3.5 Or 4.0? Guidelines?

[Antje77]

Lately I've been reading some posts which mention 3.5 instead of '4 is the floor' for hypo. Sadly, I haven't paid attention very well. Can someone enlighten me what this is about?
I'd love to tell my DN that those hypo's between 3.6 and 4.0 aren't hypo's by new standards. It would also give me some wiggle room with the results of my Libre, which usually reads too low by 0.5 to 1.5 mmol/l.

 

[Diakat]

I think it comes from the latest DAFNE info. Tagging @Mel dCP and @kev-w because I'm sure it was mentioned in T1 thread.

 

[kev-w]

It was said DAFNE said 3.5 but I queried this last week at the clinic as I disagree, NICE guideline is 4 still, a 3.5 doesn't faze me but I'd still call it a hypo.

My view is that if we creep down to 3.5 being the new 4 then our hypo awareness will diminish faster than it needs to.

 

[LooperCat]

DAFNE does say 3.5 - I turn my pump down to 50% for half an hour when I get below 4.5 and off for the same if I’m below four. I function quite happily in the high threes though - but feel distinctly hypo below 3.5.

 

[kitedoc]

I think that we have to be aware of the error range of most glucose meters and also consider Libre and other GGM error ranges.
With say, a 15% error range, a reading of 4 mmol/l = a range of 3.4 to 4.6 mmol/l. i.e. in this error range both number definitions could apply.
And in another thread, the rule of having a BSL of 5 mmol/l or higher (? I forget in which countries is it 5 and higher or higher than 5 mmol/l) before setting out to drive a motor vehicle: 5 mmol/l with 15% range = 4.35 to 5.64 mmol/l. So a possible level of 4.35 mmol/l scrapes in as above the DAFNE guidelines and above the NICE guidlelines of 3.5 mmol/l.
The possibility of a degree of hypo unawareness is perhaps given some allowance in the 5 mmol/l "rule ", but that is a guess.
There are descriptions by diabetics (and I am one) of a BSL falling at a fast rate (? how defined) causing a person to experience hypo symptoms before reaching say, 5 mmol/l, whereas a more gradual fall in BSLs may not elicit hypo symptoms til levels lower than 3.5 mmol/l.
I hope that the above is clearer than mud !!!

 

[Emile_the_rat]

4 is the roof for hypo where I live, in medical terms. But I won’t feel hypo at 3.5.

 

[SamJB]

Wow, 3.5 mmol/l? If you're on insulin, that's too low in my opinion. If I were to adjust my hypo sensitivity down to that, I'd end up with way more hypos in the 2s. Would deffo increase the rate of more dangerous hypos.

 

[Antje77]

Wow, 3.5 mmol/l? If you're on insulin, that's too low in my opinion. If I were to adjust my hypo sensitivity down to that, I'd end up with way more hypos in the 2s. Would deffo increase the rate of more dangerous hypos.

Don't get me wrong, I do treat when getting close to 4 but that doesn't mean I never dip to between 3.5 and 4. I rarely go lower than that but I'd love to tell my DN those higher ones weren't really hypo's, and I'd love to know that they don't damage my brain either.
Also, my DN looks at my Libre stats and sees a lot of mild hypo's because the sensors usually read a bit too low. I'm overweight already, and I wouldn't like to treat high 4's as a hypo only because my Libre says I'm in the threes.