Going low

how do you deal with going low?

I am asking because when i go low i lose my self’, need cold air, and have to lay down

what is you’re experience with it?

Thanks

How low are we talking about?

60 and lower

When my Dexcom alerts me I’m below my 90 threshold, I deal with it by eating something with sugar. A regular coke works very well, or a balance bar, handful of Mike n Ike’s. I certainly don’t just lay down and not deal with it.

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If I’m under 60 then after treating (of course), I really do need to sit down and wait until I start to recover from the low. The fast rise I get from treating a severe low is almost as bad as the low itself and can be disorienting. If it is just a mild low I treat and go about my day.

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I’m sort of a mess under 65. But I usually am able to just sit it out until either OJ or ??? kick in. Luckily it doesn’t happen too often. I have my Dexcom alert set to 75 so it usually forestalls any really bad issues. If I remember correctly when I hit 58 when I was sick it made me feel really bad and I felt bad for the rest of the night.

I usually grab a Hammer Nutrition gel. Fast acting and takes up bg 75 pt for whole pack. I suspend basal for a bit and test every 15 min. If I am out and about I will sit down until my sugar starts to rise. My cgm hums at 100. That is a warning I usually eat something at 75 but I have missed it a few and it when down to 60ish. I note the time and if it happens again I lower the temp basal.
If I am exercising, I either stop and go home or take a gel depending on the bg.

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Usually, I have to get extremely low for any warning that I am low at all. Occasionally I will wake up in the night with a glucose level of 45 and have no problem taking care of myself. I assume that because I have been a type 1 for so long and don’t consider 70 low, my body has adjusted to lower glucose levels. It is one of the reasons why I never get behind the wheel without testing. If I am over 60 during the day, I just eat something and go about my day. I would have to be under 50 to notice much of anything most of the time. In 60 yrs I have only had a handful of times when I have actually needed help and have never had to go to the hospital. Just lucky I guess.

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I just take a few glucose tablets and move on. Most times I just keep doing whatever I was doing. Unless of course it is something dangerous like operating machinery, a car, climbing ladders. But I do keep working, I do keep cleaning, I do keep reading. I just keep going. It really has to been very low (40’s) and one that hangs around for a long time to drive me to sit or lay down. I don’t get headaches much but sometimes those post low headaches will drive me to nap. It is the only thing that helps low blood sugar headaches.
This is another one of those that is as varied as we are as people.

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Like Marilyn, a lifetime of T1D has left me completely hypo-unaware.
While I’m fine down to about 2.3-2.4 (41 mg/dl), when I drop much below 2 (36) I’m in danger of going into the twilight zone. :flushed: Hence I have CGM low alarms set at 3.1 and urgent low at 2.9 (around 50 mg/dl).

@typ1 What flavours of Hammer Gel do you prefer?

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I tend to over-correct :slight_smile: I’m know I’m “supposed to” only take 4 glucose tablets but when I’m crashing really hard and sweating at 2am, I invariably end up pounding double the amount of glucose… usually along with a protein bar and then spike up to 300…and …then…the… fun continues. I actually do best when I take 4 glucose tablets, try to sit calmly for 15 minutes, and then retest with a glucometer (my Dexcom seems to take a while longer to show the correct number). The glucose tabs + glass of milk seems to level me out nicely too. I once had a type 1 diabetes nurse at Kaiser who told me to take the 4 glucose tablets, plus a half cup of high fat vanilla ice cream - it worked beautifully to level me out (especially perfect for late night lows - it leveled me out without the high spikes afterwards)…but then my jeans didn’t fit after about a month of that : )

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I am like @Marilyn6 and @Jim_in_Calgary, although haven’t had diabetes as long as they have. Only coming up on 28 years, although I wonder if being diagnosed as a kid versus adult makes a difference here.

I treat lows with glucose tablets. I rarely have problems. The other night I woke up at 2.2 mmol/L and just treated, waited 15 minutes to re-test and make sure I’d come up, and went back to bed. Occasionally a low will cause annoying symptoms like my mouth going numb. And occasionally it will cause things like mental confusion or my vision to be compromised, but those more severe lows happen perhaps once a year. I haven’t actually passed out from a low since I was a kid and using much less precise insulin dosing than we have available today.

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@Jim,

I like the chocolate and apple cinnamon ones the best. The others are fine as well.

@ Jolene7
I know it is hard to wait. I just started doing so after realizing I was over correcting too many times.
I use peanut butter to back up the lows when they are severe.

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I am in the same boat, however, recently my endocrinologist reminded me the less lows we actually have, the better, and the cgm can be a great help in predicted lows and avoidances… have you considered raising your alarms to 4.4? Maybe setting predicted lows 1 hour ahead also? 2.4 just seems way too low to start treating…

Each time is different for me. If I have iob those are usually the worst. I tend to crash when I eat and there is no predicting it. I have to drink a little juice pre meal and shut basal off for a while. If I start crashing during the meal and catch it, I do the same. I frequently drop to 40’s or lower while sleeping and I don’t usually feel as bad because I have been sleeping, but the symptoms are still there.

So I shut off basal, treat and rest as long as needed. Sometimes if I am out shopping and it goes to 80, I suspend basal, smarties or juice and I can keep going but I have to keep treating and watching.

It tends to crash very badly in the early am if I eat so I don’t do anything in the morning now where I have to go out. Even at home I can be at 90, get up to go to the bathroom and it drops to 50. I basically do nothing after eating for 2 hrs or more. Rest is a must for a fast dropping bad low of a certain level or just below a certain level. They tend to sneak up on me.

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Roger - I didn’t mean to imply I wasn’t treating a low until 2.4. If I’m anywhere under 3.5 I ingest Dex4 Tabs. Last night I had 4 of them, initially starting when I hit 3.3 (60 mg/dl).

I am trying to stay well above 3.0 (56mg/dl), and for the most part doing a fair job. There’s always room for improvement :upside_down_face:

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I was lucky to be a trained Firefighter/First Responder . My son developed Rapid onset type 1 when he was about 13. The first time he had a low I knew the quickest method was plain table sugar under the tongue dissolved with a very small amount of water dripped from a straw. This is very important for everyone in your family and for all of his friends to know. This is especially important if the person is low to the point of being unresponsive. Please do not give liquids or solids to an unresponsive person. They will choke. The plain table sugar will dissolve very quickly and will be absorbed under the tongue faster that any other method. Have everyone carry sugar packets with them ,In their purse , car, pockets, how ever possible. It could very well take more than one packet. This method works quickly and can and has saved many lives.

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I’m similar to @Marilyn6 - although I’ve only been diabetic for 15 years. I’m pretty functional with lows, unless I’ve been low for an extended amount of time. That’s when my brain starts to get wonky. With my CGM I can luckily catch and stop most lows before I get any physical symptoms. My usual physical symptoms when it does get bad are shaky hands, extreme confusion, loss for words, numbness in my lips and face, and a cold sweat. I’ll usually want to lay down like you.

Like Marilyn, I don’t tend to notice lows unless I am at about 60 or under. I’ve had T1D for 37 years and have mostly been able to deal with lows on my own. A few times I needed assistance from my husband or a coworker, but I usually just have a snack and go about my life. I went on the keto diet (designed by a doctor with T1D for patients with T1D) about 19 months ago and rarely have problems with lows any longer. I think each person has to find what works for them!

Agree that amount of IOB makes a huge difference for us.
So when a low happens, I want to know what the IOB is, whether Basal-IQ kicked in and what the slope of the cgm graph is.

That determines how much carbs to treat with.

Over 65 with zero or minimal IOB and with Basal-IQ active then we probably would not bother to treat as the Basal-IQ usually takes care of it.

Under 65 or with non-trivial IOB or where Basal-IQ did not activate (maybe bad sensor or disconnected or whatever) than Juice is our usual go-to fast carb. And if the Basal-IQ had not kicked in (for whatever reason) then I would typically ALSO do a 30 minute zero temp basal.

For us, the low is generally self-recognized but none of the strong symptoms as many have mentioned above.

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