I guess low is not that low

Linda, Maybe you can tell your doctor to only open her eyes 10 seconds every minute when driving. If she gets where she is going safely, then she does not need to see more. The analogy being that a lot can happen in that 50 seconds she is not seeing. So can your BG be doing a lot you know nothing about if you do not test.


I, personally, aim to keep my BG above 80. I think hanging out in the 70s range is skating a dangerous line, because we get used to the range we spend time in and 70 is just a step away from hypoglycemia. I want to be able to feel that I'm getting close to that line before I reach it, and to feel that it has to not be my norm.

Linda, I would be well out of pocket if in Australia Medicare, the public government health fund, did not cover much of the costs for teat strips. You have to have some type of diabetes to be registered with the National Diabetes Service Scheme (NDSS) administered by Diabetes Australia but a box of 100 test strips, shelf price, about $70 costs $16, concession card holders $4 and free if your out of pocket medical expenses for the year reach the government threshold. One of the first questions that many Health Professionals have ask me is, "How many times do you test?" When I say about 5 for a normal day and sometimes 20+ for a bad day, the response is "Good" and / or "I wish all my patients followed that example". As a rule we are encouraged to test.
As the saying goes, "The cost of prevention is always much cheper then the cost for the cure."

Hey Newbeach and Steve....
May I add that the doc, though young, is dogmatic and pig headed (lovely combo)...
I'm toying with searching for a new....but it's not like they're growing on trees!
As well...once you decide to change doctors, I'm sure it's written down in a little post script somewhere, that things were amiss.
(did I mention being caught between a rock and a hard place?)

IF at all possible switch doctors and/or get a good endo. You might not get more strips if Canada has gotten that bad, but I don't think that is the case from what I have heard. Then maybe buy cheap generics online or something. Cripes that's horrible....medical decisions based on budgets, and nothing else. Same crap can happen with private insurance here...my GP was telling me that I (type 1) only needed 3 strips a day.

I am with Zoe on this and consider a fasting glucose of 71 darned near perfect (I'm aiming for 70). If it's my fasting number, that means that I haven't done any bolusing for a good long time. As long as my basals are just right, there should be no worries whatsoever. And even if my basals are a little bit high, it's not going to be like a sledgehammer as my hourly basal rate is pretty low. If I was 71 an hour after dinner I'd be running for the skittles.

You bring up some key points, rubidoux: You can never underestimate the importance of having basals set as close to perfect as possible, and here there is a big divide in terms of MDI and pump: Though some people have pretty good success with MDI in setting their basal doses to keep them steady,it is, at best, an inexact science. So people with pumps tend to have more confidence that with no insulin on board other than basal, there is no reason they should drop. Second: it's hard to evaluate a number as "good" or "bad" without context. Finally there is an emotional factor where some people are overly-anxious about lows, so a number like 70 causes anxiety.

well, that may be good for you...but we're talking about a 10 year old who's new on the pump. it's rather concerning when folks come on here encouraging not to treat until 60's or below, encourage a fasting of 70...maybe some can do it, others simply cannot. we read time and time again on this site how many have passed out - seized, needed Paramedic - ER intervention(s), have hypo unawareness, etc...People post on here their horror 'low stories', how totally dysfunctional they were during low, crazy crap they did, their inability to think and or function properly, etc...it's also true that many have significant drops in the middle of the night (comes with dreaming and how glucose and insulin is used up in the body). I just don't understand why type 1's would want to push it, what's the difference between a safe, totally normal 80 - 90 blood sugar and pushing it to 60's or 70's...why? Unless you're not all that active or whatever. Again, everyone manages this differently but a 70 for an active child or even adult with IOB is pushing it, IMO. Also, true...endos have a huge responsibility when they take us on as type 1 patients. heck, they have no idea, really, what we may do at home in terms of management. I'd very much dislike being an endo. Not only do we have to partner and 'trust' them, but as their patient, they too have to trust us. If we crash and burn under their care (and I can just imagine what they've seen in their practices in terms of insulin management) then it reflects on them as our endo, in many, many ways. just be safe, please.

I agree with you Sarah...70 is too low for me...and I'm far from an active 10 y.o.
Your diabetes may vary (YDMV)
You are so right....BE careful!

You may be confusing this thread with another one, Sarah, this one was not about a 10 year old new on a pump.

But speaking just for myself I don't post on here with the intention of encouraging others to do things as I do them, I post on here to share my own perspective and choices, as others post their perspectives and choices. Then the discerning adult is free to choose from among those ideas, some combination of those ideas, or none of the above!! I think threads that go back and forth between things like "70 is a good number" "no 70 is too low"; or "You should treat below 70" "but I was taught not to treat until below 60" are missing the point. There is no one right answer. There is only what is right for you. (and the 30,000 other "yous" on here). I for one come here to read other people's perspectives and choices and share my own, not to convince anyone to do things my way.

Personally I rarely contribute to the "what was your worst and most scary low" type discussions. I'd much rather hear from someone about what led them to a particular severe low (or episode of DKA)or someone who had frequent troubling lows and developed a successful strategy to prevent them in the future.

You speak words of wisdom Zoe. "There is no one right answer. There is only what is right for you." No one wants to have a hypo and I am sure if you could tell at 90 and not have levels go over 110 we would have a "perfect"insulin.
My extremely low levels of below 20 were from injection bolus insulin and not eating before answering the phone. I have to wait 30 min after injecting morning's bolus to make sure BGL are falling. I now clip a timer to my shirt to prevent this happening again. The positive outcome from the event was, like my son, we do not go into comas or fits at these low levels. The most important thing for me is my hypo awareness level does not change.

I have been Type 1 for 33 years and my Blood Sugar can be 20 and I still can do everything. I have known many people to panic though so only do what makes you comfortable, the older I get the faster my Sugar can drop so I always have something with me.
Best Regards to you and your sister !

For me it depends on the time of day.. a 71 in the morning or late afternoon means I have a chance of dropping further depending on my activity level that given day. So I will pop a few carbs at that point, because having a low in a room with a client or when working with a fruit loopy cat is probably not going to bode well for me or anyone else nearby. I'm happy with 80-90 fasting otherwise, but I'm also happy with my A1C where it is at this point given other factors.

Wow this is an old post, doesn't even sound like me :)

No, I think you're dead om with the 70 glucose- this is usually where mine is when a true low starts to matter, at least with me. I've developed over the years nerve damage that keeps me from feeling my lows coming on like I used to... I once read that docs consider you clinically dead at 35, and I've been lower than that, walking around and not feeling a thing. I'd rather catch it early than risk that kind of low, especially with the intolerance at noticing that I've developed over the years.

I agree, Marty

Seventy-something for a diabetic, especially an insulin dependent diabetic, is an entirely different situation than for a non-diabetic.

A person with healthy glucose metabolism responds instantly to changes in BG. There really is no risk of hypo.

A diabetic has, at best, a 30 min latency for insulin reaction, and a long tail (2-4 hours) of continuous metabolic activity. This makes "control" much more difficult. It's like trying to drive the Mars rover directly when the time lag between what you see on the cameras and the control inputs you give in response is 30 minutes.

To avoid driving off that cliff you're going to have to make some steering/throttle decisions when it's way, way off in the distance. Something you just can't see way out there might become a problem in the next half hour, and there's nothing you could have done about it -- you couldn't have forseen it. All the information you were using to drive the thing was 30 minutes old when you made your navigational decisions.

Treating diabetes is exactly the same way. We are always doing our best guessing at the future, and whatever we do to affect BG has a response lag.

So, while physiologically 70's are no big deal for the vast majority of diabetics (heck, people), the issue really isn't the immediate impact of 75, or even 65 on one's state of health. Basically no one is at risk of anything harmful at those ranges. Rather, it is the risk of what will happen in the next 30-60 minutes that's truly critical, and dangerous.

Staying above 80 gives diabetics time to deal with over-administration of insulin. It really has nothing to do with actual physiological harm at slightly lower levels.

There is a great deal of wisdom in this thread but you have to sort it out. I am currently in Zoe's camp. As part of a campaign to become a smarter diabetic, I upped my testing to 8 times a day. The data helped me get a much better understanding of my insulin on board (am MDI). With this understanding, I can cruise for hours (at time in the 60 - 70 range) without worry and getting plenty of energy from my ketogenic metabolism of fats,

However, before the data showed me how to exit my personal glucose roller coaster - my experience and habits were similar to the other contributors. I would "treat" 70's and try to stay above 100 - 110. It is only in the last year, or so, that I cared enough to invest in this effort. There is nothing "right" or "wrong" with either approach. What is helpful about TuD is it exposes us to what is possible and empowers us with choice.

Sadly, "cost" is a flexible, relative concept.

"Cost" to a payer is money, and for the most part money alone. So, if the financial cost of a treatment is greater than the cost of the potential health problem, guess what the decision will be?

Over a diabetic's lifetime, the cost of pump + CGM therapy might well exceed the cost of an amputation, for example, especially when adjusting for the risk (i.e., 100% of the cost of the pump/insulin/CGM supplies is compared to something less than 100% of the cost of an amputation, because it is uncertain).

Yet, the "cost" of the amputation to the patient is enormous.