hello! i have been having some lower than ever lows for me recently (like 38, 36!). they mostly happen when i exercise and i really dont feel them when i exercise. ill usually feel a nonexercise low at 60 or even 70.
with the low lows i have felt high (nausea)but tested because i didnt believe it-thank goodness!
these instances have made me wonder how low before you pass out/have convulsions? if i get to zero i guess i die? would my liver dump glucose before i got to zero?
It depends. In 50 years, I have never passed out and have had convulsions only two times and they were extremly minor. I once held a lenghthy discussion with a paramedic who would not believe my blood glucose reading was 10 until he tested it and saw it was really that low.
But that is me. I function really well when low, but my A1Cs have been historically very low 5.1. I have way too many lows and am trying to ease up only myself.
The answer is, it just depends.
When you are doing some types of activity you can have no warning signs, they are masked by stress.
I have no idea how low your BG would have to go before you pass out and I have no idea how low mine gets when I pass out. It's a mistake in judgment or a dossing error, or activity that is to blame most of the time. You must stop going low under 70 is not a place you should be on a regular basses. You will loose your Hypo sensitivity and then you will most likely find out what passing out is all about...if you survive to tell the story!! You will here many story's from people who can tolerate low BG but this is not something to boast or brag about. When your BG is low your body warns you but if you do not treat the condition your brain will find another way to get some sugar and stop warning you and once this happens you no longer have a warning system and without a warning your BG can get so low that you will pass out then when it drops a little farther you will start suffering from cardiac distress which can lead to death.
My BG can get very low without any sign or warning and yes sometimes I can function without any issues...I'm lucky to be alive...so are base jumpers!
I agree with you, JohnG. I get low symptoms at under 70, but they are more emotional/psychological than physical when I am in the 50-60's. I do not get the shakes and sweats until I am VERY low. I do not pass out from lows in the high 30's; and can generally self-treat; but, as John G says, that is nothing to brag about. I am working on avoiding lows so I can get more of the physical symptoms back at a higher (Low) blood glucose range. I am blessed to be alive as well.
God bless,
Brunetta
I agree John, which is why I included the information about trying to raise my A1C. My doctors have told me that consistently having the lows I have experienced over the last few years can do more damage(cardiac) than high levels. As a result, I am loosening up and working to keep my glucose levels higher. My goal is actually to raise my A1C.
That is NOT a popular idea on this board and I have been slammed for comments about it before. However, I will say that is the last 7 weeks, my daily averages have gone from 70-90 to 100-120. I feel so much better, and my sensitivity to lows is returning. I am happier.
After 50 years, I am thankful. I actually removed my CGM and am LOVING IT! My need for complete control has greatly diminished.
I don’t think that there is any magic number that determines when you will pass out and/or have a seizure. Some people seem prone to pass out and have seizures while some never do.
I do think that those who have never passed out need to be careful about being too confident that it will never happen to them. None of us knows what tomorrow will bring. I have only passed out twice in 36 years of Type 1 and it happened in the same week. I had my only ever episode of vertigo. After the week was over, I figured out that the vertigo caused me to pass out at BG levels that I had previously been able to function at. My BG numbers weren’t lower that usual, but how my body reacted to those numbers changed.
One thing also to remember is that our meters are not accurate enough to reliably distinguish between low readings. A 40 on your meter might be 45 or it might be 25.
I have a mild awareness of lows because I feel off. But I don’t have any of the strong symptoms of sweating, shaking, etc. My CGMS definitely catches many lows before I feel them.
For me it is length of time that it is low more than the number. Before I had CGM I could test and see a 40 mg/dl and feel fine. Other times I've been confused and sweaty and shaky at only 60 mg/dl.
It used to happen at night for me while I was sleeping, my CGM sort of took care of that, wakes me up if I go under 75 mg/dl.
as soon as i posted this i thought, its going to be an "it depends" type answer...i love that were so special, each and every one...
what could these other factors be that jackie is talking about? time spent in the low? speed at which have reached low number?
i am taking in more carb during physical activity and have even lowered my basal on returning from a long mountain bike ride. the amount of carbs im eating on my day long cycling trips is unreal, not even counting carbs cuz my body just burns them all up. eating everything i can get my hands on.
the very rubbish part is the not feeling it when cycling, no shakes, sweating anyway, and feeling that high-i wanna-vomit-feeling.
thank you for your responses, will just have to test more often!
If you run lows, you will dip down and have a surprise. It is like night follows day. It will happen.
Experiment and take more carb BEFORE exercise and let the lowest be 70 AFTER exercise.
At any number below 100 I take enough halves of glucose tablets to get me up to 100. Each 2 grams raises me 13. Know how far a gram raises YOU so you can raise it to exactly where you want it. Test often enough when exercising that you know you're not dropping into brain-stopping-lows.
Getting your average to 100-110 or 120 will decrease the likelihood that you will dip. No one really knows at what point any of us will pass out.
Before the pass-out stage, however, is the brain-on-ice stage where you only stare and your movements become inappropriate and explaining yourself is almost impossible. At that stage you don't manage transportation home from the exercise club. Unfortunately there is a pause before the liver dumps help.
I like control. I'm a control freak. I stay at 100. 70 is my low point. I've seen people go into convulsions at 50 down to 10. I had a job of preventing the convulsion which was induced.
Now go exercise, and add the exercise of chewing glucose or eating enough that you make 70 be your lowest! It can be done!
As far as the "pass out number", my old One Touch Ultra Smart registered some crazy lows, I think a 7 once, some in the teens and 20s. I had one time I was walking, had bolused (DP) and got carried away b/c it was nice out and was like 28 by the time I checked, really noodly.
How far are you riding? I like to have carbs every 3-6 miles running, usually somewhere between 9-10 minute miles. I have a glass of skim milk before a 5K but run those a shade faster so it 1) doesn't take as long and 2) more adrenaline will push BG up if you're getting into anaerobic exercise. For a long time, I'd bring 2x bottles of gatorade on my Amphipod belt, one "high octane" w/ 45G of carbs (I get the powder so can weight it...) and one with "low" like 0-12G. This worked ok but is a pain in the butt (sometimes literally...) on the runs so now I usually take one w/ about 25G, which is pretty close to "regular" Gatorade and it works good out to about 15 miles. I think that 10-12G every 3-5 miles is usually a reasonable amount of fuel. The Gatorade is absorbed pretty quickly and also has electrolytes and other stuff that is useful for sports.
Another thing that's been useful is to know that my BG runs up at the end. Sometimes, particularly moderate runs, I'm like OK, I'm done and run faster in the "home stretch" so my BG will run up when I'm done so I don't usually have too much in the way of carbs at the end. I also turn my temp basal back to normal for the last 2-3 miles (figuring it takes a while for the basal to work...). I do notice that my pace will get harder to hold when my BG runs low. I've started thinking of the little bags of jellybeans and smarties (mixed...smarties are dextrose and work faster but are dusty, like glucose tabs...) as "emergency" fuel while the gatorade is running fuel. Another useuful thing on the long runs are Gu packets and other brands, Clif Shots, AccelGel, etc. These have maltodextrose which for me, seems to work more like food but has some carbs that will provide fuel, like a meal in a glob, if you're going 2+ hours (or 6 hours or whatever!)
acidrock, thank you very much, this is really practical information here! im riding mostly trails, usually about 25 or 30 miles. theres lots of uphill (or so it seems)and downhill, some challenging terrain. it takes like six or seven hours with our stop at a cafe and then a stop for lunch at the end.
i am going to try the eating at mileage points, which makes sense-have always been seat of pants type before t1.
im testing out a 25 gram energy gel on our ride this weekend and an energy bar i got at the bike shop. i bet theyre gonna taste mingin! thnking of gettin some haribo type sweeties. cycling is a great way to cheat the D!
thanks so much again-really helpful. i dont want to learn the hard way in the middle of the andalucian countryside.
If you are trying the gels, it's not a bad idea to try one out just hanging around, to see what they do to your BG, how your body reacts, etc.
It's very important to have some fast acting carbs, which I'm sure you do, but I think that Gatorade or some other sports drink is pretty useful, since "straight" people without diabetes usually are hitting the Gatorade at the races I've been in too. These days, just sipping on it intermittently will help me keep BG flat and keep me hydrated. I just keep a jug of it on my bike, usually 20-40G of cars worth of Gatorade for a ride of 25 miles, although we don't have any hills anything like Spain so it doesn't take me nearly 7 hours.
I have never passed out but had one serious low at night which needed Glucagon. For around 25 years of T1 this is a pretty good quota. Nevertheless I think that there are no guarantees. To operate below 70 mg/dl is not normal for the nervous system. Actually the micro-dosing of insulin by healthy beta-cells and the glucagon release by the liver will make sure that the BG does not drop below 70 mg/dl (in healthy people). With exogenous insulin we can drop below 70 easily. This is amplyfied by the fact that exogenous insulin can block the glucose release of the liver. The high level of insulin is signaling to the liver that carbs are about to come from the digestion. Thus it is not releasing much more glucose than normal. Thus our cells will consume all the glucose in the blood stream and the liver will not help much. After the main activity of the insulin has faded out the liver can be more responsive to lows.
A steep drop in glucose levels is harder to cope with than a minimal drop rate. For example -200 mg/dl in 20 minutes can cause anxiety / fear in some people. In contrast a drop from 90 mg/dl over 6 hours to 66 mg/dl can be overslept easily. The big unknown is the level of glucose that will trigger seizures with convulsions. At one point important brain functions might be impaired causing chaotic dissonances in brain activity. This state can get very dangerous. In this one situation I had (I was around 19 years old) it was a mistake that led to a massive overdose of insulin at night. With this dosage that brought me below 30 mg/dl every person would have a seizure I think. At the same time this does not mean that I will only have a seizure below 30 mg/dl. A friend of mine had seizure-like symptoms right below 50 mg/dl. Here very likely the inaccurracy of our meters while measuring low blood glucose comes into play.
i know youre a big runner so im taking your advice, getting a bottle of our gatorade. thanks again, ill let you know how it goes-looking forward to eating paella after the ride with no insulin and no worrying about going high!! and bread, and potato and chocolate cake!
I've had convulsions once in 24 years, but was more interested in consuming sugar than doing a blood test - although this was also back in the days of the colored strips.
When bushwalking (multi-day hikes), I've dropped very slowly down to 1.3 mmol (23 mg/dl) before having visual disturbances, so for me it seems to depend on the rate at which my BGL drops. Normally I get sweaty at around 3.7 mmol (66 mg/dl)