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Re: [IPk] Question on lowering BG's
1) It is not advisable to run bgs high enough all the time that a 5 always
feels like a hypo (i.e., if your bg has just plummeted from 10 to 5 within
20 minutes, I would expect a 5 to feel funny, but if it's 5 for 2 straight
hours and you're miserable the entire time, that is not so hot).
2) Treating a 5 as if it's a hypo in order to get your bg back up to 7 seems
to me sort of parallel to the phenomenon of feeding one's insulin.
3) To get used to 5-6 as 'nice' bgs will take discipline and sitting on your
hands (not going for the orange juice, etc.) when your bg has hit that
range; eventually, you're going to feel okay with those numbers. By all
means test every 20-30 minutes until you feel better in order to avoid an
unpleasant 2.5 or thereabouts (no one should feel good with a bg that
low--that's hypo unawareness). If your bg seems actually to be en route to
very low, try 10-15g carbs when you hit 4.
4) Bgs of 45 m/mmol should kill people, but at age 12 I was diagnosed at
that level. When my bg reached 10 in the hospital, I thought I was dying
because my hypo symptoms were so bad. Yet what a long-term disservice the
nurses would have done if they had encouraged me to aim for bgs in the range
of 15-20 in order to avoid that rough period of adjustment. The human body
can be very resilient and it's capable of a lot of adaptation.
5) If it is impossible for you to get used to lower bgs with your schedule +
kids, perhaps your doctor would support you in seeking DLA help for that
project? If your doctor and DSN are so keen, I should hope that your
explanation of the logistical difficulties would mean something.
6) Your dad and brother sound like 'normal' people with hypoglycemia to me.
Hypoglycemia can exist as a stand-alone metabolic problem. Though some have
suggested it might be a common 'pre-diabetic' state, as far as I know the
jury's still out on any definite link.
7) If your dad and brother's bgs have been 7, I would bet that those tests
were done shortly after they'd had hypos and treated them rather than 3.5
hours after a balanced meal, when I would expect them to be feeling all
right at 5. Remember that people who don't have diabetes get bgs of up to 10
or so immediately after high-carb meals, but because their own insulin does
its thing they're back to 5ish within an hour or so. If your dad and brother
see their bgs go down to 3.5 and eat a small snack and feel better quickly,
a bg of 7 within 25 minutes would not sound too strange to me. Of course,
getting one of them to wear a continuous glucose sensor for a few days would
explain what's happening!
IDDM 9+ years; MiniMed pumper 6+ years
Co-ordinator, Oxford University Student Union Diabetes Network
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