I was out with a friend tonight and we got into a conversation about what we consider a high blood sugar and what we consider a low blood sugar…
She thought my parameters were too loose, but I think hers are too tight…
I won’t correct anything under 210 without eating, but will correct a BG of 75… Hers were 135 and 60.
My a1cs have always been in the 7’s to 6’s, but I’m wondering if I need to tighten mine.
What do you guys consider high/low?
i will correct postprandial highs >150 (unless i have significant bolus insulin on board) and “random” highs around 130, give or take (these are pretty rare). i correct lows <60 no matter what and lows <70 if I’m symptomatic, driving, or not planning to eat soon (although if it’s 65 and i’m feeling fine i’ll usually just have an apple or a peach or something w/o a bolus rather than eat glucose tabs or candy). i also prefer to be above 100 if i’m going to the gym or going to bed, but that’s a separate issue.
I correct for anything over 110, and anything under 70. If I’m driving I need to be at least 80-85.
I think that’s an individual decision, based on your own life-style preferences, but I take seriously the AACE (American Association of Clinical Endocrinologists) recommendation of no higher than 140 1 hour after meals, and back down below 120 2 hours after meals. That doesn’t mean I achieve it all the time, but it’s a goal. No one knows how long they will live, but I don’t want to get complications in case I live a long time!
As far as lows, I always feel them in the 50’s and 60’s and always correct if I’m feeling low. So I’m not really concerned about meter readings for lows. People with hypoglycemia unawareness have a different issue.
As far as A1c, they recommend below 7%. But I’m a low glycator – my A1c’s always run lower than my average BGs. So my personal goal is to get into the 5’s, and I JUST missed it at 6.0% on my last test. When I had a coma last year and almost died, my A1c was 10.7. I know lots of people are walking and talking with A1c’s a lot higher than that, but I know myself, and so even though the CDE thought 6.0 was fantastic, I know it’s not good enough for me!
I correct highs at about 150 (depending on the time of day and how recently I have eaten–if I’m holding steady high, I might correct at 135ish). I treat lows under 60 (if I know I have insulin on board and should be higher, I’ll treat under 70). It really depends on the exact situation.
I’ve set my meter to 70-160 (though it won’t display numbers in red until 200).
I’d like to set it lower bu I can’t correct anything below 130 without extra eating since even 0.5U will let my g drop too low… depending on what I’m planning to do and the rest of the circumstances, I sometimes do something at a 125 but that’s rare.
Only thing I can do is consider calculating it in before lunch.
Correcting a 75 is a bit… shocking to hear since this is a perfect number and 60 IS too low, even for a healthy person!
I eat at anything <70 but since I’m usually not steady in the 70s, I’d eat, like, 3g <80.
There are cases I might decide differently but that’s individual situations. I think most of us do that.
E.g. I have to be at no lower than 125 at bedtime since I KNOW it’ll drop over night.
I’m starting to take the 70-140 range seriously, though. Maybe I’ll be able to hold my bg there for most of the time eventually.
A lot of my corrections depend on what the CGM suggests is going on. If it’s like 109-121–??, I’ll hit it w/ a whiff of correction but if its 119-121-122 I’ll check IOB and chill about it?
I correct above 140 at one hour postprandial and 69 on the low side (with 6 g glucose tabs). I don’t like any swings at all. My A1c is in the high 5s.
Wow! Really big range! I’m more like your friend. I target under 140 at 2 hours and I only treat lows below 60. I will usually correct over 150. At bedtime I will treat with two glucose tabs if I’m 70 or below.
I think it makes a difference too if you’re on the pump or shots. My ISF is 45 so on shots I didn’t usually correct till more like 165. On the pump it is easy just to hit a few buttons and take a small amount of insulin.
I think correcting at 75 mg/dl is recommendable if you are having tight control. In general there is no exact threshold for corrections. Test stripes are only +/-15% correct (at best). But most importantly the blood glucose has a very dynamic progression. What we are measuring in our finger can be 5min behind what is going on in our blood stream. With 75 we might already be lower - we also might be higher.
What really determines the correction is my expectation of how my BG will progress:
Scenario 1) I have 80 mg/dl and no insulin on board and I am about to make a ride with my bike (15min into the city). Then I will correct with one glucose tab because otherwise the additional physical activity will lead to a low.
Scenario 1) I have 80 mg/dl and this time insulin is on board and I am about to make the same ride. Then I will likely correct with two glucose tab (one before the ride and one after).
Scenario 2) I have a BG of 250 mg/dl 1 hour after the meal. This is because I have misjudged the meal - it was absorbed faster than expected. I still have 5 units of insulin of board. As a first reaction I will increase the drinking of water to decrease the BG and help my kidneys to get rid of the glucose (this really works!). As a second reaction I will add physical activity if possible. Activity in combination with the insulin on board will reduce the spike to something like 165 (the highest spike I will accept at the 1 hour mark). Without the physical activity I will correct with two units (experience makes me cautious of insulin stacking).
Scenario 3) I have a BG of 150 mg/dl and no insulin on board. In other words the meal had slightly more carbs than I have expected. This will be corrected with one unit that will bring me down 30 mg/dl. Over the day I am correcting to 110 and I would like to see me around 90-120 mg/dl. At night I am more sensitive to insulin thus I am correcting to 120. Before I am going to sleep I will make sure that my BG is higher than 100 (with additional carbs if necessary). If my BG is around 75 mg/dl before sleep I will eat one glucose tab.
As you might expect your rule ‘I won’t correct anything under 210 without eating’ sounds very odd to me.
I will correct anything over 120 or under 70.
Last A1c was 5.6%
Mine is very tight my pump is set to 80-130 I correct everything below 85 or over 130, but I have very good control over my blood sugar. I used to think the 250 was okay when I gave shots but now that I have better control with the pump I correct at 140. It was amazing the instant change I went through when I went on the pump. I went from not caring if my bs was over 200 to immediately correcting if its over 140. But its all about the person, everyones body is different when it comes to diabetes.
Without a CGM, it is harder to know where that 75, and the 210 are heading. I wouldn’t correct a 75 most of the time, unless there is an indication that it will go lower or there is active insulin or activity. I must say that I don’t understand why you don’t correct a number over 200 without eating? If you correct that number and eat right away, you will only go higher before you start to come back down. It is a really good idea to try not to eat with an elevated number if at all possible. This means giving the insulin ahead of time in order to let it start to work on that high number before you add more carbs. My daughter’s CGM is set for 60 and 160. I would have that 160 set lower but since she is intellectually challenged, it could present a problem because she would want to correct a 140 at one hour, and that may not be a good idea depending on the circumstances.
Over the years, reading about people that keep themselves in a very tight range has made me think differently. At first I thought that they were a bit over the top, but especially now with the use of a CGM, I think that we can easily strive for less volatility safely.
To correct for lows, it usually depends on how I feel. I could be 70 and feel fine one time and feel shaky at another time. I chalk that up to meter reading inaccuracies.
For highs, I really have to be careful. Sometimes 1 unit will drop me 100 points, sometimes only 30ish. I couldn’t imagine taking a unit to correct if I was at 140. Even though it may drop me to 110, it may also drop me to 40 and I tired of dealing with that.
This also all depends on what I have eaten, how long ago, and if insulin is still at work? (I don’t have a pump.) Also am I going to be active or sleeping? So many variables to take into account. I think we are all different and have to tweak things from trial and error and just do the best we can. It’s not easy being an external pancreas. ; )
Hi Rae. You might consider getting 1/2 unit marking syringes, which can be used with a vial or even a pen. If you use a syringe on a pen, you just have to be careful to prime well the next time you use it. BD makes 1/2 unit marking syringes and I’ve been told that Walmart and some other brands have them also. At any rate, you can be quite accurate with them.
Two cents worth from another Elizabeth. I correct anything over 120 and below 80. I should say I let pump make correction for any numbers over 120. My a1cs have been at 6% for years and sometimes they slip into the 5%.
The parameters allowed by the functioning pancreas are generally 70-150 = a1c of ~6.0. My son’s endocrinologist started him in a range of 100-200 when he was 18 months old, explaining that the reason it was higher than the physiologic levels is that lows can be much more harmful to the developing brain than highs. The range is a little higher at night because of the concern about overnight lows. They lowered his range to 80-180 last winter, and I’m told that when he’s a teen, it will go down to 70-150. Right now, his a1c is 7.4 and we’re looking to bring it down to just under 7.0 if possible. So my take, based on that, is your lower range is only slightly higher than it should be, but your upper is way too high. Your friend’s, in my opinion, are maybe a little too tight—keeping BG too low may not be as damaging long term as keeping it too high, but make no mistake, it IS damaging.
That’s the one advantage of a pump: very small doses.
I can’t inject less than 0.5 units. But I guess it’s a good thing I don’t have a pump because I think I’d correct, like, everything. I wouldn’t have a life that way.
I have been known to take .05 unit “correction” at 100 and will certainly correct 4 hours post at 110. I usually take a single glucose tab in the 60s although if I think I’m moving up and don’t feel uncomfortable I’ll just sit with it. With meals I always correct/back correct to 95.
But that’s just the thing. With a pump and a CGM, it’s easy to correct, so you CAN correct nearly everything. But when you get your basals correct, which is easy to see, because the CGM is flatlining, and your insulin:carb ratios correct, which is easy to see because you can easily tell how much you rise after a measured amount of carbs, and find out exactly how you react to exercise, you can adjust accordingly, and you don’t have to correct THAT often.
I have my lines set at 70 - 140, and I don’t correct at 150, but I correct at anything above that. If I really had my act together, I’d put the top line at 120, but at the moment, I don’t have my act together THAT much. LOL!!