What to do

[tim2000s]

Every time you go below 3.9, you are risking a small amount of brain damage, even if you feel fine. 9I do have a paper on it somewhere, but can't find it to upload.....sorry).

I'd be very interested in seeing that, given that much of the research that is readily available discusses lowering glucose levels below 1mmol/l in order to cause neuronal damage in rats.

All of the research that I can find linked to hypoglycaemia states that it is severe hypoglycaemia that causes the issues, and that mild hypoglycaemia is does not cause affect cognition. This slidedeck is quite interesting in that respect, especially the final slides talking about following 1144 T1s over 18 years and seeing no reduction in cognitive function where 0 severe hypos have taken place.

With reference to non-diabetic blood glucose levels, they do get down below 3.9mmol/l as part of normal life. As this article in diabetes care journal shows, across all populations, up to 1.7% of the day can be spent below 3.9mmol/l, with this occurring most frequently in the sample set in those aged between 29 and 45.

 

[SunnyExpat]

I'd be very interested in seeing that, given that much of the research that is readily available discusses lowering glucose levels below 1mmol/l in order to cause neuronal damage in rats.

All of the research that I can find linked to hypoglycaemia states that it is severe hypoglycaemia that causes the issues, and that mild hypoglycaemia is does not cause affect cognition. This slidedeck is quite interesting in that respect, especially the final slides talking about following 1144 T1s over 18 years and seeing no reduction in cognitive function where 0 severe hypos have taken place.

With reference to non-diabetic blood glucose levels, they do get down below 3.9mmol/l as part of normal life. As this article in diabetes care journal shows, across all populations, up to 1.7% of the day can be spent below 3.9mmol/l, with this occurring most frequently in the sample set in those aged between 29 and 45.

It does come to this conclusion though.

'Glucose values ≤60 and >140 mg/dl, measured with CGM, are uncommon in healthy, nondiabetic individuals.'

60 is 3.3%, that was a zero
70 is 3.9% that was 1.7% of the day.

So no one went below 3.3%.
And for 3.9%, 1.7% is about half an hour?
So, without knowing how low the group actually go in that time, I would say it seems about right, if I've worked hard, I can push my BG down probably that far.
Then I know it's time to eat.

Interestingly, no one went above 7.8% either, so that would seem to be the ceiling.

 

[tim2000s]

70 is 3.9% that was 1.7% of the day.

Across all, although that varied quite a bit by age groups, with those aged 29-45 spending up to 40 mins a day below 3.9mmol/l.

 

[1abRat]

We do a lot of blood glucose testing where I work using a laboratory analyser.

Most participants are healthy and aged 18-25.

I almost never see a reading above 5 unless we're doing something screwy with them like OGTT. Most of their blood tests are between 3.2-4.5 mmol/L so I think brain damage occurring below 3.9 is highly unlikely.

When we get our participants to fast overnight their sugars are often in the 2's and settle to ~3.5-4 mmol/L after eating.

I find it all fascinating of course to see how "normals" sugars behave!

 

[Oldvatr]

I'd be very interested in seeing that, given that much of the research that is readily available discusses lowering glucose levels below 1mmol/l in order to cause neuronal damage in rats.

All of the research that I can find linked to hypoglycaemia states that it is severe hypoglycaemia that causes the issues, and that mild hypoglycaemia is does not cause affect cognition. This slidedeck is quite interesting in that respect, especially the final slides talking about following 1144 T1s over 18 years and seeing no reduction in cognitive function where 0 severe hypos have taken place.

With reference to non-diabetic blood glucose levels, they do get down below 3.9mmol/l as part of normal life. As this article in diabetes care journal shows, across all populations, up to 1.7% of the day can be spent below 3.9mmol/l, with this occurring most frequently in the sample set in those aged between 29 and 45.

Interesting take on this:
http://www.healthline.com/diabetesm...cause-brain-damage-does-diabetes-cause-cramps

There are blogs that say any hypo will lead to brain damage, but most of the formal studies show that diabetic coma is most closely associated with it. There is a counter argument that damage can occur due to arythmia and heartbeat interruptions during severe hypo, rather than lack of glucose itself.

 

[SunnyExpat]

Across all, although that varied quite a bit by age groups, with those aged 29-45 spending up to 40 mins a day below 3.9mmol/l.

Sounds right, BG naturally rises with age supposedly.

 

[SunnyExpat]

We do a lot of blood glucose testing where I work using a laboratory analyser.

Most participants are healthy and aged 18-25.

I almost never see a reading above 5 unless we're doing something screwy with them like OGTT. Most of their blood tests are between 3.2-4.5 mmol/L so I think brain damage occurring below 3.9 is highly unlikely.

When we get our participants to fast overnight their sugars are often in the 2's and settle to ~3.5-4 mmol/L after eating.

I find it all fascinating of course to see how "normals" sugars behave!

That seems to completely contradict the article above, and most others that have been reported?
Any idea why you're seeing an odd pocket of different readings?

 

[Bluetit1802]

Sounds right, BG naturally rises with age supposedly.

Is there a reason why this should be? If it is a generally accepted natural occurrence then one has to wonder why the NHS and the other health bodies round the world use the one size fits all criteria.

 

[1abRat]

I know, I think the truth may be closer to what Oldvater said; that it's the symptoms associated with a severe hypo - seizures etc. cause brain damage when the lows are in what would be considered "normal range" for a non-D

That paper used interstitial fluid measured with a CGM. Anyone who's used a Libre knows it can get a bit pants in terms of accuracy towards the lower ends of glucose

 

[Oldvatr]

Is there a reason why this should be? If it is a generally accepted natural occurrence then one has to wonder why the NHS and the other health bodies round the world use the one size fits all criteria.

Possibly several factors make bgl averages rise with old age. Less activity, less mobility, weight increase, no longer self catering (meals on wheels, prepackaged meals from supermarts) less mental acuity and declining sight leading to less interest in maintining good diabetes practices. Probably a host of other lifestyle factors that change in later years. Retirement can be a major impact either way. I think Care Home and Hospital food may come into it for many.

 

[Totto]

We do a lot of blood glucose testing where I work using a laboratory analyser.

Most participants are healthy and aged 18-25.

I almost never see a reading above 5 unless we're doing something screwy with them like OGTT. Most of their blood tests are between 3.2-4.5 mmol/L so I think brain damage occurring below 3.9 is highly unlikely.

When we get our participants to fast overnight their sugars are often in the 2's and settle to ~3.5-4 mmol/L after eating.

I find it all fascinating of course to see how "normals" sugars behave!

This correspons with my own experience from before diabetes. I was often below 4 but rarely above 5.

 

[Bluetit1802]

Possibly several factors make bgl averages rise with old age. Less activity, less mobility, weight increase, no longer self catering (meals on wheels, prepackaged meals from supermarts) less mental acuity and declining sight leading to less interest in maintining good diabetes practices. Probably a host of other lifestyle factors that change in later years. Retirement can be a major impact either way. I think Care Home and Hospital food may come into it for many.

Ah ...... so you are suggesting very old age, rather than a sliding scale of advancing age from, say, 60ish.

I am one that has concerns about what might happen in the future should I ever require care.

 

[Oldvatr]

Ah ...... so you are suggesting very old age, rather than a sliding scale of advancing age from, say, 60ish.

I am one that has concerns about what might happen in the future should I ever require care.

Nirvana beckons. Elysian Fields, here we come! Yes I was thinking more of my dotage, but it was not clear what the term rising age was referenced to. However, the comment on increasing girth would seem to still be relevant even at 65 (not aiming at anyone in particular, just the general populace has a trend for this)

 

[LittleGreyCat]

Back to the OP - I would expect at least a mild feeling of tiredness directly after eating, as the body concentrates on digesting food.

However I would not expect it to be incapacitating.

 

[PosyPip]

I am not putting this here to blow mein own trumpet, but it contains a graph that demonstrated how my SD Codefree and my NEO / XCEED meters tracked each other quite consistently over time. I was able to detect and reject 2 paks of NEO strips that were duff (omitted from my results, so not shown in graph). I use my NEO for hypo management but the SD gives me confidence, especially when both trend together. Where the graph starts to diverge or converge, then this is usually due to a strip change.

Thanks, this is helpful. A couple of questions if I may. You say that they track each other consistently and that they sometimes diverge or converge. does this indicate that one generally reads higher than the other?

Do you use the NEO for hypo management because the SD is less accurate at low levels?

 

[Oldvatr]

Thanks, this is helpful. A couple of questions if I may. You say that they track each other consistently and that they sometimes diverge or converge. does this indicate that one generally reads higher than the other?

Do you use the NEO for hypo management because the SD is less accurate at low levels?

The SD has ALWAYS (with one single exception due to a misread) read higher than the NEO. I use the NEO for hypo because it seems to be more repeatable at low levels (i.e. repeat samples are closer). I also find it easier to relate to the ranges stated by NICE and DVLA. For example, last night my NEO read 3.8, and my SD read 5.2. Since it was bedtime, I took some carbs to avoid a night hypo. My FBGL this morning was 4.9 on the NEO, 6.2 on the SD

 

[Jasperville]

I would be very interested in seeing that link, if you find it.
I wonder if the study takes into account the differences in cognitive function when 'fat adapted' or keto?

It was a summary paper on hypoglycaemia guidelines from the American diabetes association I think.

 

[Jasperville]

I'm referring to two older comments in this thread, asking where the evidence is that <3.9 can cause damage. however, there are some extremely knowledgable posters here, so I'm quite happy to believe that high 3's is OK, as long as not too frequent/prolonged

 

[RuthW]

Feeling sleepy immediately after food. At bg 5

Getting back on topic, your tiredness may be due to something else. Tiredness after eating can be a symptom of anemia, especially if it is happening very often.


Sent from my iPhone using DCUK Forum mobile app

 

[CherryAA]

I would agree with you if our bgl meters were accurate so we could rely on them, But you have to allow for +/- 0.8 mmol/L error on any reading below 4mmol/L, so the quoted reading of 3.4 could actually be 2.6 and the meter would be considered correct. It is worse if the meter is an SD Codefree or an Accuchek since these are calibrated to measure 12 % higher than other meters, (3.4 then could be 2.3)

I find I start to go into hypo at 3.4, although this is not a major evemt since I an fat adapted due to running my LCHF into ketosis However, it is possible to run LCHF without ketosis, and in that case the level of 3..4 could represent a significant event requiring assistance..

I recently purchased a an Abbott freestyle monitoring system. After 15 days it is recording an estimated Hba1C of 40mmols. Yesterday I did a home hba1C test which came out at 41 mmols - so everything seems to be consistent.

MY SD codefree is generally consistently recording higher blood sugars than the Freestyle libre
cmg . I was searching for information about whether the SD codefree does record high and found this post suggesting it is actually calibrated to be higher which was news to me.
Presumably if that is true then any people using the codefree get a pleasant suprise when they get hba1C tests done, assuming they test often enough to end up with a mental average of sorts?