I’ve stated this idea many times here; please forgive my repetition. The simple exercise of more closely watching my diabetes numbers, both fingerstick and continuous glucose monitor, tends to improve those numbers going forward. The numbers trend toward better even before I put in place any conscious tactics to affect that improvement.
My guess for the cause behind this effect is that my subconscious mind gets to work on the situation and influences my diet, exercise, and sleep choices – all important drivers of blood glucose levels.
The brain is the best management tool
My brain is my most potent resource when it comes to glucose management. I’m aware that consciously adopting specific BG thresholds when I commit to stopping everything and devoting at least a few moments to take stock of my glucose metabolism and then come to some decided action consistently helps me manage.
Now I realize that diabetes is a complex situation where adding insulin, exercise, or food can all exert an immediate effect, yet also trigger subsequent down-line effects that must be taken into account before taking the initial action.
For instance, if you add insulin to bring down a high BG, you may moderate or even cancel that action due to personal experience during this time of day when adding insulin led to a subsequent hypo. Diabetes, like chess, requires you to think more than one move ahead.
I maintain in my head certain glucose thresholds that I’ve committed to taking deliberate action, including taking no action. I actually keep a gradient of levels both on the low and high side in my mind with varying levels of action, but for the sake of this discussion I’ll just use what I consider the most important lower and upper trigger points.
My low and high thresholds
On the low side, I regard 65 mg/dL (3.6 mmol/L) as a significant glucose level that requires a deliberate decision. This is the level where my body start to produce counter-regulatory hormones. Adrenaline, for example, triggers my heart to beat faster.
At 65, I take a look at how much of my last meal/snack is still in play as carbs on board (COB). I also look at my insulin on board (IOB) to see how much downward “push” this hypo trend is under. I definitely put off any plans I may have had to exercise. In addition to adding a glucose tab, I also consider temporarily raising my BG target from 83 to 100 (4.6 to 5.6).
The higher threshold that causes a similar commitment to action or inaction for me is at 100 mg/dL. Choosing this relatively lower “high” level is my overall commitment to keep my glucose primarily between 65 and 100 (3.6 and 5.6). I do relax this threshold after eating to the 120 level (6.7) for a few hours.
In summary, 65 mg/dL (3.6) on the low end and 100 mg/dL (5.6) on the high end are significant BG landmarks that cause me to pause, observe, and deliberately decide my next move, if any.
What specific blood glucose levels cause you to reassess?
Now I know that some people consider this level of attention to metabolic detail as an unnecessary interruption to the real business of life. I’m interested in your perspective, too.