, I'm irritable, I strike out at people for no reason. I, at times, can understand that my behavior is wrong, but to be honest, I can't control it. Other times, I feel that I'm completely justified, until a long long time afterward.

My "normal" blood sugar level is around 40ish. If I drop below 30 that's when i start reacting. I've only passed out once. But I do know the feeling of not being in control at the low end. 

However, even when I know what I'm doing is wrong, be it later or while it's occurring, I don't allow it to be an excuse. I apologize for my behavior. Family and close friends understand it and some will in fact get my glucose tabs, or orange juice with some form of protein and attempt to bring be back to where I should be. 

There isn't an excuse for the behavior, but there is a reason behind it. The brain doesn't function well at the low end. These are the times when I am absolutely irrational. I don't like it. I'm trying to reign it in.


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