At what point do you treat a low or a high BG? And what is your target range?

Type 1 and LADA
#1

i have my Dexcom CGM high and low alarms set between 80 and 180. my target range is 125. i use a Medtronic pump. if my sugars are trending down (even with a straight cgm direction arrow), i like to cut a low off before hand, and pop a glucose tablet. this can happen when my BG is around 100 after coming down from 144 (post meal) very quickly. but, if my sugars are dropping down below 80 and above 60, i take 2 glucose tabs. if my BGs continue to drop, i treat this with a glass of OJ. i try to be patient and wait about 15 minutes to 1/2 hour for my BGs to come back into a safe range.

what is your ā€œsafeā€ range? how do you treat your highs and your lows? what are your highs and your lows? do you feel your highs and your lows coming on, or have you become insensitive to the symptoms and rely (as i do) on your cgm to let you know where youā€™re at?

#2

As discussed in another thread, it ALL depends on what is going on, and what is going to be going on. I like to micro manage and have little tiny snacks. Ghirardelli square peppermint bark candies are 7 carbs of pure joy.

I find it odd that you have one set target number. My entire range is 70 - 130. Different times of the day, different activities, need different numbers (for me) I donā€™t want to be the same number before I eat as before I go on a long drive (for example). I have different goals for different things.

#3

Dexcom low alarm set at 70. High alarm set at 170 during the day, 180 overnight. Target is 100. (I still donā€™t understand the reasoning behind setting a target BG that is higher than what is considered ā€œnormalā€, i.e. 100. Why ā€œshootā€ [pun intended] for a high BG?)

Lows are treated with Glucolift tabs (raspberry is yummy); the number of tabs depends on how low the low is and the directional arrow. Overnight lows are treated with apple juice.

Highs are treated with (wait for it) insulin, often times along with an increased temp basal. And water. And exercise.

My daughter, thank G_d, is hypo-aware. So is one of our cats (hypo-aware of my daughterā€™s lows, that is) about 30% of the time, and the puppy (even though I canā€™t train her to stop pooping on the carpeting) alerts us about 40% of the time. [Or maybe they just coincidentally need to go outside to peeā€¦] But we depend on my daughterā€™s scary-accurate Dexcom the most.

#4

i am a frequent flyer of the temp bolus feature on my pump. i use it for different activities and different situations. i love this feature. but i think that you misunderstood me when i said that my target range is 125. i like to shoot for 125, that doesnā€™t always end up happening. its just a number; a goal for myself. my range is anywhere between 100 to 140. thereā€™s never been a flat line and i doubt that there ever will. (although as i write this, i realize that often my cgm shows a flatline, but when i look backwards at the BGs for the entire day, there is a swing from here to there of ups and downs)

#5

RE my target of 100 for my daughter, I should clarify: 100 just feels right to me as an overall goal. Believe me, Iā€™d be jumping for joy if my daughter consistently remained between 70 and 140 the majority of the time. Flat lines are few and far between these days while my daughter is actively pubertizing. Before marching band/color guard practices and events, Iā€™m a little more comfortable having her at about 150-ish.

#6

I will often correct below 70 or above110, and always below 60 or above 120. My target is 80 to 85. Empirically, fasting blood sugars for non-diabetic individuals typically fall between about 75 and 90, so thatā€™s what I aim for. All of that makes for many small corrections as opposed to a few big ones, which is not only safer but easier to gauge. (The Laws of Small Numbers)

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#7

For all correction boluses, I target 83. My target range where I want to spend at least 80% of my time is 65-140. I will not carb nudge until I start to drop below 65 unless Iā€™m carrying significant IOB or expect to exercise. I will vigorously defend 140 and uptrending with walking, Afrezza, or an IM injection.

My Dex low warning is set to 70 and the high to 120. My dog alerts to anything under 100.

When I wake up in the morning I correct anything over 95. My micro carb corrections are 2 grams, lately 3 Tic-tacs. My IM corrections are often 1 unit or less.

My favorite correction for after meal highs is 20 minutes or more of brisk walking.

#8

My target range is 4.0 - 8.0 and my target on my pump is 5.5 mmol/L. Lately my blood sugars have been crazy and Iā€™ve gotten completely sick of the alarm going off constantly, so I turned off my low alert (thereā€™s a built-in low alert at 3.1 mmol/L that canā€™t be turned off) and set the high alert to 11.0 mmol/L. I still check my Dexcom all the time, but am not bothered by alerts that I know will happen (usually) before they happen, or that keep going off every five minutes while Iā€™m waiting for a situation to resolve.

My corrections depend entirely on my CGM direction. If Iā€™m sitting perfectly flat at 4.0 mmol/L, and am not sleeping and not doing any type of activity that might lower it, I may let it sit there for hours. But if Iā€™m at 6.0 with insulin on baord and an arrow straight down, I may eat 20 grams of carbohdyrates to (hopefully) prevent a low. For lows during the day I use giant Rockets (Smarties in the U.S.), and for lows overnight I use glucose gel.

Highs are actually most difficult for me in terms of corrections. Iā€™ve tried temporary basal rates, doubling my correction bolus, and using extended boluses. No matter what I do, it seems like there are times when the insulin takes hours to begin working, btu once it begins working it lowers me to exactly where I should be. Doing temporary basals or correcting with insulin results in me going low once the insulin finally kicks in and starts working. Iā€™ve found what works best for me is to test every half hour or so and give corrections based on my blood sugar, and give 0.5 or 1.0 units extra if I seem to be heading upward, but no extra insulin if Iā€™m flat or heading down.

Iā€™m hoping that eventually Iā€™ll be able to move my high alert back to 8.0 and have a reasonable chance of not setting it off constantly. Today, for the first time in a long, long, looooong time, I havenā€™t been above my 11.0 high alert, which is progress!

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#9

My Dex alerts are set to 70 and 140 during day, 70 and 120 during night. My pump target is set to 80. My goals are to never trigger the Dex alarms but instead try to treat anticipated lows and anticipated highs before they actually happen. I am fairly disciplined about not over-treating lows, which I feel helps me a lot. Of course, I do not always succeed, but after about a year of practicing tighter control using Dexcom I am staying between 70 and 140 close to 90% of time.

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#10

i had a major panic attack watching my BGs drop after breakfast this morning. i didnā€™t do anything different than i usually do for breakfast; i had the same breakfast, same time and place, etc. but for whatever reason, i watched as my dexcom #s started plummeting w/ the direction arrow straight down at 119. i freaked out and did a finger stick. same BG # for the most part. so to prevent a serious low from happening, i had a few sips of apple juice. big mistake BGs went up to what i thought was a healthy range (140 ) stayed there for over a 1/2 hour, but then soared up to 200. OMG.
i did a correction bolus and hour before lunch, but have been chasing my tail all day long. last BG test was at 169. all from a few sips of apple juice. :anguished:

#11

The definition of ā€˜Insanityā€™ is doing the same thing repeatedly and expecting different results. Funny, that IS diabetes! Does this mean that diabetes is a form of insanity? :anguished:

#12

Sounds like one of those unpredictable situations - probably familiar to everyone on the forum - thatā€™s the nature of the D beast. Iā€™d say just correct, correctā€¦ the best you can, and move on.

#13

thatā€™s exactly what i did. i had to correct a few times, but by bedtime i was back in range. (well, a little on the high side, but nothing to worry about.)