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'going lower' trend worries

The absolute floor is a fairly irrelevant discussion.

But let us say a type2 has a bad hypo and is driving a car. Should we then assume he is to remain at the wheel, at a steady pace down the m4 waiting for his liver to dump? Hardly.

Or he's mountain-biking in on a slope, tending to machinery...

The immidiate effects of a hypo are the same. The fact that the body 'auto-corrects' in Metformin users is hardly the same is 'not dangerous'. Not progressing into death if you're flat on the floor waiting is not the same as not harmful or dangerous.

-M
 
Mileana said:
The absolute floor is a fairly irrelevant discussion.

But let us say a type2 has a bad hypo and is driving a car. Should we then assume he is to remain at the wheel, at a steady pace down the m4 waiting for his liver to dump? Hardly.

-M
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The point here is though,diabetes is a condition of RAISED blood sugars,Diabetes DOESN'T in it self cause Low blood sugars,It's the certain drugs that are used to treat the high blood sugars that can cause a Hypo so in a Type 2 who uses metformin or diet control,why would they be dangerous to drive down the M4 any more than a non-Diabetic?
 
Mileana said:
The absolute floor is a fairly irrelevant discussion.

But let us say a type2 has a bad hypo and is driving a car. Should we then assume he is to remain at the wheel, at a steady pace down the m4 waiting for his liver to dump? Hardly.

-M
Click to expand...

No, he/she shouldn't mileana. However, if they are on diet only or metformin, there's no reason why they should have a bad hypo. That's why the DVLA don't require us to provide them with info about our condition if we're on diet only or metformin. They ask about "hypos requiring third party assistance" for insulin users, uncontrolled hypos and stuff like that.
 
smidge said:
Hey all!

I completely agree with Grazer on this.

'4s the floor' is just aimed at insulin users. Below 4 isn't actually a hypo - it is just on its way to one and they don't want insulin users to go any lower for fear of a quick fall into dangerous levels. I'm on insulin (Insuman basal and Apidra) for LADA. I will happily maintain my levels in the 4s and let them drop a little lower on occasions depending on: when my last bolus was, whether my basal has passed its peak, what I am doing at the time, when my next meal is due etc. I know that my BG can go to the high 3s and stick there for ages (unless I have a lot of active insulin in me at the time). On the other hand, if I fall to the low 5s/high 4s within 2 hours of a meal and my basal is strong (usually after breakfast if it's going to happen), I take a preventative jelly baby to push them up a bit to avoid dropping too low. It is about understanding how your body is likely to react and taking into account the other relevant factors. You learn and you get better at it. The insulins we have these days allow us pretty good control. Other choices like type of diet also help. So for me, I'm happy to run low levels and assess the risks for myself - I don't tell other people to do it, but I do tell them not to fear mild hypos too much - they are easily corrected and prevented. In fact, pregnant women are advised to keep their's down as low as 3.6 - they wouldn't be told this if it was dangerous would they? There's a lot of margin built into 4!

Just my views

Smidge
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Me too Smidge!

The confusion here I think is that what Borofergie is saying is its the disorientation of low blood sugar that is dangerous for a T2 or non diabetic. What I am saying is that its the fact that there is no safety mechanism in T1 or Insulin taking diabetic, that will prevent the already low blood sugar dropping to dangerous levels ie coma etc, without some action........glucose tabs then a low GI substantial type food to maintain a stable BS
Luckily I have never needed medical assistance or gone unconcious as I have always known to test ( warning signs ) and to take action.

The worst hypo I ever had was the 1st one after diagnosis where I was actually drooling ( nice! )
Lucy.
 
Grazer said:
borofergie said:
If my BG drops much below 4mmol/l my liver will dump - exactly like it's supposed to - and then it won't be at less than 4mmol/l anymore. I'm not hypoglycemic so there is no risk to me.
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Exactly the point. Just like a non-diabetic's would. I frequently go into 3's when I play golf; there's no magic barrier about "less than four" if you're on diet/metformin. It always goes back there anyway.
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Yes it depends largely on what Type of diabetic you are. If you are an insulin using diabetic or one on powerful insulin stimulating drugs you are advised to take remedial action if your level falls below 4 although its also recognised most people wont actually risk levels becoming dangerous until they fall under 2.5mmol.

If you are not an insulin using diabetic or not on powerful insulin stimulating drugs then no such recommendation should apply. It's obvious really as the average non diabetics fasting level is around 4.2mmol. The keyword is AVERAGE. This will mean some peoples normal fasting level will be above 4.2 and just as importantly some people will be below 4.2. Quite a few people including some T2's on this site have fasting levels in the 3's. My lowest recorded level has been 3.2 after doing some running. I felt fine and I specifically wanted to see what happened if I kept exercising so I ran some more. I still felt absolutely nothing although when I measured 5 minutes later my level was over 7. Liver dump so I work as I should! If you are diet only or diet only like Metformin like me just trust your body it will self correct as it has been doing since you were born. The difference is you never use to think or know about it before becoming diabetic. Before being diagnosed I bet most people have at some point have felt a bit dizzy or woozy etc and just sat down, had a rest or ate something without ever considering their blood levels and things like liver dumps. You just got on with things. Bet you never thought "I'm having a hypo!" Low blood sugars are not the sole preserve of diabetics they happen to anyone and do so all the time without those people falling into coma's!
 
shop said:
Me too Smidge!

The confusion here I think is that what Borofergie is saying is its the disorientation of low blood sugar that is dangerous for a T2 or non diabetic. What I am saying is that its the fact that there is no safety mechanism in T1 or Insulin taking diabetic, that will prevent the already low blood sugar dropping to dangerous levels ie coma etc, without some action........glucose tabs then a low GI substantial type food to maintain a stable BS
Luckily I have never needed medical assistance or gone unconcious as I have always known to test ( warning signs ) and to take action.

The worst hypo I ever had was the 1st one after diagnosis where I was actually drooling ( nice! )
Lucy.
Click to expand...

Well explained Shop, and you Smidge.
Just about to have lunch, so trying to avoid images of you drooling shop! :sick:
 
Grazer said:
shop said:
Me too Smidge!

The confusion here I think is that what Borofergie is saying is its the disorientation of low blood sugar that is dangerous for a T2 or non diabetic. What I am saying is that its the fact that there is no safety mechanism in T1 or Insulin taking diabetic, that will prevent the already low blood sugar dropping to dangerous levels ie coma etc, without some action........glucose tabs then a low GI substantial type food to maintain a stable BS
Luckily I have never needed medical assistance or gone unconcious as I have always known to test ( warning signs ) and to take action.

The worst hypo I ever had was the 1st one after diagnosis where I was actually drooling ( nice! )
Lucy.
Click to expand...

Well explained Shop, and you Smidge.
Just about to have lunch, so trying to avoid images of you drooling shop! :sick:
Click to expand...

Thanks Grazer !

Hope you enjoy your lunch :) Sans the image of me drooling :oops:

:thumbup:
 
For those type 2's that think it's Ok as your liver will dump for you.... have you heard of hypo unawareness and also have you heard that your liver can fail to dump glucose as diabetes progresses? Yes, I was warned by my endocrinologist early in my diabetes journey that you need to be careful as you should be trying to 'avoid' your liver from dumping. Your liver dumps to save your life... if you allow your liver to keep doing this it may just fail you like your pancreas can fail. You don't want that... so the practise of knowing your body and testing is very important. Too low is risky, so is going too high. There's no such thing as a safe hypo either... a hypo is a hypo and must be treated quickly. Whether you're T2 or T1 is irrelevant.
 
Mileana said:
But let us say a type2 has a bad hypo and is driving a car. Should we then assume he is to remain at the wheel, at a steady pace down the m4 waiting for his liver to dump? Hardly.
Click to expand...

Unless you're taking insulin or insulin stimulating medication (or you have a separate condition that cause hypoglycemia) then you shouldn't have a "bad hypo" that would impare your driving in any way.

Just because your blood level drops to 4mmol/l or below doesn't mean you are "having a hypo", it just means that your BG levels are low and that your liver will shortly dump some glucose into you BG. This process doesn't involve passing out or crashing the car. It happens to me half-way through a 5k race every Saturday morning (I know because my BG are low and the start and very high by the finish).

I rang my insurance company up to tell them that I had been diagnosed as a NID T2. They weren't interested, neither are the DVLA. That's because diet/metformin controlled diabetes is not associated with hypoglycemia.
 
borofergie said:
Mileana said:
But let us say a type2 has a bad hypo and is driving a car. Should we then assume he is to remain at the wheel, at a steady pace down the m4 waiting for his liver to dump? Hardly.
Click to expand...

Unless you're taking insulin or insulin stimulating medication (or you have a separate condition that cause hypoglycemia) then you shouldn't have a "bad hypo" that would impare your driving in any way.

Just because your blood level drops to 4mmol/l or below doesn't mean you are "having a hypo", it just means that your BG levels are low and that your liver will shortly dump some glucose into you BG. This process doesn't involve passing out or crashing the car. It happens to me half-way through a 5k race every Saturday morning (I know because my BG are low and the start and very high by the finish).

I rang my insurance company up to tell them that I had been diagnosed as a NID T2. They weren't interested, neither are the DVLA. That's because diet/metformin controlled diabetes is not associated with hypoglycemia.
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Good Explaination Borofergie :thumbup:
 
From NetDoctor why Non-Diabetics can suffer from Hypoglycemia:

What can cause hypoglycaemic episodes in non-diabetic patients?
Too much insulin in the blood:

reactive hypoglycaemia (see below)
a tumour – very often benign – in the insulin-producing pancreas. This is a very rare condition indeed
an overdose of insulin or diabetic tablets either by mistake or on purpose.
Other diseases:

a disease in the adrenal glands (Addison's disease)
a weakened pituitary gland
a severe reduction in liver function
patients who have had their stomach removed
sometimes cancer
fasting, malnutrition
following alcohol ingestion.
Reactive hypoglycaemia
Reactive hypoglycaemia is possibly the most common reason for hypoglycaemia in non-diabetics but is often overdiagnosed.

This form of hypoglycaemia is probably caused by an overproduction of insulin from the pancreas after a large meal with a lot of carbohydrates.

The insulin can still be detected even after several hours, although the level should be back to normal at this time. This condition is probably most common in overweight people and those with Type 2 diabetes, where the large demand for insulin can sometimes cause too much insulin to be produced in the pancreas. There is some evidence to suggest that reactive hypoglycaemia can precede Type 2 diabetes.
 
:lol: Seriously... if you have symptoms stay off the road and do not operate machinery. Don't wait until you're in a coma or dead... as you won't be able to do a thing and you possibly may have caused injury or fatality to others.

And don't assume that people on diet and metformin can't get hypos.... that wasn't true in my experience and I can tell you I don't suffer from hypoglycemia either.

You should always be on your guard. Hypos are a serious matter and not to be taken lightly... if you get the chance, speak to your endocrinologist about it.
 
mep73 said:
:lol: Seriously... if you have symptoms stay off the road and do not operate machinery. Don't wait until you're in a coma or dead... as you won't be able to do a thing and you possibly may have caused injury or fatality to others.

And don't assume that people on diet and metformin can't get hypos.... that wasn't true in my experience and I can tell you I don't suffer from hypoglycemia either.

You should always be on your guard. Hypos are a serious matter and not to be taken lightly... if you get the chance, speak to your endocrinologist about it.
Click to expand...

Not sure what the LOL emoticon is about, but we ARE being serious. We keep giving you sensible scientific rationale, with links from credible sites, with statements from health organisations, and you just keep repeating a view which is just your own. T2s in this country don't get "Endos", but I've paid privately as a one off to see a specialist endo who lectures doctors on diabetes, and he's said EXACTLY what i've said here about hypos. Can't see the point in keep repeating what I and others have said, including the doctors and endos on official health sites I've given you links to, so I'll leave it at that.
 
mep73 said:
And don't assume that people on diet and metformin can't get hypos.... that wasn't true in my experience and I can tell you I don't suffer from hypoglycemia either.
Click to expand...

How do you know EXACTLY the same thing wouldn't have happened if you hadn't been diagnosed diabetic? No one is disputing with you that what you said happened what we are disputing is that having the label "T2 diabetic" was the cause.

Lot's of people go dizzy, get nauseous or even pass out who don't have that label. Encouraging diet only or diet only plus Met diabetics to be more concerned about hypo's than the general non diabetic population is complete nonsense. It fact I would argue it can cause a newly diagnosed diet only T2 a load of issues if they get told "Now you are diabetic expect to hypo" Doing so can stop them getting their levels under control through a belief that they are now "different" to everyone else in the general population and that for some reason run higher risks and should therefore keep their levels high.

Did they have a smaller risk of a hypo the day before they were diagnosed? What about a month before or a year before? Did most even know about hypos before they were diagnosed or have even recognised one if they had one in their previous non diabetic life?

Why is a diet only T2 any more likely to hypo than a non diabetic? Where is your evidence?
 
The silly thing is, that as a low-carbing T2 I'm less prone to hypos than non-diabetics. My brain burns ketones, reducing its requirements for glucose to tiny amounts, all of which can be supplied from breaking down protein and fat. I run for 10 miles without eating, I can fast for days and I will never get dizzy or faint.

It's silly to suggest that T2 diabetics stuff themselves with Jelly Babies everytime their blood hits "normal" levels.
 
you UK peeps love your debates is the reason for my previous :lol:

My points based on my experience:
1. Low levels are dangerous
2. Testing BGLs regulaly helps
3. Treat a low BGL immediately
4. I wasn't on insulin when I had my first hypo I was on metformin :shock:
5. My first hypo ever was as a diabetic... not a non diabetic. I never experienced anything like it prior to diabetes.

What's to say there won't be someone else reading this that doesn't have the same experience? Science to me means nothing when I've experienced it..... sorry.

Things you should seriously consider (based on info given to me by my medical team):
1. You can get hypo unawareness
2. Your liver can fail to dump to save your life
3. If you have symptoms, it's dangerous as it means your judgment has already gone.

Our job is to protect ourselves? So what you do is make sure you try and stay in safe BGL levels... that was my original point... BGL balance. And, yes you do need to test to know this. I'm not sure how we got off topic from my original post on this thread?


:D
 
Low BG is NOT in and of itself DANGEOUS.
If it were, where would all the non-diabetrics be?
It's only dangerous if medication is preventing your body from restoring your bg to an acceptable leveel and your level continues to fall. HOWEVER. I have never been able to find any verified instance of someone's actually dying from hypo. It only happens in novels.
+Remember the target levels as quoted by DUK originated in the USA, where they were set as a protection for doctors prescribing insulin. so they wouldn't be sued if something went wrong. And were never designed to protect the patients.
Interestingly, the American Diabetes Association has revised its targets downwards recently.
Hana
 
I think it's wrong to be so totally dismissive even though it's relatively rare.
You may even be more likely to find people on forums that have hypos whilst on met; their diabetes doesn't conform so they start looking for answers.
Here's one case . It may have had a contribution from an ACE drug, which many people also take.
http://www.japi.org/june2007/Corr2.htm
The UKPDS also found a very small number of cases, very few but there all the same.

http://www.jdcjournal.com/article/S1056-8727(05)00119-4/fulltext
Interestingly one group who were more likely to have hypos (with any treatment) were those who who were antibody positive (ie they probably had LADA but were being treated as T2; this trial was one of the studies that led to differential diagnosis) This makes sense with the sort of roller coaster presence/absence of insulin that seems to characterise early LADA.

Borofergie: No-one should stuff themselves with anything when hypo, Even with the 15g advice this would be only 3 jelly babies
 
I just read the whole thread and on the original point and speaking as a T1 - I do not strive to keep my levels as low as possible. I aim for around 6 but see quite a variety of fluctuation as I will let my BG level go high before exercising and, when exercising regularly, have to take less insulin and eat more to keep my levels up around 6.

I've always been advised by my Doc to aim for a HbA1c of 6.5 and as I am normally under that and sometimes 5.8/5.9 they remind me regularly that if I am averaging 5.9 then I must be low a lot of the time. I am more afraid of being low than high as I know I can correct being high by taking insulin (although I have only ever done this once in the early days after a nasty xmas cake episode!) or by getting the trainers on and running. If had a reading of 10 (eg) I could have that down to 5 in 20mins with a quick run.

From a T2 point of view I really can't say, so I won't. I have one question though :)

Does anyone have any symptons of Hyperglycemia that the DVLA would be interested in?? Personally, I get incredibly irritable and short tempered so would be more likely to suffer from road rage. Ask my Wife :)
 
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