08/16/2012 05:30 pm ET Updated Oct 16, 2012

One Excellent Reason for Not Keeping Your Diabetes a Secret

I can think of at least several good reasons for not keeping your diabetes a secret. It is usually a good idea to let at least a few of your close friends and/or colleagues that you see on a regular basis know you have diabetes. Today, however, I want to focus on perhaps the most important reason for not keeping your diabetes a secret.

On occasion your blood glucose level may start to dip a bit too low -- not seriously low yet, but low enough to where you start acting a little odd. You may drop low enough to where you might become the topic of conversation over lunch or in the break room, and not because of your good looks.

You see, there are times when your blood glucose is coming down and you may not notice it at first, particularly if you are wrapped up in a project or intensely concentrating on something else. You may fail to notice that you are beginning to shake and sweat, that your heart is beating fast and hard. or that you are not speaking clearly or making good sense. This situation is even more likely if you have had diabetes, particularly Type 1, for a long time.

This is when it becomes helpful to have someone there that knows you have diabetes and that also knows what to do if you start acting odd or looking odd (such as sweating and shaking in a 72-degree office or making inappropriate remarks during a staff meeting). In such situations, your confidante can encourage you to excuse yourself from the staff meeting to check your blood glucose level and then treat it if necessary.

I have heard frequent reports over the years where it seems that the last person to know they had a low blood glucose level was the victim that had it. I have had patients tell me that they are fine unless they get below 40. This comment usually inspires responses by loved ones to the tune of, " What are you, nuts? Are you kidding me?" If these people believe they are fine until their blood glucose drops below 40, then that means that they may try to drive, cook, or do something else in this impaired state.

In a more extreme situation, if you were to lose consciousness and people were standing around wondering the cause and what to do, your confidante would likely know (depending on the events leading up to your loss of consciousness), and be more likely to do the right thing in a prompt manner, like call 911.

In summary, you need to have someone that knows what is going on with you. Someone that you have told ahead of time, "Look if I ever start to act goofy, or do this or that, or start sweating and get lightheaded, this is what it means and this is what you need to do." This person becomes your safety net. I would recommend letting more than one or two people know. I think you would feel more comfortable in the long run.

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