I want your opinion on this because I´m not sure myself.
Do you concider a low every blood sugar that needs to be treated?
Is a low also counted as a low when you discover it on it´s way down and treat it before the actual number on your meter is low?
I´ll be grateful for all answers and opinions on this topic as I´m on my way to find peace with and a sane way to treat my diabetes.
Thanks, Terry. I do low carb too and find it to be the only way to stabilize my blood sugar and gain any sort of certainty in life. Maybe they just exit in my head these diabetics that never have to "up" their blood sugar with some carbs now and then? I do this often daily and sometimes as often as 2-3 times a day. Maybe my actual question is if it´s even possible to achieve a stable bloodsugar without having to do a minor correction more than maybe once or twice a week.
Maybe my actual question is if it´s even possible to achieve a stable bloodsugar without having to do a minor correction more than maybe once or twice a week.
There probably are some diabetics with such stable blood sugars that they can avoid lows without even a mild carb correction. Perhaps someone with some residual native, endogenous, insulin production. I'm not one of them. I also have "drifting" lows that approach my 70 mg/dl threshold at a low angle. For these I use Altoids, three mints = 2 carbs. If I can keep my BG above 70 then I don't count them as a low.
You've asked a good question. I can't imagine a T1D without endogenous insulin maintaining that kind of control. If that's possible, I'd like to know how they do it! What your question implies is what I hope for in the artificial pancreas project, where I can assume the role of passive observer.
I agree with Terry that for most of us we have occasional lows and occasional highs and I believe that prompt correction is the way to keep your blood sugar stable. However, returning to your original question about "how many lows is acceptable". You said that you correct lows daily and sometimes 2-3 times a day? For me, at least, that would not be acceptable. That much lows is a clear indication that too much insulin is being used. I would look for a pattern in my numbers. If the lows are two hours after a particular meal I would lower my I:C ratio for that meal so I got a tad less insulin. If they are in between times/waking or bedtime then I would look to the basal. Though lows (and highs) come with the Type 1 territory for most of us, if they are regular or show a pattern than there is a need for tweaking of dose.
Thanks Zoe, I too have had thoughts about having too many lows as a symptom of something not beeing right with my insulin regimen. But for now I will settle with what I´ve learned from all the great thoughts and response I´ve got here. I have lately got myself great tools to work with (Dexcom G4, pen with 0.5 units, 0.4 mm needles, iPod Touch with RapidCalc) and life feels so much easier alltogether. I know now it will take care of itself with time.
I pretty much tweak my doses by small amounts whenever I see a pattern of lows or highs. Just curious, since you have a CGM and other technology that I don't even know what it is..lol...have you considered getting a pump? It makes it waaaaay easier to regulate doses and levels.
I understand your curiosity, Zoe. Answer is kind of a long story: Two years ago I had two islet transplants and got off the pump which was the technology I then had used for almost 20 years. Insulin pens never worked for me back in the 80s, I never understood how to use them, a pump was easier to use and understand, and I felt safer always having only small amounts of insulin on board. Drugs I had to use after the transplants was devestating to me. The gain of producing my own insulin never outconquered the side efects from the drugs and I was really never myself for these two years. Finally I ended in a hospital bed for a whole month (this november) due to kidneys starting to fail, serious malnutrion and whatnot other things. After testing and testing again for a month where I slept through the whole thing, they concluded with all my symptoms being side effects from the drugs.
Writing 2013 I´ve finaly got off all the drugs, starting to use insulin again and slowly recovering. Alongside I have had to learn and accept the whole diabetes thing again, or maybe for real this time. I don´t want to go back to using a pump yet because pens - for me - is easier "needle wise" and a short 4mm needle is almost painless. When I was on the pump I alwas had serious trouble every time I had to change the cannula. I could do 2-3 cannulas before I found one that flowed freely. That said, when it worked it was kind of a breeze. Lantus is new since last time I used an insulin pen, so is the CGM and not to mention the RapidCalc I keep talking about. This is an app that works like an insulin pump, I´ve posted a discussion about it here: http://www.tudiabetes.org/group/lantususers/forum/topics/useful-app...
I could easily get an Animas Vibe with a built-in Dexcom G4, but for now I´m figuring out if the regimen I´m on right now actually is easier for me both mentally and in daily life.
Thanks for the explanation and history, Sirc. Wow, you've been through a lot. I'm glad you came through it well physically and emotionally sound like you are at a good point as well. I can understand "keeping it simple" and doing what works for you at this point.
Good to hear, Terry. Maybe it´s just how it is beeing diabetic for many of us. They´ve used the term "brittle diabetes" on me several times, so clearly I´m not one of those rare, stable diabetics out there.
To me a low is anything under 60; some people treat anything under 70. No, I don't treat if I'm not (yet) actually low.
As for how many lows are "too many" there is no exact answer for that. We are all different. Some people are naturally more stable than others. But I start seeing a pattern of daily lows or lows in the same time spot I will make changes in my insulin doses. If you have lows too frequently you put yourself at risk to be hypo unaware.
Thanks, Zoe. I´ve been hypoaware for years so that´s not part of the deal for me. I seldom have severe lows but bloodsugar is often too unstable to be trusted not going too low if left unattended. I just got myself a CGM and that´s the greatest tool I´ve ever had and without my knowing missed for the last 30 years.
"To me, every low is a different tactical challenge. I hardly ever take 15G of carbs to treat them as probably 90% of the lows I have are more "drifts" into the 60s than the sort of precipitous "dive bombers" going from 120---> 45 in like 1/2 hour because of some sort of calculation error. The drifts, I kind of nudge up, maybe 3-8G of carbs."
About the same strategy here. First getting used to the pump, my main goal was not to over correct lows based off of reading and IOB. I try to keep my range between 70 and 100 all day, so I get quite a few "steady drops" into the 60's that I don't feel at all. When I do treat, or I start feeling crappy, I do it in baby steps.
Drift is a good word for most of the lows I experience too. I never overtreat them, I´ve got that part covered. I use regular soda and has figured out that one sip equals 1 gram carb. I never treat drifts or lows with anything else than liquid with the same amount of sugar in it. Baby steps is the way to go, I agree on that one. Thanks for your reply, Black Llama.