Average lows per week?


(Coolwater) #1

Hey guys. I'm just a tiny bit concerned about something. I read somewhere on the internet that diabetics should have an average of 2 lows per week. I have an average of 2 lows per DAY and am worried that I won't notice if I go low anymore! :

Just wondering what you guys average per week with lows?

 

 


(A-D) #2

Riaan,

That is a great question!  I know I go low at least a couple of times per day but they are incidents I can manage on my own without assistance or intervention.  I always pictured that guideline as applying to younger D's but... Maybe one of our medical or near medical members can shed some more light on it!

Cheers!

A-D

 


(Christylwf) #3

I was in the hospital having my baby a year ago and was told I had "horrible control" of my diabetes b/c I had more than 2 lows per week.  I have NEVER had 2 lows per week, it is ALWAYS more.  I have been diabetic for 31 years, type 1.  Got it when I was 3.  I have no diabetic complications and my A1C averages 5.5.  I probably have at least 4 lows or more a week.  Don't worry about what the DR's say, alot of times they are reciting what they read somewhere.


(Coolwater) #4

Thanks for the replies guys, glad I'm not the only one doing more than 2 lows a week :)


(misstifyde) #5

Man, I wish we could even discuss lows.. J's not had any lows since the hospital almost killed him in Oct.

 

I'm fighting the highs right now... :(


(Coolwater) #6

=[ Omg that's so not cool!

What happened?


(misstifyde) #7

Yeah not cool at all.. My son was preadmitted to the hospital for a lymph node biopsy and to make a long story short the nurse used an insulin protocol intended for adults and OD'd him twice on the insulin drip and he needed an emergent IV push of D50.

Let's put it this way, those are the kinda lows none of us ever want!


(Coolwater) #8

OMG I'm so sorry to hear that, how did that even possibly happen! Things like that should never happen, no excuses. Was that nurse even slightly qualified in anything...


(misstifyde) #9

It's a bit of a long story. Unfortunately I live in a relatively small town. We don't have the most cutting edge medical specialists. We don't even have an Endo in the whole county!

In any event, it was a case of not listening to the parent. I repeatedly told her she was giving him too much insulin and he crashed twice before she got a clue.

In retrospect I should have screamed to the stars. I did go to the hospital administration after discharge and amazingly enough they have a new protocol for children, they revamped the adult one (which was wrong even for adults). I did a speaking engagement in front of the entire hospital management regarding the alarming numbers of patient deaths due to medical errors and told my son's story. From that they are implementing a program called "Condition H", which is a wonderful fail-safe for patients, parents, family to use if they feel the patient is in jeopardy.


(Coolwater) #10

Well it's really good you did all that, now it seems there won't be any repeats of what happened to your son.  I also live in a small place, Botswana, Africa actually and the medical here is just as bad, the knowledge of diabetes here is very weak so it's always a hassle of explaining to the doctors/nurses here about type 1 diabetes. (they think only type 2 exists)

The "Condition H" sounds like a really good idea, congrats on getting them to straighten up over there, you might have prevented a lot of bad cases to follow.


(Julia1982) #11

Riaan  I go low all the time at least twice daily and probably 3 nights a week I wake up with sugars in the 40's.

Out of curiosity what do your  A1c's run? mine are always in the low 6's and I used to think that was great but at my last dr visit my doc told me that it was reading that way only because of my frequent lows and not necessarily from great control. that really bummed me out because all this time I thought I had great control and now i'm told that the A1c # might be off.  A real bummer.


(Coolwater) #12

Twice daily and 3 nights a week is exactly how mine runs to be honest. And my A1c was 5.2 last time, and my Doc said the same thing after looking at my readings, it was only this good because I was running low a lot of time which was a real bummer as you say! :)

Are you on a pump or shots? Because I'm on shots and really want to get on a pump with CGM because these days I find it hard to notice when I'm low, and it would be nice to see readings every 5 minutes, so that I can hopefully prevent all those lows!


(JamesChambers) #13

Julia/Riaan,

I'm not sure what to think on that whole 'your A1C is only good because of your lows' thing from your docs. 

When we go to clinic our endo and dietician tell us to live by the A1C and live through the highs and lows.  We were explained that the A1C is the crystalization of sugar in your blood whereas your meter's just giving a snap shot.  It's the long term view (the A1C) that causes the damage if it's too high.  Keep it down, keep it down...

Beemer (our kid) does usually 6.9-7.1 on his A1C - which is good, we're told, for his age - and we deal with 2's (or, 40's I guess) several times a week. 


(Coolwater) #14

Hi there

What we mean with the A1C is that it gives you an average of what your blood sugar has run for the past 4 weeks up to 3 months. It is explained quite well here http://en.wikipedia.org/wiki/HbA1c

What we mean is that your blood sugar can run at 10.2 mmol/L (183.6 mg/L) half of the time, and the other half of the time it can run at 2.2 mmol/L (39.6 mg/L) and you will get an A1C of 6.2 which would be great, but if you look at the bigger picture you run high and low most of the time which doesn't help you at all. This is where the A1C test can be very innacurate and give false interpretations of how your bs is running.

Hope that explains our opinions :)


(Julia1982) #15

Riann, Are you sure you are only 16?  You talk like you are way older. lol


(Julia1982) #16

Oh and I am on shots. I take lantus in the mornings and have been doing that for I think about 8 years. my endo told me to start taking it at night and see if that stops the overnight lows. but old habits are so hard to break I felt like I was trying to learn how to breath or walk or something. you know what I mean.  taking my shot every morning for 8 years I just could not remember to take it at night. so some of this may be my own fault. That is also what scares me about trying the pump. I don't deal well with change.


(joe) #17

Hey Riaan (this is loooong)

 

A-D hit it right on the head, how low is low?  If you feel low and test at 50 and eat a glucose tab or 2 on your own, test in 30 mins and you’re 100 it’s not exactly a dangerous low.  If you are found by your parents, incoherent and unable to stand… it’s a low.

 

Under 2 hypos per week might very well have been a gauge for Type 2 diabetics, as they make up over 85% of the people who have diabetes.  I only believe 5% of what I read on the internet and only half of what I see in real life. =)

 

I wanted to add something I think is important here too and in light of the “what’s a good a1c” question

 

 “under 6%” is only really good (and I use good only as a description of non-diabetic blood sugars) if you are not having hypos.  The way you can gauge your control is by A1c and the standard deviation of your home bs meter readings.  A nice small standard deviation means you aren’t swinging wildly and just have a good “average”.  (nice, small means a STD of under 20 mg/dl daily)

 

There seems to be a lot of folks who loose their ability to sense a low and end up in a severe hypo.  My old CDE was certain it’s because of repeated, mild lows.  I don’t know.  I have had diabetes 31 years and I don’t have a guess for this either.  The first decade or so of this disease I took NPH and felt low before every single meal.  Now I feel low maybe 8-10 times a week.  In 31 years I never had a low where I couldn’t go help myself.

 

The medical community would like us to achieve normal blood sugars, a1c below 6 and STD below 20.  In light of the fact that our medicine, and our testing tools makes this almost impossible, the next conservative thing would be “under 6 and no lows” which is statistically impossible so the next step is under 6.5 and no lows.  If unachievable, under 7 and no lows.  It’s conservative, and it’ll keep a person from saying YOU TOLD ME UNDER SIX and I had to go to the HOSPITAL from an overnight low… you get the idea

cheers


(Coolwater) #18

Julia

Firstly, yes I am 16 years old haha :D And I understand what you mean. After 8 years of one constant routine it must be extremely hard to change that routine since it's pretty much second nature already. Good luck with any changes though, I'm sure after a while they will also become second nature.

Joe

Wow, thanks so much for the reply, really nice and detailed and understandable thank you. And yes, I have now officially become hypoglycemic unaware and am certain it has been caused by my very frequent mild lows (as you said). So I'm just going to follow A-D's advice and run it higher for 2 weeks and hope that all will be back as it was. :)


(JamesChambers) #19

Thanks Riaan,

I understand what you're saying, but I would suggest that there needn't be concern over any single BG test.

Your A1C will give a much better picture of the 'crystalized content' of your blood, i.e., the stuff that will hurt your organs.  From a long-term health perspective any single high or low will not affect your heart, eyes, other organs, etc., but multiple high A1Cs over an extended period of time would indicate that damage may be occuring.

I think we're saying the same thing here, but what is important to know is that the outcome of your BG tests don't have a direct correlation to your A1C.  For example, if you're testing 30 mins after you eat and always getting high results, you may still end up with a low A1C.  Likewise, you might be testing before you eat and seeing lots of lows, then over-carbing and getting higher A1Cs.

It's all a balance, which you seem to be well aware of!

Highs and lows are important, but for a different reason: it's how you feel.  You don't want to be passing out or feeling sluggish or irritable, you want to be a productive happy individual with lots of energy.  That's what the BG tests are good for, and your endo should know the difference.

Because a T1s body doesn't produce insulin, you're going to spike.  Your doctor shouldn't be criticizing you simply because of the timing of your tests.  If you learn your body well enough and time it right you could get perfect BG scores for three months straight and still end up with an A1C of 10.

Again, I think we're saying the same thing, but just in a different way.  As long as you feel good and you can manage the highs and lows, it doesn't really matter how you end up with a good A1C, just as long as you get there.

Thanks again for coming back to explain your side...I completely understand your concerns, I was actually meaning more that I didn't get why the endo was criticizing a good A1C!


(Keely) #20

So, if I have an A1c of 6.4, and when I test before lunch my BS is, say 77, and then I test 2 hours after and it's 140, that's not good?