my "low" level seems higher than most

[gbswales]

I have never actually had a hypo (type 2) but find whenever my blood sugar drops to about 4 I start to get symptoms suggesting of hypo - unnatural sweating is the first sign I notice - it starts to get much worse at around 3.5 and have never let it go below this. This seems quite high to me (tested with several meters to make sure not a faulty meter) when I see people on here saying they are aiming at 4-5 as a normal pre meal level. I want to avoid hypos at all costs is it possible that some peoples levels are different in this way or does every normal person average 5 - I would find it almost impossible to maintain the 6-7 threshold that some people talk about without risking the possibility of a hypo

 

[cugila]

Hi gbswales

What you are describing is the first signs that you are going into Hypo territory, Hypoglycaemia. Anything below 4 mmol/l is considered to be the 'floor' which should be avoided. This level is not high ? The symptoms you describe are your body warning you that your Bg levels are getting too low and you need to do something to raise them again. Hypo awareness.

As a T2 your pre-meal levels should remain within 4 - 7 mmol/l. Lower is better, but never lower than 4 mmol/l. You will hear of people able to operate at levels below 4. This is not advisable as it is as dangerous as when your Bg levels are much too high. Neither is recommended.

Here is some further information about Hypoglycaemia which may be of interest to you ?
http://diabetes.niddk.nih.gov/dm/pubs/hypoglycemia/

Ken.

 

[phoenix]

I'll answer in points because its easier!
1) You have had a hypo. The word just refers to low blood glucose ( definitions vary but 3.5mmol would be considered to be hypo by most people). The level you choose as a target must be one at which the quality of your life is not marred by frequent hypos or fear of them. This varies from person to person/regime to regime

2) the level at which people sense hypos does vary, if you have been used to higher levels you will also feel hypos at higher levels. It works the other way too and for myself I now don't really feel hypo until in the low 3s or even lower. This is not a good thing and potentially dangerous for someone on insulin.(so I'm working with slightly higher levels to try to revese my awareness)

3) Low blood glucose occurs in non diabetics . The normal 'treatment' is to eat. Hypos only pose a potential danger if the cause is too much of some sort of medication such as insulin which can't be stopped and if they occur quickly, withour warning or are not treated with fast acting carbs (glucose)
There are many people on this board who control their diabetes with metformin or just diet. For them very low targets aren't a problem

4) Tight control on insulin ... one of the factors as to whether it's safe is the type of regime.
and how well you have learned/are able to manipulate it.
Mixed insulins are far more difficult to manipulate,, you can't change the basal part of the mix independently so fine control is difficult.
Its much easier/safer to aim for tight control with MDI (basal/bolus). In a person with a well adjusted basal insulin the blood glucose level should remain stable once the mealtime insulin has finished working.( the problem in this case is that not every day is the same and things like exercise or a hot day can make the levels fall)
A pump allows even more flexibility. Only rapid insulin is used and it can be reduced to a trickle or even switched off if necessary.

5) If you use insulin and you are type 2 (and particularly 1.5 ) things may be complicated by your own insulin production which may decide to up its own production . Insulin needs can change dramatically making tight control difficult.

 

[hanadr]

YYou are describing hyposymptoms.
I keep in the 5s and don't get them often, because Metformin doesn't cause them and it's the only medicine I use.
On a low carb/ low dose medicine control regime, hypos are rarer than with a high carb/high dose regime. the Bg swings are much less too.

 

[gbswales]

Thanks Phoenix for that long and detailed response - add to that a very eratic pattern of meals, sleep and lifestyle in general and you can see why I have a problem. As a child the quality of my life was severly inmpeded by hemophilia and as soon as I reached the age where I had full control of my life I decided that "Hemophillia, and treatment for it, would have to adapt to my lifestyle not the other way around!" This worked well and I did things which most contemporary hemophiliacs would have avoided. When diabetes came along I took the same approach (after a few months of near depression). However with diabetes it isnt so easy to adapt the illness to fit your life - especially when a big part of my life evolved around eating nice foods (I use the work nice rather than good as often the two are not synonymous)

Despite all the upbeat comments and encouragemnt I read here, when it comes down to it good diabetes control is something that requires compromises in lifestyle and for someone who has never really accepted compromise that can be difficult. I am used to sleeping when I am tired, eating when I feel hungry and doing pretty much everything at the times I feel like it. (ok work has been a compromise but now I am close to retirement, and hoped for a completey free lifestyle, I am finding that diabetes may well continue to dictate to me - and to be honest I find that depressing.

when I am not at work then breakfast might be anytime from 6am until 2pm (as it was today!) and all other meals move correspondingly - I might sleep all aftrnoon and half the evening then stay up most of the night, go to late night cinema or shopping in tesco at 3am - that all makes it very difficult!