I don’t recommend anyone targets running below 50 (2.8). The CGM above represents the 2nd day of a 48hr intermittent fast. The red line is 70 (3.9).
Unfortunately there was a period during the night when the CGM indicated 40 (2.2). This was likely far closer to 55 (3.0) as the Dexcom becomes inaccurate at uber low numbers.
Also, being in Ketosis, I don’t suffer from the same level of cognitive impairment when my sugars fall below 50.
I don’t know if better cognitive performance necessarily follows from ketosis. During my first 28 years of regular and abundant hypoglycemia, including < 50 mg/dL (2.8) and without ketosis, I hold distinct memories of being very low and feeling cognitively nimble. I didn’t start using a low-carb high-fat way of eating until year 28. So, at least in me, ketosis was not the protective factor for clear thinking while low.
I’ve never read any insight as to why the very same low, clinically serious hypoglycemia levels, can sometimes have no effect on cognitive ability while the exact same glucose level can leave one unconscious and heading toward seizure. I have read reports that suggest the so-called “dead in bed” syndrome is likely caused by sustained multi-hour lows that create heart arrhythmias and can lead to death.
I wasn’t referring specifically to your numbers, only that there is a point where objective, physiological reality takes over. There has to be a point where every diabetic experiences hypoglycemia,even if the threshold number itself varies. That’s why it’s tricky to fall back on the notion that “everyone is different”. Everyone is different, but at some point we’re also all the same.
I’ve suffered from hypoglycemia unawareness for more than 20 years, but like you until recently was aware of cognitive slowdowns once my numbers fell below 3.5.
At numbers below 3, until recently, I’d need help.
My sugar went low (low alert) and I was so sure it would rise later. Later I got out of bed and fell and passed out and broke my wrist. I now keep the cgm alarm at attentive… It is annoying when it bounces from 179 to 180(high alert) and then 180 then 181. I use to have it set at 300 so I would not hear it. I think for me I need to be annoyed with the alarms,
