I think it is a great article.
I am a Type 2 and I have lost count of the times on here I have posted about Hypoglycaemia in general and the consequences for Type 1's regarding severe hypo's. It almost seems to be like some badge of honour to some that they can go low down to 1's and 2's and almost boast that they don't feel anything, they can function properly. This seems madness to me.
Ken, I can assure you that it is no badge of honour that any of us who are dependent on insulin get to find at times that our bg levels have dropped really low down to 2 or even 1.? something. Often very worryingly people actually feel completely normal and the brain just hasn't sent the signals to warn us. Why this happens does need to be investigated. It might be due to the modern insulins but who knows?
This article clearly points out the dangers of such intense tight control. Now, I am all for everybody keeping tight control but there are limits to what is good for you. Most know that high levels are bad for you and will eventually cause complications, however there are many who seem to think that ultra low will make it better. Not so ! There are consequences to everything.
Going too low, below the medically defined level of 3.9 mmol/l (rounded up to 4 for safety) is something that should be avoided at all costs. It is as bad for you as those high levels and can, as the article points out be fatal. I am also convinced of the argument that frequent low levels affect the cognitive abilities of the individual over time. Think about it, when you are hypo how do you feel.........cr*p !
Yes thanks to the use of the 3 day cgm, consultants are now finding out that some people are remaining in the low bg range overnight for too long a time and that there is the possibility of getting some damage to the brain resulting in mild dementia.
I know, just as a T2 who is having hypo's regularly because I am trying to get medication and food intake back into sync after cancer treatment decimated my tight control that I start to behave differently, shake, lose concentration, make mistakes (yes, I know !). None of this is good for us. It must have an effect in the long term to be like that regularly.
So, I go with tight control.....but the levels need to be kept within acceptable limits at BOTH ends of the scale. That's why I will never tell anybody that the lowest possible is the best. It can end your life, it certainly will impair it.
I now take the NICE guidelines regarding bg testing for Type 1s (and those who also depend on insulin) with a slight pinch of salt. Through following the guidelines and trying to aim for a bg level of 4 before I ate often meant that I would be on 2 or 3 instead, so none of that for me now. My target is to be on 6 or 7 before I eat and then be on 9 or 10 two hrs later.
Then there is the little matter of hypo unawareness......something which if you drive can lose you your licence. The people who boast of these low levels are probably breaking all the DVLA medical rules and shouldn't be driving, they are almost certainly breaking Road Traffic Law regarding hypo's as well.
If people test frequently and make sure that their bg levels are somewhere near 10 before they start their car engine and also have some sweets within easy access on the dashboard, then hypos in vehicles should not happen. I never take any chances at all where driving is concerned, it's far easier to suck a couple of sweets to prevent going low than it is to start to feel hypo and have to navigate the car to safely pull up beside a kerb.
As an ex Traffic Cop it worries me that there are people who consider themselves responsible adults, yet think that is Ok, to take risks with their lives....but more importantly with the lives of those around them, loved ones.....all because they think it is clever to go ultra low and not feel bad.......rant over !
Ken
