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[IP] Re: low BG (was ...re: Trina Andrews)

 "Kathy Bruckmeyer" <email @ redacted> said

>>Low blood sugars......I believe that over a period of time, we lose our ability to determine our lows but...
many years ago, my doctor from NY told me that it's not how low your b.g. is but how fast it drops that determines whether or not you can feel one coming

Well, part of that is correct...but we also know that when lows come on gradually, when you ae in a relaxed state, or sitting still, or using very little energy, those BGs can drift downward and you are not aware until you:
*need to react quickly
*need to move quickly
*need to wake up

With a sudden BG drop (example, 100 points within 15 to 30 minutes), the adrenalin and glucagon kick in making us aware of the low BG.

With long-standing diabetes, a history of frequent lows, or widely swinging BGs, you can lose the adrenalin and glucagon (counter-regulatory hormones)response, or the response may be blunted, from repeated chronic high BGs, severe low BG episode, medications, (other drugs), or alcoholic beverages.

>>I think with the pump, things rarely drop quickly and since we get the constant drip of the basal, it is a slower process than if we just shot a whole lot of insulin.<<

If in optimal pump control, this can be true, once basal and bolus is fine-tuned. YMMV

>>Of course, if we bolus improperly or don't eat everything we bolused for, the chance of lows is always there....<<

There's the beauty of rapid-acting insulin analogs. You can give part of a meal bolus after the food has been eaten. The chance of lows is also there is adjustments for physical activity are not accounted for. Again, YMMV

Info has been provided for the benefit of the IP list.

Look for an article about hypoglycemia unawareness in an upcoming issue of Diabetes interview.

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