When your BG feels lower than your meter says you are

[ButtterflyLady]

I was diagnosed with T2 Diabetes about a year ago and am doing reasonably well with dietary management and Metformin.

Lately I've had episodes of feeling weak, headachy, and irritable, with a BG of 5.2. I then eat something and feel better. I know the threshold for having a hypo is 4, but do any of you feel unwell before getting this low?

 

[Grazer]

Hi Catlady. Unless your meter is wrong, which it could be, it's unlikely I would think to have low blood sugar symptoms with a level of 5.2
How long have you been getting your BGs down to these levels? What often happens is that our body gets used to running with high BGs before we are diagnosed. Therefore, when we start to get our blood sugar levels down to more normal levels, our body feels that it is "low" by comparison. Eating something pushes it back up to levels the body has got used to so we feel better. However, we don't WANT to send our BGs back to those levels, so we should put up with the slightly uncomfortable feelings rather than eat; our body will soon get used to these improved levels.
It means you're doing things well to get your BGs down!
One thing on hypos.
DANGEROUS hypos come when a person takes too much insulin, or similar sugar lowering drugs that stimulate the production of insulin, for the amount of carbs they eat, or do more exercise than expected.
I see you only take metformin. Metformin doesn't reduce blood sugar levels by increrasing the production of insulin. It works by improving our sensitivity to the insulin we DO produce and stopping the liver from releasing quite so much sugar into our blood in the first place. At best, it can only lower our BGs by 1 to 2 mmols/l on the maximum dose. So you can't get dangeropus hypos if you are only on metformin. You CAN get low blood sugar levels (which strictly speaking is a mild hypo) the same as any other non-diabetic person can if you don't eat enough or exercise a lot without food, but that's different to a dangerous insulin-produced hypo. I've had readings down to 3.2 without problem after a lot of exercise without food. But i'm not going to collapse.
I suspect that those who do report bad hypos on diet only have some other factor affecting them or perhaps simply don't eat enough of anything to give them the energy they need for the life-style they lead. A marathon runner has to eat something to keep going! And this applies equally to the non-diabetic community.

 

[ButtterflyLady]

Thanks for the information, very helpful. In answer to your question, my BGs have only been this low recently, during and since a long fast pre-surgery. The long fast was not appropriate, and upset my glucose control for about a week. I also developed a mild electrolyte imbalance and minor infection. I'm in the process of making a formal complaint to the hospital for failing to recognise that my diabetes required additional management, and failing to respond to my requests for this. At this stage they do not even think there was a problem.

The low-5s readings were from the hospital's meters and my own, so I think my meter is probably correct. I do often feel a bit weak if they are around this level - but I know it's not dangerous or even technically a hypo. When at home and not sick, I can put up with it for the sake of good control - I have many decades of life left and I want to reduce complications as much as I can.

My last HbA1c was 6.3%, so I am happy with my ongoing control. I have been under a lot of stress lately and also have other medical conditions, so I'm not being too hard on myself. I would need to read a lot more about the pros and cons of tight control before deciding to go all-out to reduce my HbA1c further.

This morning my fasting BG was 7.3. Not sure if that's due to the infection (which is still resolving). If this was a normal fasting BG, should I be trying to get it under 7?

Thanks again.