Thesis: for healthy individual, <70mg/dL isn't bad - Hypoglycemia

[Rémy75]

Hello,

French 32yo, M, 1m85, 70kg, lean. Run every other day (mostly z2 and rarely z5 intervals) and strength workout when not running.

I noticed since I monitor my blood glucose that I am most of the nighttime below 70mg/dL. However, when looking into it, I don't have any symptoms or problems related to Hypoglycemia. I sleep well and feel refreshed. My sport trackers are all confirming this feeling (hrv, hr, etc.). I don't follow a particular diet, and my schedule is very basic, just breakfast, lunch and dinner.

After a few weeks of testing different things, like having many carbs for dinner, no carbs, and different other combination of foods: I haven't seen any difference of night blood sugar level. Always in Hypoglycemia territory.

During the day, after a few hours on the computer, it is the same, it goes below 70. However, if I move/walk a little, it comes back to 70-75mg/dL without the need to eat anything. I don't feel hungry neither.

Thus I am starting to think that maybe for a healthy individual, there isn't such thing as lower bound limit for blood sugar level, especially if not having any symptoms?

Curious to hear what you think about that theory.

Edit: HbA1C test is of course OK, I don't have diabetes or pre-diabetes.

https://imgur.com/a/TyvSq4A

 

[Deleted member 527103]

The level of 4.0 mmol/l or 70mg/dL is considered a concern for people who are treating their diabetes with blood sugar lowering medication such as insulin. The problem is not that level but the risk of going lower. It is not at all unusual for people without diabetes to experience levels in the high 3s (apologies, in the UK we use mmol/l so I am more familiar with these units) especially during or after exercise.

However, if you are seeing these levels all the time, my first thought would be whether your sensor is accurate. They are "factory calibrated" and it is not uncommon to find our interstitial fluid (what sensors read rather than blood readings) is calibrated differently.
My recommendation would be to do a few finger prick tests to check your levels before drawing any conclusions as this is likely to be more accurate than Libre.

 

[Lamont D]

Hi and welcome to our forum.
First of all we can't diagnose you.
Has your cgm or glucometer been synchronized.
It It usual for some people to be in the lower range.
Have you had readings below 77?
A cgm can get analogous readings through the night. Did you take a finger prick test to confirm?

Did you eat during this time? What are your readings pre meal and after?

If I had continuous hypoglycaemic readings, I would contact a doctor.

 

[Rémy75]

The level of 4.0 mmol/l or 70mg/dL is considered a concern for people who are treating their diabetes with blood sugar lowering medication such as insulin. The problem is not that level but the risk of going lower. It is not at all unusual for people without diabetes to experience levels in the high 3s (apologies, in the UK we use mmol/l so I am more familiar with these units) especially during or after exercise.

However, if you are seeing these levels all the time, my first thought would be whether your sensor is accurate. They are "factory calibrated" and it is not uncommon to find our interstitial fluid (what sensors read rather than blood readings) is calibrated differently.
My recommendation would be to do a few finger prick tests to check your levels before drawing any conclusions as this is likely to be more accurate than Libre.

Well, it is my 6th sensor already, and I am always in <70 during the night. Thus I can say that it is not a problem with the sensor itself.
But I will will do a finger test to confirm soon.

 

[Rémy75]

Hi and welcome to our forum.
First of all we can't diagnose you.
Has your cgm or glucometer been synchronized.
It It usual for some people to be in the lower range.
Have you had readings below 77?
A cgm can get analogous readings through the night. Did you take a finger prick test to confirm?

Did you eat during this time? What are your readings pre meal and after?

If I had continuous hypoglycaemic readings, I would contact a doctor.

Hi, thanks.
I don't need to be diagnosed, just sharing my experience.
77 is just the time of the screenshot.
Look the red line, I was at 55 most of the night.
I will do a finger prick test soon to confirm. But 6 sensors, thus 12 weeks and it is always the same pattern, <70 most of the time.
Eating doesn't change much the level, always top around 75.

 

[Lamont D]

Hi, thanks.
I don't need to be diagnosed, just sharing my experience.
77 is just the time of the screenshot.
Look the red line, I was at 55 most of the night.
I will do a finger prick test soon to confirm. But 6 sensors, thus 12 weeks and it is always the same pattern, <70 most of the time.
Eating doesn't change much the level, always top around 75.

I'm sure you probably won't need a dianosis.
thanks for the information.
I'm not trying to influence you either.

However, the way you are describing this, has me wondering wether if these readings are correct and consistently at around 77. And eating doesn't move it much at all. In other words your blood glucose levels are in steady level all the time. Am I right?

If I am, I have come across a condition called flatline hypoglycaemia.
This is something that needs no treatment unless it changes.
As you say, you live with it well now, you don't get symptoms and the only way you found out is wearing a cgm.

You could consult a specialist if you are concerned, but it might be beneficial to find out.

The how and why, I don't know.

Best wishes.

 

[Antje77]

Well, it is my 6th sensor already, and I am always in <70 during the night. Thus I can say that it is not a problem with the sensor itself.
But I will will do a finger test to confirm soon.

My sensors ALWAYS read lower than a fingerprick by 0.8 to 2.0 mmol/l (14 to 36 mg/dl), it's a consistent thing.
So all your sensors acting in the same way doesn't mean they're correct.
Your 55 mg/dl is on the low side, but 60 to 70 is very normal in non diabetics.
Considering you don't have symptoms, I wouldn't worry about it.

May I ask why you are monitoring your blood glucose?

I added a handy conversion chart so it's easier to look up the translations of the numbers.

 

[bulkbiker]

Thus I am starting to think that maybe for a healthy individual, there isn't such thing as lower bound limit for blood sugar level, especially if not having any symptoms?

There will almost certinaly be a lower limit beyond which the body will have trouble producing enough glucose to keep us alive.. it obviously it isn't 70 mg/dl though.
Even me, a T2 in remission, has been in the mid 60's (3.5 mmil/l) when on an extended fast.
Edit to add there was a paper referred to by Prof Phinney where healthy people in ketosis had been injected with insulin driving their sugars down to the 30's I think.. they were fine although it's not recommended and probably would be deemed unethical these days.

 

[bulkbiker]

There will almost certinaly be a lower limit beyond which the body will have trouble producing enough glucose to keep us alive.. it obviously it isn't 70 mg/dl though.
Even me, a T2 in remission, has been in the mid 60's (3.5 mmil/l) when on an extended fast.
Edit to add there was a paper referred to by Prof Phinney where healthy people in ketosis had been injected with insulin driving their sugars down to the 30's I think.. they were fine although it's not recommended and probably would be deemed unethical these days.

I think it is this one

https://coconutketones.com/wp-content/uploads/2016/10/CahillGF_CerebMetabolism.pdf

 

[Rémy75]

I'm sure you probably won't need a dianosis.
thanks for the information.
I'm not trying to influence you either.

However, the way you are describing this, has me wondering wether if these readings are correct and consistently at around 77. And eating doesn't move it much at all. In other words your blood glucose levels are in steady level all the time. Am I right?

If I am, I have come across a condition called flatline hypoglycaemia.
This is something that needs no treatment unless it changes.
As you say, you live with it well now, you don't get symptoms and the only way you found out is wearing a cgm.

You could consult a specialist if you are concerned, but it might be beneficial to find out.

The how and why, I don't know.

Best wishes.

Yes blood glucose are in steady level all the time, even in bellow normal ranges. No spike whatever I eat.
Thank you!

My sensors ALWAYS read lower than a fingerprick by 0.8 to 2.0 mmol/l (14 to 36 mg/dl), it's a consistent thing.
So all your sensors acting in the same way doesn't mean they're correct.
Your 55 mg/dl is on the low side, but 60 to 70 is very normal in non diabetics.
Considering you don't have symptoms, I wouldn't worry about it.

May I ask why you are monitoring your blood glucose?

I added a handy conversion chart so it's easier to look up the translations of the numbers.

To answer your question, I am a data scientist for work.
Thus it translated also personally, because I am passionate about data... So I started to collect different kind of data, not only health related.

There will almost certinaly be a lower limit beyond which the body will have trouble producing enough glucose to keep us alive.. it obviously it isn't 70 mg/dl though.
Even me, a T2 in remission, has been in the mid 60's (3.5 mmil/l) when on an extended fast.
Edit to add there was a paper referred to by Prof Phinney where healthy people in ketosis had been injected with insulin driving their sugars down to the 30's I think.. they were fine although it's not recommended and probably would be deemed unethical these days.

Well it seems spending the night in 50-55 is fine, at least for me.
But you have to admit, that for a guy like me, that has never done research on diabetes before, the first few pages of the search engine says below 70 is dangerous made me wonder.

I think it is this one

Thank you! But I am not into keto diet, or alternating diet whatsoever Interesting read nevertheless.