How low can you comfortably go?

I am doing a trial run with a CGM, and although the thing is a pain in the butt it has really helped me figure out my basal rates.

My numbers have been really good lately, and they stay steady in a range of about 70-80. I am not used to this (I’m usually around 100-120), and I am wondering if perhaps I am being too aggressive in my treatment. I am also testing more than I used to to make sure that I don’t slip into a low, even though I don’t suffer from hypo unawareness.

What fasting numbers do the rest of you shoot for? For the fellow pumpers, what do you aim for when setting your basal rates? Is hovering around 80 dangerous?

I do shots but I have noticed recently that my fasting levels are down in the mid 70s to mid 80s. This is in the morning and also between meals. There is a bit of a risk of going low but I also test frequently and actually feel really good at these numbers. If you are aiming for normal BG those numbers are really normal. I am not doing anything differently, I just think my pancreas is in a good phase right now. I am early LADA and still have some C-Peptide and insulin production.

If I am in the 70-80 range, I cannot move or I will go low.

I am new to the CGM but the other day I was below 100 most of the day and I have found if am below 100 and no bolus floating around I can stay steady and if I am just sitting at my desk, I am okay with this, but if I do any movement at all I like to be above 130, but I won’t stay there if I do much movement or if a bolus is active.

Hope I am making sense.

When you are in a fasting range of 70-80, at what point do you treat for a “low”? I used to treat for a low at around low 70s, but after reading more about non-D BG numbers, I think that low 70s isn’t necessarily a “low” number.

A recent diabetic study was halted because a disproportionate number of test subjects died, leading researchers to believe that “non-diabetic” numbers in diabetic patients may actually be dangerous. Here is the link to the NY Times article.

Just another frustrating development in the treatment of an already frustrating disease…

The reason the people died is not because they had non-diabetic numbers but because the way they tried to achieve those numbers was through large amounts of drugs and a high carbohydrate diet. Jenny has written an interesting analysis about this study on her blog.

I treat when I am under 70.

Libby has it right!

For perspective, the people in the ACCORD study where there was a SMALL number more deaths than the control were middle aged overweight Type 2s who were diagnosed with heart disease before the study started.

They were given some mixture of sulf drugs, Avandia, and Actos, all known to worsen heart disease, along with metformin, Byetta (so new its effects are unknown), and huge doses of basal insulin. Told to eat a VERY high carb diet and nagged on a schedule by registered dietitians to be sure they were getting their 300 grams of carb a day.

Since a bigger, longer study ADVANCE found no excess deaths when they lowered BG using only ONE drug, it’s pretty clear that the problem was some interaction of the multi-drug regimens. They say it can’t be blamed on any one drug, but the design of the study makes it statistically unlikely they can ever pin it to a combination of drugs, because there were too many different combinations and dosages being used.

Pregnant ladies with GD are told to shoot for a fasting near 70 mg/dl. It can’t be that dangerous. Most children are at that level.

My guess is that if you can stick with it you’ll end up with superb health. I would give a lot to be able to get my blood sugar down to that level, but one bizarre feature of my Type Weird diabetes is a ferocious counter-regulatory response that kicks in any time my blood sugars drops below the 90s. At one point I inched it down to the 80s, but now I’m getting jolted out of sleep again when I have as much as .5 a unit too much Lantus and if I can get a fasting bg under 95 I’m thrilled.

Though it is starting to look like I don’t have to worry about hypos. A heart attack from all that epinephrine, perhaps, but not hypos.

I completely agree that HOW you get your levels down has a lot to do with the “danger” of “normal” blood sugar levels. I guess it depends on how you define “aggressively treating” – if this means extremely low carb intake (I keep mine less than 120g / day) you’re probably on the right track. On the other hand, eating “normally” and taking lots of medicines should be viewed with suspicion.

I’ve realized recently that it’s easier for me to control the crazy ups and downs by dropping the Amaryl from my regimen and relying on Metformin and low carb (I’m type 2, 10 years). The Amaryl was giving me lows before lunch, forcing me to eat more carbs that I would have otherwise – ending up with later highs (as well as weight gain).

When I was pregnant I was told around 70 fasting and 120 post-meal – with insulin and low carb levels (but higher than now, since I was supposed to gain weight!). While I’d love to be at that level again, getting there with a drug cocktail likely isn’t the best way to do it. More drugs are never better – but we live in a society where throwing a pill at your symptoms is easier than addressing the underlying issues.

By the way, I only do about 4-5g carbs to bring me up and then test again. I am happy if I am then between 75-90. I believe in “the law of small numbers” which is why I do very low carb and low insulin doses. I am unusual in that I have autoimmune diabetes but am not yet insulin dependent. I can manage with low carb and exercise only and have an A1C in the 5% range but with a small amount of insulin I can add some dairy and fruit to my diet which I prefer to the higher protein and/or fat diet.

“Type Weird”… lol

That should be the new official name for anything that doesn’t fit in to the strict type1/type2 distinction.

Thanks for the tip. I think working on not over-correcting a low is the next step on my list. One thing at a time…

120 post-meal… Wow! I am working at getting below 140.

As a type 1, being “aggressive” does mean more drug intake, but of only one drug: insulin. I have definitely upped my insulin over the course of the last week, which is why I have been hyper-vigilant with testing.

I aim to keep my numbers between 70 and 160. My aim for my fasting numbers to be between 90 and 120 during the day. I aim for closer to 110 or 120 when I go to sleep.

Hi Sara,
I don’t think there is exactly a set number that we have to treat. I think it really has to do with the individual and what is going on at a specific time. I try to keep my numbers around 100 and lower all the time. I don’t always manage, but work hard to do it. I can be very comfortable at 70. But there have been a couple of times when i had a reaction at 86 or 87. When you feel like you have to treat, I don’t think the number should be the deciding factor. I think the way you feel should be what you base your decision on. Each if us is so different and whatever load of hormones we are carrying at a specific time affects how we react to things. I just think the best bet is to go with how you are feeling.

100 is the target.

If its lower fine won’t actively prevent it… higher fine too, just keep targeting on 100.

70-80 is technically not “low” (low is 60 or lower) but unless it happened magically not sure I’d feel safe with no “wiggle room”


I can often feel low if I’m around 80. I think that’s good considering I’ve been diabetic for so long. I don’t want to develop hypo-unawareness, and letting your BG’s hover too low will lead to that. I prefer 90-110 BG’s. I don’t like when my BG gets into the 50’s or 60’s before I feel my low. That’s just looking for trouble, and if you decide to be OK with a 70 or 80, that’s bound to happen. So it’s not being at 70 that’s dangerous, it’s what it does to your own hypo-awareness and since your body can’t self-regulate, it may not take much for that 70 to become 40 or 50 or lower before you have a chance to even realize it.

But some people are hypo-unaware, and can develop hypo-unawareness if they let their BG’s hover too low on a regular basis. I’ve also had plenty of times when I feel low with a mid-80’s reading, but I chalk that up to meter error since meters aren’t perfect. There are plenty of folks who could get themselves into trouble if they just decided to treat when they feel low.

I don’t treat unless I’m below 70. I feel best at 80-90 fasting, but I think I was hypoglycemic for years without knowing it & my body must have gotten used to lows. In those days, I’d get ravenously hungry & eat three candy bars to feel normal again.

If below 60, I get foggy & my hands shake. I worry about hypo unawareness because of years of probably being hypo, so test a lot.

I try to be around 100-110 before going to bed.