Like "To me, out of control would be high BG but also out of control as far as just not managing it. Not because you can't afford your meds, etc though. Not being managed because you are choosing to ignore it. It could be any of the reason you asked about but I really think it comes down to you and your motivation. I think for some they get out of control because of things beyond their control. Not being able to eat consistent meals, not being able to get your meds, not being able to exercise or eat a good diet for any number of reasons. I'm learning that having a high BG in the morning because I had something a little extra the night before doesn't equal out of control. It just means I had something a little extra and I need to keep an eye on that or account for it if I know about it. If I don't, if something just happens, it doesn't mean I'm a bad person or I am not paying attention. It just means Sh-- happens. The highs scare me too. Right now it is because I don't feel any different. I know what low feels like but being higher like I am right now, going up more doesn't feel any different to me. It scares me because I know what it can do to my body and I have to wonder if I hadn't caught it now, what could've happened. I have the complications that are typical (high BP, high cholesterol, etc) and am working on them too. But right now, it is about controlling my BG to get it down where it needs to be. But I have to accept that it is going to take time and my body is going to have to adjust too. I've not had an unexplained low but with the new meds I am on, they said it could happen. A friend of mine suggested keeping peanut butter cups with me. The chocolate has carbs to up my BG quick, while the peanut butter has protein to help keep it up a bit longer. Now this is in a pinch, not all the time kinda thing. I've had one low so far for me (Hit 197, which for me right now was low). It sucked and I didn't feel like myself at all. They are scary in their own way. It's like watching yourself from the outside. You know you are being cranky but you just can't stop yourself. You know you have than name/number/answer on the tip of your tongue but you just can't reach it. You have 8 million things to do but you just can't get moving. I am lucky to have my hubby and educating my kids to know that when Mom is grumpy, maybe suggest some juice or give her something to up her BG. But have her test first. It will help get to know when you are low and how to tell. Learning those warning signs may help you head it off at the pass before it gets bad and give you some sense of control again. "