Why so low

[celast]

Had a shock today,decided to take a test 4 hours after Sunday Lunch,it was only 1 7, straight away after it was 3.2 so after couple of rounds of toast for sunday tea it went to 4.2. why is it so low ? any ideas.

 

[Grazer]

If 1.7 went to 3.2 "straight after", it suggests 1.7 was a duff reading. The other readings say you're doing great! Have you tested one of your strips with the fluid they give you to make sure they are ok? Also, what were you doing in the 4 hours after lunch? Any exercise?

 

[celast]

Thanks Grazer, I never had any fluid with my strips, so you think 3.2 is ok ? I HAVE TO SEE THE SCREENING NURSE THIS WEEK THEN A DIATICIAN NEXT WEEK, sorry about the capitals forgot to change it back after the i......

 

[Grazer]

Ivehad 3.2 and lower. As you're on diet only, it's not an issue as it would be if you were on insulin or other blood sugar lowering drugs (metformin doesn't count here) Was there a reason why you were testing at four hours? We normally test two hours after eating to ensure the food we ate was ok for us
If you didn't get any testing fluid, the meter manufacturer will probably send you some if you ring. It's to make sure your strips are "within range"

 

[Sarah1005]

In my book 3.2 is classed as a hypo! Did you have any hypo symptoms?

 

[Grazer]

In my book 3.2 is classed as a hypo! Did you have any hypo symptoms?

Just to clarify something.
This is quite a common theme regarding "hypos" for type 2's on diet only /metformin. There is a lot of confusion caused by the definition of a "Hypo"
"Hypo" is short for hypoglycaemia, which simply means low blood sugar. However, there is a massive difference between low blood sugar and the sort of hypo often referred to in relation to diabetes. Perhaps I can give my understanding.
Low blood sugar is not caused by diabetes. ANYONE, diabetic or non-diabetic, can get low blood sugar. Where energy demands are greater than the energy provided by the food (or drink) we've consumed, our blood sugar will continue to fall as demand is greater than supply. I've recorded 3.1 and been lower; and I've known of people hitting the 2's (my athletic non-diabetic daughter - tested her once when she had an episode) This can lead to light-headedness or dizzy, feeling emotional, etc. Eventually, the liver will release Glycogen to compensate and bring BGs back up. The ONLY reason why a diabetic on diet only/metformin may be more likely to get this than a non-diabetic is because we are more likely to be on a diet and fall into the energy out being greater than the fuel in trap.
When referring to diabetic hypos, we are normally referring to the sort of dangerous hypo that can occur with an insulin dependant diabetic, or one on strong sugar-lolwering drugs (not metformin) Here, BGs can fall into the 1's and the individual could become comatose and, ultimately, die. Intervention by a third party to help is sometimes required. An aware Insulin dependant diabetic will solve the problem themself by taking on board some instant fuel (such as with glucose tablets) to raise BGs. This problem is caused by the intake of insulin being greater than that needed. Perhaps the individual miscalculated the dose needed, or didn't eat the expected food on schedule, or experienced greater exerciser than planned, or drank sugar lowering alcohol in quantities without adjustment. Whatever the cause, the insulin taken has dropped BGs greater than the expected need. This is why Metformin doesn't cause Hypos. It doesn't stimulate the release of insulin as some drugs do. It merely makes the liver release slightly less sugar after food than it normally would, and makes the insulin we DO produce (which occurs after food when our BG is rising) more effective. So it can stop our sugar level from rising quite as high as it would after food, but it doesn't LOWER it as insulin does.
So, in summary, diabetes doesn't cause hypos. Metformin doesn't cause hypos. Insulin can. Insulin-stimulating drugs can. Lack of food causes low blood sugar for either a diabetic or non diabetic (officially a hypo, but not dangerous and not requiring outside assistance). There is a big difference between low blood sugar and a dangerous hypo.

So Celast may have been having a low blood sugar episode, but NOT a dangerous hypo, so if she felt ok (which obviously she did) there was no need to worry which is why I didn't want to start confusing her with talks of hypos. Remember, error on her meter and error in taking the test could mean she was a fair bit higher anyway.
Hope this helps.

 

[celast]

Thank you Grazer,that was a wonderful explenation, thank you very much, I am learning all the time, btw, I am a 75 year old chap called Charles..... :lol: :lol: :lol:

 

[xyzzy]

Charles (and Sarah)

I posted this a few weeks ago and it also includes a previous post from a moderator on this subject. It just reiterates what Grazer has said but because this area gets mis-understood its worth saying again.

The general rule is if you are a T2 on no meds or just Metformin you will be no different to a non diabetic and non diabetics can get low sugars just like a T2. The level that low starts to effect you varies from person to person and from situation to situation so I've recorded a 3.2 and felt fine but on other occasions have got dizzy / nausea symptoms (not hypo) at slightly higher levels as well. The speed your levels fall also has an effect.

In the end a no or minimal meds T2 should self correct. The body has a mechanism for doing this called a liver dump. At some point your brain will go "had enough of this" and tell your liver to dump a load of glucose at which point your levels will rise quite considerably. In the one case I've managed to measure the effect after doing some running I went from 3.4 to 7.1 in 5 minutes. Normally a liver dump is caused by doing stuff like strenuous exercise which will lower levels. Alternatively it can and does just happen if you slowly fall to a very low level because maybe you haven't eaten for many hours. Even though we do self correct it doesn't alter the fact that sometimes you get the sickness dizziness thing before the dump would occur. If you are lucky like I was after running the liver dump occurs before you get any symptoms but sometimes you get the symptoms first. What you have to remember is that throughout your life this liver dump mechanism has probably cut it loads of times without you ever realising it.

In a T1 or insulin injecting diabetic or occasionally a diabetic who is on insulin stimulating drugs a true hypo can occur. In this case the normal cause is an over injection of insulin. This causes a rapid fall in levels that can simplistically override the bodies normal liver dump responses. In these cases nothing apart from orally taking on board extra glucose will stop the decline and is therefore very dangerous as under around 2.5 most people start to run the risk of falling unconscious. Even then the body has its own defences. It will try and keep important bits like the brain at a higher levels than non critical bits. Some T1's on the forum have been happily conscious and alert with readings in the high 1's.

The ADA (American Diabetes Association) says for an insulin injecting diabetic the hypo range begins under 4 but does not become dangerous until levels fall below 2.5. The key thing in that statement is insulin injecting.

Another way of looking at it is to realise being diabetic doesn't cause hypos. True hypos are caused by insulin injections or powerful diabetic drugs not the diabetic themselves.

Another thing for a newly diagnosed T2 to be aware of is that those dizziness and sickness symptoms can occur at levels far higher than 3 or 4. These are called false hypos and happen simply because that diabetics body has got use to running at very high sugar levels so their bodies object to having the sugar taken away. This is actually quite dangerous as it can act as a big disincentive to a T2 who is trying to get to normal levels as the level the false hypos can occur can be well above the recognised max safe level of 8. If the person doesn't realise what's happening then its quite likely they think their levels are too low and that they are "hypoing". They then eat a load of sugar and their body goes "thanks" and then continues to damage itself by having too high levels. If these occur you should try to bring your levels down slower but don't give up trying.

Right... there needs to be a clear definition here... many non-diabetics regularly have blood glucose of below 4 mmol/l... if the mean fasting blood glucose of the general non-diabetic population is in the very low 4's then by definition some people are going to have fasting blood glucose in the mid - high 3's... (3.3 mmol/l is commonly citied as the 'lower level' of normal blood glucose). What you don't see is them regularly falling over or collapsing from hypo's because this is 'normal' blood glucose.

Anyone controlling their diabetes that doesn't use pancreas stimulating drugs or insulin is as likely as a non-diabetic to suffer from a hypo... i.e. yes you can still have them but you are going to have to have done something pretty daft to suffer from one... i.e. drink a lot... do a lot of exercise without eating... etc... This is exactly the reason why for instance the DVLA does not require these types of people to undergo the same level of scrutiny as insulin taking diabetics.. the risk to them is no greater than a normal member of the public.

If you take insulin then ofcourse you need to be much more aware of what your blood glucose are doing... as a type I diabetic of many years the danger from hypo's comes from the rapid change in blood glucose that insulin can produce.. Along with the fact that your body is not in control of the amount of insulin in effect... in a non-insulin controlled diabetic as your blood glucose drops lower your body stops producing insulin, your liver dumps glucose and all is well... in an insulin controlled diabetic that insulin keeps acting if there is too much insulin in your system them your livers glucose dump is not enough and your blood glucose continues to drop..

Therefore it is advised that you keep your blood glucose above 4 mmol/l... this ensures that you have some buffer to dangerously low blood glucose and also ensures that you maintain a hypo awareness (for most people)...

The point at which low blood glucose becomes dangerous is when it starts to effect brain function this is known as Neuroglycopenia.. Neuroglycopenia causes the majority of the symptoms that we associate with hypos... mood swings, fatigue, weakness, apathy, lethargy, confusion, amnesia, dizziness, delirium, etc... these symptoms typically present at between 2.0 - 2.4 mmol/l...

So in summary: If you are a diabetic who does not take pancreas stimulating drugs or insulin then a reading of between 3.3 - 4.0 mmol/l is nothing to be overly concerned about (you aren't about to drop into diabetic coma!.. indeed this may even be 'normal' for you). If you plan on exercising or drinking or any sort of activity that may effect your blood glucose or you have recently undertaken any of these activities then you may want to eat some carbs...

If on the other hand you are taking insulin or pancreas stimulating drugs and you get a reading that is sub 4 mmol/l then you should take it seriously and actively correct.

 

[Grazer]

Thank you Grazer,that was a wonderful explenation, thank you very much, I am learning all the time, btw, I am a 75 year old chap called Charles..... :lol: :lol: :lol:

So sorry Charles! Don't know why I made that assumption........c'est la vie et vive la difference!

 

[xyzzy]

Thank you Grazer,that was a wonderful explenation, thank you very much, I am learning all the time, btw, I am a 75 year old chap called Charles..... :lol: :lol: :lol:

So sorry Charles! Don't know why I made that assumption........c'est la vie et vive la difference!

Yes I think I made the same mistake when you first joined. Must be your writing style at least that's my excuse. First time I've managed to call a man a lady normally its the other way round Anyway apologies Charles.

 

[Defren]

Thank you Grazer,that was a wonderful explenation, thank you very much, I am learning all the time, btw, I am a 75 year old chap called Charles..... :lol: :lol: :lol:

So sorry Charles! Don't know why I made that assumption........c'est la vie et vive la difference!

Yes I think I made the same mistake when you first joined. Must be your writing style at least that's my excuse. First time I've managed to call a man a lady normally its the other way round Anyway apologies Charles.

Yes, you and Grazer both called me a man when I first joined. :lol:

Welcome to the forum Charles.

 

[xyzzy]

Yes, you and Grazer both called me a man when I first joined. :lol:

Welcome to the forum Charles.

Oh for God sake not you as well! That makes it ladies 3 men 1

 

[Defren]

Yes, you and Grazer both called me a man when I first joined. :lol:

Welcome to the forum Charles.

Oh for God sake not you as well! That makes it ladies 3 men 1

Yup, that's why I add my name to some posts. Initially I added Jo, but was still called a dude, or mate so now add Joanna, seems to cut out the confusion :lol:

 

[lucylocket61]

I thought you were a bloke too Defren

Sorry.

 

[Anonymous]

I don't think you can safely say that you're not having a hypo... anything under 4 is too low.

My endo has asked me to stay above 5 at all times... so that says something.

You need to be very cautious of going too low as it can get dangerous.

I certainly had my very first hypo on metformin only and I hit a wall with my head.... so yes it's dangerous! It doesn't matter whether you've gone too low or not... I was 4.2 when I tested after hitting the wall. I can tell you I didn't feel too good either.

My endo has taught me to understand your 'safe' level and to stay above it at all times. I know for me if I'm below 4.5 I'm in trouble... so that's why my endo has requested he'd prefer I stay above 5.

It might be worthwhile having a discussion with your endocrinologist about this as everyone is different. Too many hypos is not good for your body either. Be aware of the symptoms and also be aware that you could have hypo unawareness too.

 

[Defren]

I thought you were a bloke too Defren

Sorry.

Lol, no Lucy, I am all female :lol:

Think I should add to my sig: My name is Joanna and I am woman :lol: My screenie is pretty ambiguous so perhaps my own fault really.

 

[Grazer]

My endo has asked me to stay above 5 at all times... so that says something

Mep, with respect, you're on insulin! That's an entirely diferent set of circumstances. And if you hit your head on a wall at 4.2 - well, so you had a dizzy spell. 4.2 is completely normal for a non-diabetic; in fact, is probably pretty average as a BG considering their HbA1c will be only 4.6 on average. Yes, you can get low blood sugar, but read my post again. There's a major difference between low blood sugar and a dangerous hypo. And it's NOT dangerous to go below 4 for a non-diabetic, or a diabetic on diet only which Celast is. And I very much doubt Celast will have an "Endo" as a T2 on diet only. You can't compare your situation with T2s on diet only.

 

[Anonymous]

My endo has asked me to stay above 5 at all times... so that says something

Mep, with respect, you're on insulin! That's an entirely diferent set of circumstances. And if you hit your head on a wall at 4.2 - well, so you had a dizzy spell. 4.2 is completely normal for a non-diabetic; in fact, is probably pretty average as a BG considering their HbA1c will be only 4.6 on average. Yes, you can get low blood sugar, but read my post again. There's a major difference between low blood sugar and a dangerous hypo. And it's NOT dangerous to go below 4 for a non-diabetic, or a diabetic on diet only which Celast is. And I very much doubt Celast will have an "Endo" as a T2 on diet only. You can't compare your situation with T2s on diet only.

Just let me clarify... I've been on all types of treatment for diabetes... I'm no novice to it. I also was treated on diet only for a time. My endo gave me the above 5 advice long before I was placed on insulin, I've only been on insulin since 2010.

 

[Defren]

I don't think you can safely say that you're not having a hypo... anything under 4 is too low.

My endo has asked me to stay above 5 at all times... so that says something.

You need to be very cautious of going too low as it can get dangerous.

I certainly had my very first hypo on metformin only and I hit a wall with my head.... so yes it's dangerous! It doesn't matter whether you've gone too low or not... I was 4.2 when I tested after hitting the wall. I can tell you I didn't feel too good either.

My endo has taught me to understand your 'safe' level and to stay above it at all times. I know for me if I'm below 4.5 I'm in trouble... so that's why my endo has requested he'd prefer I stay above 5.

It might be worthwhile having a discussion with your endocrinologist about this as everyone is different. Too many hypos is not good for your body either. Be aware of the symptoms and also be aware that you could have hypo unawareness too.

I think it needs to be said here that it is unlikely that a T2 on Metformin will hypo. If hypo's were a real danger to those of us T2's on either diet alone, or Metformin, then I am certain we would have been warned of the danger.

My opinion, read the posts above this one (ignoring my tangent on the sex of posters) as that is where the sense is being told. No offence to you at all mep73, but I know the posters above have many years of knowledge behind them, and only ever share information they know to be tried, tested and true!

 

[Grazer]

My endo gave me the above 5 advice long before I was placed on insulin, I've only been on insulin since 2010.

And what drugs WERE you on then, to have an endo. T2s on diet only don't have "endos" You obviously didn't go from diet only to insulin, so if you were on glic or some other insulin-stimulating drugs, then my earlier post regarding hypos still applies. As does xyzzy's, and as does Pneu's, an experienced type 1. As does every T2 on diet only/metformin on this forum who is joyous when they get a reading in the 4's. Do you think All the succesful T2s on here getting HbA1cs in the 5's, low 5's and even 4's do it by keeping their BGs above 5 at all times?