Type 1 Blood glucose levels too low?

As I am not a doctor I cannot confirm but if you are not having hypos I shouldn't think it's too much to worry about. However I would check with your DSN and care team.

Samanthakate said:

Hi there, I have only recently been diagnosed with type 1 and I've started following a low carb diet, My regular blood glucose levels are usually 4's, is that too low for my normal level? I test before meals and once before bed and that's usually what it is, do I need to reduce my insulin intake?

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Are you in the 4s and staying steady at, I dunno, 4.6? Or are you in the 4s and coasting down to a hypo? You do need to check this out with a basal test if you are going to bed at 4 to check you aren't having unnoticed hypos overnight.

You also need to bear in mind the DVLA 5 to drive rules.

As you are recently diagnosed you should still be in close contact with your DSN, it probably worth getting in touch with them for advice.

As you are low carbing I'm assuming you are carb counting and appropriately adjusting insulin for the carb content of meals?

Basal test - the job of your basal insulin is to keep you steady in the absence of food or bolus, basically it's fighting the trickle of glucose your liver gives out to keep you going. Here are guidelines on basal testing - https://mysugr.com/basal-rate-testing/

You can teach yourself carb counting. There is a free NHS course available online - https://www.bertieonline.org.uk

DSN - diabetic specialist nurse

Samanthakate said:

, My regular blood glucose levels are usually 4's, is that too low for my normal level?

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In the long-term you will likely lose your hypo awareness symptoms running bg levels so low, as far as I'm aware there's no benefits in running your bg levels in the 4's over running them in the 5's (although I'm happy to be corrected).

noblehead said:

In the long-term you will likely lose your hypo awareness symptoms running bg levels so low, as far as I'm aware there's no benefits in running your bg levels in the 4's over running them in the 5's (although I'm happy to be corrected).

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Is there scientific data out there to back that statement? I asked genuinely as I'm not aware of any and my only experience is what Ive personally dealt with since my t1 diagnosis 2 years ago.

My levels often stay in the 4.0-5.0 range when I'm on a stricter low carb diet (<10% of total calories) and running 20+ miles a week.

I don't intentionally keep them that low but my body's natural glucagon response seems to function very well. I actually have much better hypo awareness and fewer lows in that environment. To quantify that, I can usually tell as soon as my blood sugar is below 3.8.

In contrast, when I introduce more carbs into my diet (20%+ of total calories) my fasting levels will hover in the 6.0 range, and my basal needs can increase by more than 50% (I currently take 12u of Tresiba and can need more than 20u to keep my fasting blood sugar level).

Long story short- it's not really a choice for me but it's also not a problem (at least for now).

Side note: I attribute my widely ranging insulin needs to glycogen depletion and storage. When my glycogen is depleted my levels remain very low and my sensitivity to carbs is very low (1:15g or lower). When my glycogen storage is full my sensitivity to carbs is much higher (1:8g).

TorqPenderloin said:

Is there scientific data out there to back that statement? I asked genuinely as I'm not aware of any and my only experience is what Ive personally dealt with since my t1 diagnosis 2 years ago.

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Not sure if there is but a Google search will say either way @TorqPenderloin.

I'm sure Dr Bernstein is hypo unaware and has been for some time, whether that is to do with his tight bg control or longevity with diabetes I wouldn't like to say.

Seems like it's within normal. I start to get hypo symptoms at 4.5, but that could just be because I'm new to diabetes and have had generally higher BGL - 6-12. Best to check with the professionals

Samanthakate said:

Hi there, I have only recently been diagnosed with type 1 and I've started following a low carb diet, My regular blood glucose levels are usually 4's, is that too low for my normal level? I test before meals and once before bed and that's usually what it is, do I need to reduce my insulin intake?

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I would think you are doing just fine. Just make sure you do not go hypo in connection with exercise or otherwise. The thing is that staying at 4.5 does not leave you a whole lot of buffer zone before going hypo: 3.8 or lower. There are tons of posts on exercise and its effects on blood glucose on this forum.

Also, do some reading on carb counting, the basic principle is relatively simple. The practice can be tricky sometimes.