I have type 1 diabetes--it seems to run in the family. I've made no secret of this to the folks I play with, though it's not the greatest conversation starter. "So, hey, I like to stab myself with needles." Yeah... nope. But because I like to raid, it's important for me to get the information out there. Why?
Most people know about the needles thing (or about insulin pumps), but they know a bit less about diabetes in general, including the effects of an overly high or low blood sugar. It can be a little tricky to manage at the best of times, and since many guilds raid right around dinner time, that's a less than ideal situation. I need to be sure that I will have the support I need if I encounter something I didn't expect in my blood sugar levels, so that I can get up and deal with it immediately.
Raid time overlapping with dinnertime is the least serious of my concerns, but can still be a problem. I take two kinds of insulin--one that lasts 24 hours and keeps my between-meals blood sugar steady, and one that kicks in very quickly after I eat. If I'm snacking during a raid, it's hard to keep track of how much short-term insulin I need to take, and if I get really distracted, I've been know to forget altogether. Not good! On the other hand, taking half an hour out to cook and eat a full meal isn't really an option, either.
My raid-night solution is to make dinner something that pretty much cooks itself, or takes very little time. I'm not much of a sandwich eater, but bagels and cream cheese with some carrot sticks are always good, as are basic nachos. My favorite is tossing some pasta in to cook with a can of soup--mmm! I also make an effort to estimate how much I'm going to be eating, and take my insulin before I get started. This lets me eat a set amount while I raid (unlike snacking where I don't keep track at all), and helps cut down on the chance of my blood sugar being too high or too low later on in the evening.
High Blood Sugar:
High blood sugar is my second worry. While in the short term it's not too dangerous, it can have long-term consequences as the high sugar levels can be very damaging over time. The solution is easy--take more insulin--but noticing the problem is a bit trickier. Things that I watch out for include headaches, irritability, and drowsiness... if I feel like crap and I know it's not low blood sugar (which has its own set of symptoms), I check my blood sugar. If it's from 150-200, I may wait a few minutes and test again to see if it's going down--if it's over 200, I make an effort to bring my sugar down to normal as quickly as possibly. It's no fun to raid with a crabby Hunter, after all. ;)
Low Blood Sugar:
Low blood sugar is the most immediately dangerous situation, and definitely the least pleasant. I've heard different levels for determining a "low"--anywhere from 70-60 and below--but for me, symptoms start if my blood sugar drops below 80, so that's when I start to treat it as a low. When my blood sugar is low, I may get grumpy and confused. My fingers just don't work right, and I shake all over. Sometimes my speech is slurred or I don't make any sense. I've never passed out, but that's also a risk of low blood sugar.
If my blood sugar drops below normal levels in a raid, there's a chance I may not notice right away--the excitement of downing a boss can cover up the shaking, and playing a Hunter doesn't require too much concentration (just kidding!) While I'm always the best person to catch myself acting odd and check my blood sugar, I also rely somewhat on the other folks on vent to tell me if I'm being a bit weirder than usual. I'd rather waste a test strip than put myself in danger, and chances are that if I'm acting "drunk" it's because my blood sugar is low. (I don't drink at all, both for religious reasons and because I'm a year too young anyway.)
Once I know my blood sugar is low, I have to bring it back up quickly. Glucose tablets (think giant Smarties of the American variety) are the best immediate solution as they are processed extremely quickly. I try to keep a roll of them by my computer, but if they've been moved (like if I had a low blood sugar incident during the night and Jon brought them to me in the bedroom) or if I've run out, I need to be able to get up from the raid and deal with the problem immediately. Letting my guildies and the raid leader know ahead of time that I am diabetic is what makes this possible--I still try not to go AFK without a fair amount of warning, but knowing that there won't be negative consequences when I need to deal with an emergency is a huge boost to my confidence.
There are several major things that raid leaders have done to make raiding easier for me, especially as a diabetic:
- Trust. I trust my raid leaders enough to let them know I have a problem that might come up during raids, and they trust me to deal with it and not be a disruption. They know that I don't like messing up a raid any more than they do, and that this isn't something I do for fun or attention.
- Concern. A lot of guild and raid leaders get to know their guildies very well over vent, which means that if someone is acting odd or out of character, they notice. I've had people tell me I was acting weird before I felt a thing--and sure enough, my blood sugar was not where it was supposed to be.
- Pacing. A raid where we get no breaks at all is one where I'm most likely to have trouble. Just a five-minute break after every other wing of Naxx can make a difference by giving me time to check my blood sugar and grab some food if it seems it might be getting low--not to mention that giving the raid a bathroom break definitely improves focus.
- Understanding. The best raid leader is the one that knows his or her group well enough to recognize their unique needs. He understands that the Warlock is in school right now and shouldn't raid past 9 PM, that the pregnant Priest is going to be making frequent trips to the ladies' room, and that a certain Hunter is completely worn out and just glad to be alive, and should probably take the rest of the night off (whether she wants to or not).
For more information on diabetes, this website is pretty much my favorite--if you're interested in what exactly happens with low blood sugar, their hypoglycemia page is great.
I won't link to the American Diabetes Association (they've harassed me asking for donations in the past) but for something a little less information-dense their website might be good as well.