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Re: [IP] Re: A1C targets

My husband was never that aware of  his low blood sugar levels.  I was, but 
just before he went on the pump, I couldn't tell how very, very low he had 
gone either.  Bottoming out in spades!  Still, if you have to treat for low 
blood sugar at 4  (4)(18) or 72 in the American system, does anyone feel 
that bad?  I recall getting a number below that one night on my own arm:  I 
felt nothing.  I came home once from shopping and just for fun took my blood 
sugars--I hadn't eaten all day and I was shaking slightly and slightyly 
irascible and slightly befuddled--the bg was well above 4 and I felt fairly 
awful.  Low blood sugars don't necessarily make you feel really bad and 4 
definitely doesn't make me feel bad every  time.  As you say, if I have been 
running around a lot, a 4 might.

Also, if you go low, you send out hormones that will make you go high some 
hours later, right?

>From: email @ redacted
>Reply-To: email @ redacted
>To: email @ redacted
>Subject: Re: [IP] Re: A1C targets Date: Fri, 14 Nov 2003 11:02:08 EST
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>  From: "Dianna Inkster" <<A
>HREF="mailto:email @ redacted">email @ redacted</A>>
>Date: Fri, 14 Nov 2003 14:29:30 +0000
> >  Hypoglycemic unawareness is more common on the pump, is it not, just
>because the decline is so gradual.<
>Well, not necessarily!  Where did you get this statement?
>Hypoglycemia unawareness is an autonomic neuropathy where the
>  counter-regulatory response is blunted or no longer exists. Maintaining 
>goals at higher
>levels, (100 to 200 mg/dL) is often recommended as safe. Some pumpers have 
>return of recognition symptoms after several weeks to months of maintaining
>higher BG goals.
>Unawareness does not have to be common when using the pump.
>The BG decline can be gradual even if not on a pump. You just need the 
>set of circumstances:  - too much available insulin relative to the amount 
>available food (hypoglycemia), plus a relaxed state where there are no 
>demands (unaware of dropping BG), followed by an increased demand for
>  available glucose...ie, moving from a resting state to an active state. 
>would be
>other scenarios, but your glucagon and adrenalin need to be able to 
>If the hormone response is minimal or non-existant (common in many Type 
>then you can "bottom out."  Repeated low BG episodes lead to more low BG
>  episodes as counter-regulatory responses also need recovery time, even if 
>work well.
>Glycogen storage needs to be replaced. If the warehouse (the liver)  is
>continuously accessed, it is eventually empty.
>Stay safe with BG levels.
>Barbara B.
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