How many lows?

I have been thinking that I go low A LOT more than other people with type 1 / type 1.5. I wanted to check though! How often do you have low blood sugar/hypoglycemia?

Recently I go low once often twice a DAY. I know this is a sign of not good control (even if the A1c is ok) and that I need to improve. Part of the problem is that I wake up low often (what I call my “reverse dawn phenomenon”).

I was just curious how many times you go low… to know what I should expect!

I’m not totally insulin dependant yet, but on bad days I go low sometimes twice. Commonly- it’s in the 70s (when I start feeling like crap and get a bit out of it and irritable) at least 3-4 times a week.

I have only rarely been in the low 60s- which is good because I was totally useless then and as belligerant as you could possibly be. It was because of these, and the common lows that I finally instituted two policies- 1. I never leave work and drive without testing myself first. 2. I got a medic alert bracelet, even thought I am not on that much insulin. I finally realized that if I can get lows now, and as often as I do, then I should be prepared.

How functional are you when you are low?

Monday it was 3 times. Tuesday none. Wednesday one. Today nothing below the 60’s. I probably average 3 times a week. Sometimes more. Never less.

I’ve found myself averaging about one completely unexplainable one per week, plus usually one that can be explained, i.e. overnight after working out for 45 mins at 7pm.
I’ve also noticed a tendency to cluster, which you seem to have too. Once I get one in a day, I feel like I need to be extra cautious, like skip the gym or take the bus instead of walking home, to avoid another.

Thanks for your responses! It helps to know that I’m not the only one going low frequently.

Most of my low’s are in the 50’s and 60’s and I feel them. I am relatively functional with the lows. My control has improved recently… so some of them might be the “nuisance lows” that Flo described.

I noticed that I am not as aware at night as I used to be. So that worries me the most. I wake up at 40 now. I have a much lower basal at night already, but I will lower it more I think…

I also notice that my lows cluster. Once I have one, then I have several. Could this be because our liver is not able to “re-stock” in time to respond to the lows that come soon after ? ( a really non-scientific guess)

When I was first diagnosed (in January) I was low very often. Usually 2-3 times everyday. I adjusted my basal dose and some other things and am doing better now. I was originally doing 22 units of Lantus every day and now I’m doing 14. I go low maybe 2-3 times a week now, but I’ve been having a few more highs (I think because I’ve moved and my exercise routine got interupted) but nothing bad, never over 180.

Kristin, I sometimes go low 1 or 2 times a day. Other times I can go 3-4 days without any. I feel so much better about things since I’ve started using the CGM. The Dexcom 7 will sure wake a person out of a dead sleep! And it has helped me to set my pump settings more to what they should be. But then I have the problem of my insulin needs changing SO VERY often, like every other day. I wish I was one of the luckier ones whose needs stay the same.

I’m Type 1.5, still have some insulin but I recently started on basal in addition to rapid for meals. For the first couple of weeks I was getting a lot of “nuisance” lows- high 60s low 70s and feeling them each time. Over the weekend, I was gardening and went down to about 65 three times. The last few days, my body has adjusted and I am regularly testing at 77-80 between meals and I feel great. Part of it is what you are used to. I had similar fasting levels for long periods of time and then 75 feels OK. But when my BG has been running a bit higher, then 70s feel like a low.

Wow, I feel so much better now, as I suffer from lows daily sometime 2-3. I recently started exercising a ton, so I know that is a big part of the problem, so I am logging with Libby’s logs she sent me and making changes to my basals. I am on the verge of giving up exercise as it is easier to control my bgs, but then I look in the mirror and say who is that person with all that extra weight, so I continue to log and decrease my basals. My endo stated with tight control comes lows, but lately this is bordering on the ridiculous, but this post makes me feel normal. :wink: ha!! Then of course lows means eating, ahhh!!!

Hi. Tight control and lows go together. I find there are patterns with my niece. High/normal, normal with a few lows a week, then beautiful numbers, meeting postprandial goals, with many more lows. We test a lot so we catch them. We do night testing as well. We adjust insulin but it is difficult to keep her stable in the normal/few lows a week pattern. My tip would be if your numbers seem to be really great, postprandials good, look for lows. The better the control, closer to the edge it seems to be. YDMV, though. If on a pump, you can reduce basals for your reverse dawn phenomenon. She also goes lowest 2:30 or 3am thru 5:30 a.m.

I’ve had three in the past 6 weeks since diagnosis, only one was explainable and I have taken steps so that won’t happen again, I have no idea about the others. Two were in the high fifty’s and one mid 60’s, but the scary part was I didn’t feel them until I reached that point. It used be I would feel it in the low 70’s.

I hope you can work it out so you don’t have to worry about the lows so much.

I don’t go low often…I usually catch it before it drops below 60. I think I maybe go low maybe once or twice a month. I stop lows by eating reg and eating snacks in between meals. I don’t know if me being type 1.5 is helping me out or not…Hope you feel better
Cherise

Dangerous lows, none. Potentially dangerous lows, every single one. Probably once a week on a really really really bad month. Typically far, far less. Regardless all kinds of reasons, mostly over zealous with the short acting insulin, excessive long acting on board, etc… Am definately not a “beginner”, tight-control has serious side effects ; ).

Stuart

Dr. Philip Cryer, who studied hypoglycemia extensively and is generally considered one of the foremost authorities on this topic, wrote the following:

Hypoglycemia is a fact of life for people with type 1 diabetes. Those attempting to improve or maintain glycemic control suffer untold numbers of episodes of asymptomatic hypoglycemia; plasma glucose levels may be less than 50–60 mg/dl (2.8–3.3 mmol/l) 10% of the time. They suffer an average of two episodes of symptomatic hypoglycemia per week—thousands of such episodes over a lifetime of diabetes—and an episode of severe, at least temporarily disabling, hypoglycemia approximately once a year. An estimated 2–4% of deaths of people with type 1 diabetes have been attributed to hypoglycemia.

This may not address your question completely, but at least it puts things in perspective on just how “normal” the frequency of lows is likely to be.

Wow Scott, that’s a @&(#@*# spooky statistic. I’ve adamently believed that was the case for a very very long time. That little fact gets overlooked by the “sugar faeries” and their cheerleaders but the DCCT was awfully clear on that point as well (::: (

Thank you for sharing the link to the original source too!!!

Thanks for sharing this Scott! It was new info for me and it speaks right to my question.

I was really starting to wonder if my A1c was “artificially” low because I am having multiple lows, but given that they are generally in the 50’s or 60’s, I will take them as part of good control and hope to avoid severe hypoglycemia altogether!

I’ve fallen low 2 times a day at times to and that’s not the best feeling at all! I seaize b/c my ability to tell when I’m low is long gone! Get a trip to the hospital via the ambulance a few times. Now I have Gluagon shots here to bring my bs back up. I can tell sometimes when I’m low but it has to be below 45 for me to tell at all! Good luck and always eat enough to cover them. Atleast I’d rather be a little high than low at anytime! A little that means with in 50 points of my goal it’s like 120 so I can go up to 170 and still be ok I really don’t want to go higher though I often do!

You should not be having any lows, because it will not give you the entire picture you need for your HGBA1C. It is an average, so it includes lows, which will throw it off. I suggest eating at least every two hours. I have also noticed, when I change my site, the fresh insulin is much more potent. So dont
get complacent about not checking your BS level. I test 10 times a day and more if I have to be on a regimen of steroids. Steroids are our worst enemy!!!
Really, checking your blood sugar often is the key, if you dont know what it is, how can you deal with it?

Hi kristin! Normally i got a low a day, but not a bad one, something around 70. it’s also because i don’t eat much carbos so it’s aasier to get lows! but as long as you feel them i don’t think it’s bad.
take care, Ale x

I used to go low quite often - twice a day wasn’t unusual. Since pumping, I’ve tracked trends (food/exercies/boluses, TTD, basal/bolus %'s, mentrual cycle, etc.) through the day and month, and have adjusted my basal rates to three patterns I use, depending on the time of the month, and my activities. Now I have 3 or 4 lows ( around 3 mmol) per week while managing fairly tight control (A1C1’s between 6 and 6.5). It took a lot of determination on my part as I can be really lazy about journalling every event, but the end result is worth it. I’m going through the same task again now that I’ve switched to a CGMS pump.