Riding Blood Sugar Waves with Calm
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Topic
Blood sugar swings (type 1 diabetes, tight control with 88% time-in-range and an average of 126 over 90 days) and high/low blood sugars (notably when my blood sugar is going up/down quickly even if I've already done what I can to correct) causes sharp emotional spikes (often anger) that my brain doesn't seem to know what to do with. I can settle the feeling temporarily by thinking that it is my blood sugar but the emotional spikes keep repeating every few minutes while my blood sugar is moving quickly and catch me off guard eventually. A guide for options to calm it and think about it would be helpful.
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There is a particular kind of weather that happens inside a body, and it is strange that most of it is invisible. From the outside, a person may be sitting in a chair, answering an email, chopping an onion, listening to someone describe a minor inconvenience with a parking meter. The face may be still. The hands may be doing ordinary hand-things. But somewhere in the bloodstream, a small dissolved sweetness is changing concentration, and the brain, that damp electrical animal in the skull, is noticing. Not always with words. Sometimes it notices by becoming sharp. Sometimes it notices by throwing up a flare of anger so sudden and bright that it seems to have arrived from another person entirely. One moment there is a sink, a cup, a familiar room. The next, the room has acquired edges. The cup is too loud. A question from another human being becomes an intrusion. The minor friction of the world becomes proof of something. Proof of what, exactly, the mind may not know. It only knows that the body has declared an emergency. This can be especially bewildering when you are already doing everything correctly, or as correctly as human beings are allowed to do things involving hormones, digestion, sensors, insulin absorption, exercise, sleep, stress, and the mysterious private behavior of the liver. There is a quiet absurdity in being told to “manage” blood sugar, as if it were a small administrative task. As if glucose were a stack of papers that could be alphabetized. But in type 1 diabetes, blood sugar is not a simple number. It is a moving object. It is a small river with tributaries. It is affected by food that has not yet become blood, insulin that has been injected but has not yet fully spoken, muscles that are either hungry or full, stress hormones rising like startled birds, sleep, illness, weather, old infusion sites, new infusion sites, the timing of a walk, the composition of a meal, the accuracy of a sensor, and sometimes, apparently, the moon’s personal opinions. And yet, even within all that, a person can do extraordinarily well. Eighty-eight percent time-in-range over ninety days, with an average of 126, is not casual. That is not neglect. That is many small acts of attention, repeated day after day. It means that in the background of ordinary life there is also an ongoing, mostly invisible technical operation. A kind of cockpit monitoring. A quiet mathematics of meals and corrections and waiting. But tight control does not mean stillness. It does not mean the internal weather has become calm. In some ways, the closer one watches the system, the more aware one becomes of its speed. A number is not just a number when it has an arrow beside it. One hundred and thirty with a flat arrow is a different creature from one hundred and thirty with two arrows down. One hundred and eighty rising slowly is not the same as one hundred and eighty rising like it has somewhere urgent to be. The emotional system seems to know this, or at least it responds as though it does. The curious part is that the anger can arrive even after the practical task has been done. You have corrected. Or you have treated the low. You have looked at insulin on board, carbohydrates on board, trend arrows, timing. You have made the reasonable move. You have placed your offering before the metabolic gods. And now, in theory, the next task is to wait. Waiting, though, is not empty. Waiting while blood sugar is moving quickly is one of those states that looks like nothing from the outside and feels like a hallway with alarms going off. The mind says, “This is blood sugar.” And for a moment, that helps. The thought creates a little frame around the feeling. It says: this anger is not a revelation. It is not necessarily the truth about the person in front of you, or your life, or the cup, or the email, or the particular way the door failed to close on the first try. It is a chemical storm passing through the interpretive machinery. But then, three minutes later, the feeling returns. It does not return politely. It does not say, “Hello, it is I again, the blood-sugar-related emotional surge previously identified.” It bursts in wearing a disguise. This time it seems to be about the noise from the refrigerator. Or the person breathing nearby. Or the fact that someone has put a spoon in the wrong part of the drawer. Or the fact that your own body, which you have been tending with such vigilance, is still not behaving with the grace one might hope for from a lifelong companion. And so you identify it again. Blood sugar. It calms. Then it returns. This repetition can be more exhausting than the first spike, because it begins to erode confidence in recognition itself. If naming it worked once, why did it come back? If the mind understands, why does the body keep insisting? But maybe this is not a failure of understanding. Maybe it is simply that the body is not convinced by a single sentence. The brain is not one listener. It is more like a committee of old systems layered over one another: a verbal narrator, a threat detector, a balance monitor, a hunger system, a social interpreter, a pain assessor, a memory librarian, a small mammalian panic office, and perhaps some ancient fishlike department concerned mainly with salt, motion, and survival. The verbal narrator may say, “This is glucose movement,” while the mammalian panic office continues to stamp documents marked urgent. Blood sugar changes are not merely information to the brain. They are conditions under which the brain must operate. The organ doing the interpreting is also the organ being affected. This is a little like asking a smoke alarm to provide a calm, nuanced analysis while smoke is inside the alarm. So perhaps the aim is not to convince the feeling to leave permanently. Perhaps the more realistic aim is to build a small set of ways to receive it each time it arrives, without handing it the keys. Not to become serene. Not to transform the moment into wisdom. Just to reduce the chance that a biochemical wave gets mistaken for a moral fact. One option is to treat the repeated anger like a recurring visitor with a badge. Not a welcome guest, exactly. More like a municipal inspector who keeps entering the room every few minutes because the pipes are making a strange noise. You do not have to like the inspector. You do not have to have an interesting conversation with him. But it may help to have the same phrase ready each time he appears. Something simple. Almost boring. “Fast glucose movement. Anger signal.” Or: “This is a body alarm. I’ve already acted.” Or: “Not a verdict. A wave.” The wording matters less than the repeatability. During sharp emotional states, elaborate thoughts can become slippery. A sentence with too many clauses may collapse. The phrase should be small enough to pick up with one hand. There is something useful in making the phrase a label rather than an argument. If you say, “I shouldn’t be angry because this is just my blood sugar,” the mind may begin litigation. It may say, “Well, actually, there are many valid reasons to be angry.” And perhaps there are. The mind is talented at finding supporting evidence. It can build a legal case out of crumbs. But a label does not argue. It tags. “Anger signal.” “Glucose drop.” “Rising fast.” “Alarm chemistry.” The label leaves room for the feeling to be present without becoming sovereign. Another option is to separate the practical question from the emotional question. When blood sugar is moving quickly, the practical question is: is there anything medically useful to do right now? That question may involve your existing plan from your clinician: treatment thresholds, correction timing, insulin on board, carbs, rechecking, avoiding stacking, glucagon if needed, asking for help if things are unsafe. The details are individual and medical, and they belong with the professionals who know your care. But once the practical action has been taken, the mind may continue searching for another action because the body still feels urgent. This is where the second question can help: “If I have already done the diabetes task, what is the waiting task?” The waiting task is different. It may be to sit somewhere safer than standing in the kitchen with knives and opinions. It may be to postpone all conversations requiring nuance. It may be to stop typing. It may be to become very interested in the sensation of your feet inside socks. It may be to watch the number move without treating every refresh like a referendum. The waiting task might be humble: do less damage while the chemistry catches up. There is a kind of dignity in that. Not dramatic dignity. More like the dignity of putting a lid on a pot that is spattering. When anger spikes, the body often wants discharge. It wants to say the sentence, send the message, slam the cabinet, correct the universe by force. The emotion arrives as energy organized around a target. But in blood sugar movement, the target may be assigned after the fact. The brain feels activation, then looks around for a reason. It is a very fast storyteller. It says, “Ah, yes. The reason is this person’s tone.” Or, “The reason is that this room is intolerable.” Or, “The reason is that everything is broken.” Sometimes the reason is partly real. That is the complicated bit. A person can have blood sugar-related anger and also be legitimately irritated. The spoon may genuinely be in the wrong drawer. The email may indeed be foolish. But the scale may be distorted. A small match may appear to be a building fire. It can help to use a temporary rule: no conclusions while arrows are steep. Not no feelings. Feelings will happen. No conclusions. No major interpretations of character, future, relationship, competence, or the meaning of life while glucose is rising or falling quickly. The court is adjourned until the body is less meteorological. This is not because those conclusions are always wrong. It is because the instrument is vibrating. A compass near a magnet is not evil. It is just not the best compass at that moment. There may also be use in creating a physical ritual for the waiting period. Humans are animals who understand repeated gestures. We pretend to be purely cognitive, but much of us is still soothed by the arrangement of limbs and objects. A “rapid-change protocol” could be very plain. First, confirm the practical action: “I treated,” or “I corrected,” or “I’m monitoring according to plan.” Second, change location if possible. The body often reads movement into a new space as a change in chapter. Not always, but sometimes. A particular chair, a particular step outside, the edge of the bed, the bathroom with the fan on. The location should be low-demand, low-interaction, and low-breakable. Third, reduce inputs. Anger loves complexity. It feeds on noise, light, conversation, clutter, and screens full of tiny provocations. This does not mean creating a spa environment. It may simply mean turning away from the computer, dimming the phone, putting one earbud in with brown noise, facing a blank wall, or stepping into air that has fewer human voices in it. Fourth, give the body a job that is not argument. The job might be slow exhaling. Not heroic breathing. Not a formal practice with a name that sounds like something printed on a retreat brochure. Just making the exhale slightly longer than the inhale for a few cycles. Inhale as if smelling a piece of toast from across the room. Exhale as if fogging a window very gently. The body may not become calm, but it may receive the message that not every alarm requires sprinting. Or the job might be temperature. Hold something cool. Wash hands in warm water. Put a cold cloth on the back of the neck. Bodies are strangely persuadable by temperature. It gives the nervous system a concrete fact. Or pressure. A blanket. A hoodie. Sitting with your back against a wall. Pressing feet into the floor. Holding one wrist with the opposite hand. These are small signals of containment. The animal body often likes to know where its edges are. There is also the option of making the anger observable in a way that does not invite analysis. For example, rating it from one to ten can help some people, though for others numbers become another instrument panel, and type 1 diabetes already provides plenty of those. Another way is to describe it as weather: “Hot front in the chest.” “Electrical jaw.” “Shoulders preparing for battle.” “Face full of sparks.” This is odd, but useful. It moves attention from the story of anger to the texture of anger. Instead of “I am furious because…” it becomes “There is heat behind the eyes and a pressure to speak quickly.” The second version may still be unpleasant, but it is less likely to become a weapon. Describing the body with curious precision can create a small space around the experience. The anger becomes an object in awareness, not the whole sky. There is something almost extraterrestrial about observing oneself this way. Here is the human organism, seated at the edge of the bed, wearing fabric tubes on its legs, waiting for sugar to enter cells. Its jaw muscles are contracted. Its hands want to become tools of emphasis. Its mind is producing accusations at high speed. A sensor attached to the body estimates the sweetness of the fluid between cells. A tiny graph implies the near future. The human has already consumed carbohydrates or delivered insulin, and now must endure the lag between action and effect. Seen from a distance, it is not a personal failing. It is a complex mammal doing an extremely difficult regulation task without the organ originally assigned to do it automatically. That distance can be gentle. Not detached in a cold way. More like sitting beside yourself as a field researcher who has grown fond of the subject. “Oh, look. The organism is in the steep-arrow state. It becomes convinced that the dishwasher is an enemy.” This kind of humor, if it comes naturally, can help. Not forced cheerfulness. Just a mild estrangement. The ability to see the absurdity without denying the discomfort. Because it is absurd, in the old sense of the word: out of tune. A person can have excellent long-term numbers and still be ambushed by short-term velocity. The average of 126 does not describe the lived experience of a rapid descent. Time-in-range does not reveal the emotional texture of the minutes when the graph is falling through the range like a bird dropping through air. A ninety-day summary is a satellite photo. The spike is weather on the skin. It may help to distinguish between level and velocity. The number is where you are. The arrow is how fast the room is moving. Emotions may respond strongly to velocity. A fast drop can feel alarming before the number is technically low. A fast rise can feel agitating before it is very high. The brain does not only care about the present value; it predicts. It is always predicting. It is a forecast machine made of meat. If the forecast machine senses rapid change in available energy, it may become defensive, irritable, urgent. So one calming thought might be: “My brain is reacting to speed, not just level.” This can make the experience feel less mysterious. The anger is not proof that you have failed to be rational. It may be the brain’s rough translation of metabolic acceleration. Still, recognition will fade. It will have to be renewed. Perhaps that is the central practical point: expect to relabel repeatedly. Instead of hoping the first insight will settle the entire episode, plan for the anger to reappear in pulses. You might even imagine setting an internal repeating chime. Every few minutes, as long as the arrows are steep: “This is the same wave.” Not a new emergency. Not a fresh truth. The same wave. The mind tends to treat each emotional surge as new evidence. But during rapid glucose movement, it may simply be the same physiological event arriving again at the shore. If you can recognize it as recurrence, there is less need to solve it each time. There is also a social version of this, if another person is nearby. It can be useful to have a prearranged sentence that does not require explaining while angry. Something like: “My blood sugar is moving fast. I’m safe, but I need low input for a bit.” Or: “I’ve treated it. I’m irritable from the swing. I’m going quiet until it passes.” This is not an apology tour. It is traffic control. It lets the other human know not to bring complicated emotional freight into the room at the exact moment your nervous system is misreading shadows as wolves. The sentence should be created before it is needed. During the spike, language may become either too sharp or too elaborate. A prepared phrase is like a handrail installed on a staircase before the power goes out. If speech is too much, a text or signal can work. A note on the fridge. A specific emoji. A hand gesture meaning: not now, glucose weather. The phrase “I’m safe” should only be used if it is true. Severe lows, confusion, inability to treat, vomiting with highs, ketones, or anything outside the known plan are not merely emotional weather; they are medical situations. In those cases, the correct social signal may be: help. But for the familiar rapid-change irritability where treatment or correction is already underway, a low-input request can protect the minutes that follow. It might also be worth considering the aftermath, not as a moral reckoning but as maintenance. Once the number steadies and the mind becomes more itself, there can be a brief review. What helped a little? What made it worse? Were there predictable triggers during the swing—noise, screens, conversation, hunger, certain tasks? Was there a point where the anger wanted to become action? What would be good to remove from future episodes, if possible? The review should be short. Too much analysis can turn diabetes into a room one never leaves. But a small note may reveal patterns. “Fast drops + work messages = bad combination.” “Rising after dinner makes me want to argue.” “Standing in the kitchen while waiting is not wise.” “Cold water helped.” “Explaining too much made it worse.” These are not grand insights. They are trail markers. One could even create a small “swing kit,” though the phrase sounds more charming than the experience. It might include glucose supplies, of course, according to your plan. But also nonmedical items: earbuds, a bland audio track, a note with the repeated phrase, a soft shirt, a small object to hold, a list of things not to do during steep arrows. Not to infantilize the self, but to reduce the number of decisions required when the brain is under chemical weather. The list of things not to do might be the most useful part. Do not answer the emotionally loaded message. Do not solve relationship questions. Do not evaluate your entire diabetes management. Do not decide that the day is ruined. Do not discuss logistics with someone who uses too many words. Do not stand in front of the open refrigerator and conduct a philosophical inquiry into food. Do not interpret the first angry thought as special. Again, not because these things are forbidden forever. Only because timing matters. A thought that might be reasonable at 4:00 with a flat arrow may become feral at 3:18 with two arrows down. There is a tender frustration in the fact that the body lags. Insulin has curves. Carbohydrates have curves. Sensors lag behind blood. Emotions have waves. The conscious mind, which likes immediate cause and effect, is forced to live inside delayed systems. You do the thing, and the result does not arrive at once. So the mind keeps checking the door. Has it worked yet? Now? Now? The graph updates, and each update can become a little emotional event. The number is data, but it is also narrative. It seems to say whether you are safe, whether you judged correctly, whether the previous decision was enough. This is a heavy symbolic burden for a measurement taken from interstitial fluid by a device stuck to a living mammal. Sometimes, during rapid movement, it may help to decide in advance how often to look, if safety allows. Continuous data can become continuous provocation. For some people, watching closely is reassuring; for others, it keeps the nervous system hooked to the arrow. There may be a middle way: follow your medical plan, set a timer, and between checks, let the number exist without being stared at. A timer can hold vigilance for you. It is a small machine that says, “I will remind you when attention is needed.” This frees the mind, a little, from hovering. There are moments when the best available calm is not inner peace but external structure. A timer. A chair. A phrase. A closed laptop. A person warned in advance. A rule about no conclusions. A cold glass held between both hands. These are modest technologies. Humans have always used objects to regulate inner states: beads, stones, cups of tea, walking sticks, doorways, blankets, lamps. Diabetes adds other objects: meters, pumps, pens, sensors, strips, tabs, alarms. The trick is to let some objects be instruments of care rather than instruments of interrogation. It is also worth saying plainly that anger during blood sugar swings is not imaginary. It is not overreacting in the usual sense. Glucose availability and rapid change can affect cognition, irritability, anxiety, and impulse control. The brain is metabolically expensive. It is always dining. When the dining conditions shift quickly, the atmosphere inside the skull can change. Knowing this does not make the feeling pleasant, but it can make it less lonely. And if these spikes feel dangerous, frequent, unmanageable, or new in intensity, it would be reasonable to bring them to an endocrinologist, diabetes educator, or mental health professional familiar with chronic medical conditions. Not because you are failing, but because the system has many adjustable parts. Rate-of-change alerts, insulin timing, correction factors, meal composition, activity patterns, fear of lows, sleep, stress load—any of these may be relevant. Emotional volatility is part of the data too. It belongs in the conversation. But for the ordinary episode, the one where you know what is happening and still have to endure it, perhaps the guide is something like this: First, do the medical thing according to the plan. Then stop trying to make the body immediately agree that the medical thing has been done. Let the feeling repeat without treating repetition as failure. Name it each time in the same plain language. Reduce input. Give the body a simple physical fact. Postpone conclusions. Avoid exporting the anger into speech or decisions if possible. Let time become part of the treatment. There is an odd humility in waiting for molecules. The modern person is accustomed to immediate interfaces. Press the glass rectangle and light appears. Send the message and it crosses the planet. Tap the card and the machine approves the purchase. But in the body, events take time. Insulin diffuses. Carbs digest. The liver releases. Muscles uptake. The sensor follows. The nervous system recalibrates. The anger, having risen like a guard dog at the fence, circles several times before lying down. During those minutes, you are not doing nothing. You are hosting a storm without becoming the storm. Not always gracefully. Sometimes you will snap. Sometimes you will believe the anger for a while before remembering. Sometimes the third or fourth wave will catch you from the side, and you will find yourself halfway into a sentence that has too many teeth. Then the work is simply to stop as soon as you notice. To say, if needed, “I’m in a swing. I need to pause.” To return to the chair, the phrase, the wall, the breath, the cold water, the timer. A human life with type 1 diabetes includes many invisible acts of interruption. Interrupting meals to calculate. Interrupting sleep to treat. Interrupting exercise to check. Interrupting plans because a number has become directional. Here, too, there is an interruption: interrupting the anger before it becomes a story with consequences. Maybe the gentlest way to think of the repeated spikes is not as separate attacks, but as echoes. The body has shouted into a canyon. The first shout is loud, but then it returns from different surfaces: the sink, the email, the spoon drawer, the nearby person, the old frustration of having to manage any of this at all. Each echo sounds briefly like a new voice. But it is related to the original shout. “Same wave,” you might say. “Same alarm.” “Fast glucose movement. I’ve acted. Waiting now.” And then, because the body is physical and not persuaded by philosophy alone, you place both feet on the floor. You feel the floor accepting the feet without comment. You unclench the jaw, perhaps only slightly, perhaps only for three seconds before it clenches again. You notice the hands. Hands are often the first creatures to become angry. They want to grip, point, type, throw, emphasize. You give them a cup instead. Or you fold them into sleeves. Or you press the thumb gently against each fingertip, one at a time, counting not because counting is magical, but because the mind needs a small rail to run along. Outside the body, the world continues with its baffling calm. Cars pass. Pipes tick. Someone laughs in another room. A dog considers a smell with scholarly devotion. The evening light moves across the wall, slow and indifferent. Inside, the glucose curve is still making its argument. But perhaps it is beginning to flatten. Or perhaps it is not yet. Either way, the next minute can be made a little simpler than the mind wants to make it. No verdicts. No grand interpretations. Just the organism, the weather, the waiting task. And after a while, often later than desired, the internal atmosphere changes. Not dramatically. More like a room tone fading. The cup becomes just a cup again. The refrigerator resumes being a machine rather than an insult. The other person’s breathing is no longer evidence. The graph becomes information instead of prophecy. Then there may be tiredness, or embarrassment, or relief, or annoyance that such a small invisible thing can have such reach. All understandable. But perhaps also a trace of curiosity remains. The body, difficult and intricate, has passed through another weather system. The mind, though fooled repeatedly, kept finding the label again. Not perfectly. Perfectly is not the standard available to mammals. The standard is smaller. Notice. Act. Wait. Relabel. Protect the world from the temporary chemistry where you can. Let the wave spend itself. And when it comes again, as waves do, meet it not as a mystery, and not as a message from the deepest self, but as a known visitor in a bright vest, carrying urgent paperwork from the bloodstream.