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'going lower' trend worries

lucylocket61

lucylocket61

Expert
Messages
6,394
Location
Wrexham
Type of diabetes
Type 2
Treatment type
Diet only
I am a bit concerned and confused with what i perceive as a trend here for people to push to go lower and lower with their blood sugar levels.

I read a post this morning where someone had a breakfast and their 2 hour reading was 7.4 - which I thought was a perfectly reasonable post-meal level. Someone else replied that they personally wouldnt want to go that high.

In another thread then pre-meal levels of 6.5 were considered a bit high by some.

I am just using these as examples, not picking a fight.

But there does seem to be a number of people who want to aim for the lowest end of the recommended levels at all times. Even post-meal.

Is there something I am missing here (apart from lots of brain cells)? Are the recommended levels of under 7.8 still a bit high and should be viewed as undesirable? and the recommended base level of 4-7?

If i should be aiming for lower levels, I would like to know and also see the evidence upon which this is based. If I need not be aiming for lower levels than recommended, I would also like to know that so I know I am doing things right.
 
Hi Lucy

These are the "official" figures according to this site http://www.diabetes.co.uk/diabetes_care ... anges.html so I assume that most who are aiming for the lower figures are trying to keep their levels as close to non diabetic as possible.

I really think it is a personal thing. I don't feel able to go really low carb and I don't think I really want to but that's my choice. I am diabetic and my mindset tells me that it is just too much of a struggle practically and financially to follow the diets that some prefer. Having said that, I admire those that do it and I don't see a problem with it in the slightest, especially as those who talk about it on this forum just share what they do, they don't tell others that this is the only way to go.

I have numbers mostly in the 5's and 6's, I have not been testing regularly recently as too much going on elsewhere and too much stress..don't want to give myself more! After meals I don't really want to see my levels above 7.5, to me that is a realistic number which I am happy with.

I am not good with the graphs, research etc that some of our esteemed fellow members are able to come up with but I do wonder if the lower levels actually do make a difference to us in regards to any complications? Am I at higher risk with my 5's and 6's than someone who gets 4's and 5's? Is there any research to show that I am?

Answers on a postcard please.
:D
 
Very good question Lucy, and good answer from Ladybird. I'm kinda in her camp re targets and diets.
Fact is though, the NORMAL non diabetic will have an A1c between 4.6 and 5.5. Forget levels used to diagnose diabetes/ pre diabetes, that is where they are with the majority at the lower end of the scale. Professor Christiansen at the Oslo summit showed that even a NON diabetic on 5.5 has an increased risk of cardiovascular disease compared with a NON diabetic on 4.6. So, the lower the better. That's why lots of us want to be as near to non diabetic levels as
Possible. Now, although 7.8 after eating is ok as a max, if you're ALWAYS at that level after eating you'd never get near to those lower A1cs, so that's why people aim lower. A non diabetic would very rarely be above 6.5 two hours after even a big carby meal, hence some of the "targets" you see people discussing,
Personally, I accept the risk of an A1c anywhere in the 5s so eat accordingly, but STILL wouldn't get there if I was 7.8 post prandial on a regular basis. I like to he below 7 at most.
Hope this is helpful
 
Is it a trend or just what people aim for? I personally have my own goals, and I do what I must to keep them within my own figures. I want to be as low as possible, but I have always said that, as complications terrify me. It has to be difficult if people are told a 7.8 PP is high, yet they have tried hard to reduce their numbers. I'm not sure what can be done, as we all have BG figures we feel are good to aim for, even if they are not good for everyone.
 
Can see where you're coming from Lucy.

There are lots of targets bandied about and it could be confusing for a new person joining. As it takes time (and effort) to bring the numbers down it could be disconcerting to be aiming for <8.5 or <7.8 then see someone wants to be lower still.

To a point I agree with what's been written above, in that I want to be as low risk as poss BUT having said that I use <7.8 as my benchmark, I dont even tend to note how below that the reading is. just if it is =/+ 7.8. Then I note the carb or the reason it surprised me - i.e had a glass of wine the last time I tried it and this time I didn't.

Mary x
 
As Grazer says, there is some evidence that the complications set in above 7.8 mmol/l, even in non-diabetic people.

I aim for non-diabetic numbers, all of the time. My fasting levels are a bit higher than a non-diabetic, but I try to stay below 7.8 mmol/l always (even 1 hour post-meal). I hope that by losing weight, and keeping a non-diabetic HbA1c, I will eventually reverse my diabetes althogether. Even if that doesn't happen, I hope to minimise my chance of diabetic complications.

There is a possibility by adopting extreme measures like <20g a day of carbs, that I might be exposing myself to other health problems. But I prefer to minimise the known risks of diabetes, over the speculative risks of low-carbing.
 
It's all a personal choice thing. Above 7.8 is where research shows complications can begin from but saying that if you are prepared to take the risks exceeding them then that's a personal choice as well. Just do so from a position of realising you are taking risks. I aim for non diabetic numbers and try to be under 7.8 after 1 hour and under 5.5 at two hours for most meals. Like others have said 95% of non diabetics will be under 6.5 after two hours even if they eat something carby and 75% will be under 5.5 after two hours.
 
I prefer to stick to my own targets and never look to see what the next person is trying to achieve, time and experience has taught me that we are all experts in managing our own diabetes but not necessarily other peoples, set your own targets lucy and don't try to shoot for the stars :)
 
Shoot for the stars if you want to though Lucy :)
 
noblehead said:
I prefer to stick to my own targets and never look to see what the next person is trying to achieve, time and experience has taught me that we are all experts in managing our own diabetes but not necessarily other peoples, set your own targets lucy and don't try to shoot for the stars :)
Click to expand...

+1

That's a very important point. We all have metabolisms that a broken to a different extent, it's futile to compare yourself to someone who might be more, or less, broken than you.
 
I agree with you Lucy, when I had my second HBA1C done my GP said not to keep aiming for really low ones as going much below 6.5 can correlate with a higher incidence of heart problems. He had been reading some medical paper on it apparently.

Who knows! I think there are a gazillion things at play including overall health, genetics of course as well as blood sugar control that determine what we contract in the future. Oh and I am a firm believer our environment and the myriad of chemicals in everything ain't helping but that's just my thoughts. We can only work within our own parameters and do the best we can I guess.

Ali
 
lucylocket61 said:
I read a post this morning where someone had a breakfast and their 2 hour reading was 7.4 - which I thought was a perfectly reasonable post-meal level. Someone else replied that they personally wouldnt want to go that high.
Click to expand...

Yes, I noticed that... My personal view is that if my levels are always below 7.8 then that's ok, but I prefer to be in the 6's. But I don't want to discourage anyone who has managed to get their pp numbers in to what we've stated as a 'safe' level, by seeming to move the goalposts.

S
 
Ali H said:
I agree with you Lucy, when I had my second HBA1C done my GP said not to keep aiming for really low ones as going much below 6.5 can correlate with a higher incidence of heart problems. He had been reading some medical paper on it apparently.
Click to expand...

He's misinterpreting the data:
http://forecast.diabetes.org/news/low-b ... dictor-mor
 
I think one of those someone's was me, and normally I actually try to be 'fair'.

There is in my opinion a must do that is below the 7.5-7.8 mark if at all possible and that includes carb-counting or halving.

Then there is the 'want normal numbers' thing, or 'what if what I tried doesn't work' which is low carb'ing, trying to hit below 6 or even 5.

Then there is the whole discussion about where people are coming from and what is easy and hard for them - like someone who needs to persuade their wife too, or have other problems.

The next logical step is really the best anyone can do.

I think in that particular case I may have been less nuanced than I would normally be - mainly because I have been in other posts and was just summing up. It may have looked a bit wrong out of that context.

I do think that there is a difference between saying 'I would not - you could try this' and then saying 'Not good enough'. If the former meaning drowned, I must apologise.

I can only agree that goals are different and that we all aim for the best we can do and the best we know how.

Regarding the things I have heard, the risks aren't bigger for cvd unless you have already had diabetes for a long time. For me it is rather new, so I aim for normal (ish).

-M
 
I should perhaps expand on my first post.

My concern was that there was something I should be more aware of, and be trying to aim for. Not that I was concerned about the advice given.

And my confusion was about what was the right levels I should try to aim for, and how to achieve it. :crazy:

Sorry if it came out wrongly Mileana. I forget that we are not telepathic and think I have explained things perfectly, when i havent.

This is all helpful info people are posting and I think I am getting more idea of how to decide on what to focus on next. It is a learning process, plus i get waves of rebellion, denial, and self-pity every so often and try to find a get-out clause in all this.
 
I did my research and set my self targets. I wanted to be meds free, attain as near a non-diabetic level as I could be and enjoy the widest variety of tasty and satisfying food as I could for the rest of my life.
Knowing from my meter how hard my pancreas must have to work to knock down my BG level to get it in range, I set myself an upper limit that I feel comfortable to stay under at all times and for me it does not reach 7s ever.
If my figures trend upwards I might have to consider more exercise. I don't have a particular regime on exercise but do enjoy a weekly exercise group, gardening, joining husband and dogs for a walk occasionally, monthly bush dance, attend fire callouts and plenty of volunteering.
If that doesn't work then I would re-consider medication but at the moment I am 'there' and life is good!
Alison
 
clearviews said:
I did my research and set my self targets. I wanted to be meds free, attain as near a non-diabetic level as I could be and enjoy the widest variety of tasty and satisfying food as I could for the rest of my life.
Knowing from my meter how hard my pancreas must have to work to knock down my BG level to get it in range, I set myself an upper limit that I feel comfortable to stay under at all times and for me it does not reach 7s ever.
If my figures trend upwards I might have to consider more exercise. I don't have a particular regime on exercise but do enjoy a weekly exercise group, gardening, joining husband and dogs for a walk occasionally, monthly bush dance, attend fire callouts and plenty of volunteering.
If that doesn't work then I would re-consider medication but at the moment I am 'there' and life is good!
Alison
Click to expand...

What she said, except I do take metformin, I have a significant amount of weight to lose and that will affect my insulin resistance and numbers. I can feel lousy when my numbers go up. My numbers are also affected by my menstrual cycle, they go up no matter what I eat before my period starts. Aiming low means that the sluggishness and other stuff is minimised as the numbers rise.

What testing has taught me is how unwell I can feel when my numbers go over 6.5 for more than a few hours, when I start to feel sluggish and headachey. I have an outbreak of my rosacea if the numbers are too high for only a few hours. These are fairly immediate effects for me and occur at lower levels than what NICE recommends. Testing has told me that the NICE guidlines are simply too high for me to maintian my health.
 
:lol: frustrating isn't it Lucy. We're a very competitive lot too and I think that when it comes to managing yourself that is not necessarily a good thing as you can stress yourself out if you are not seeing the BGLs you want to see.

My docs have also warned me that going too low is just as dangerous as going too high.... apparently too many lows can affect your brain and other organs long term my endocrinologist advised me. I wasn't even aware of that!

I used to feel sick everytime I tested my BGLs in the earlier days of having diabetes. I used to get extremely frustrated. I noticed that the stress of it just didn't help anyhow. These days I have to be careful either way... not too high, not too low. I am also aware that if I fall below 5 my BGLs can drop extremely quick (like in 20 mins or so) and I can be having a hypo before I know it. It depends on what I'm doing too.... if I'm doing more physical activity, I want my BGLs higher as I know I'll be dropping considerably. An example of that is that everytime I do my grocery shopping my BGLs drop by a minimum of 3mmol and sometimes more than this in the space of an hour (and guess where I tend to have hypos in public places? yep the shopping centre). So I aim to have my BGLs a lot higher just before going shopping. But this is just what I've figured out for myself.... it's all about balance. :D
 
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