Is it dangerous to stay around 55 for long periods of time?
I'm adjusting my basal dosages and have been experiencing a lot of spikes and dips due to over basaling and then overcorrecting the lows- then over correcting the highs, etc.
Today, though, I've been pretty stable, but around 50 / 60 for the past 4 hours.
Is there danger in riding out the 55? It's been really stable - almost a straight line- and I'm really reluctant to fix it.
Am I being stupid?
I’m not sure if there is any physical damage but i do know that long periods of time being low will lead to hypo unawareness
Timmy- Yeah, I guess that’s true. I’m just trying to figure out what’s TOO low to stay at?
Like if I kept myself at 35, I’d be an idiot, but 55 is so close to “normal” people’s 65 that… I dunno… I’m second guessing myself.
Jeez. Do you really like being hypo unaware? A key to restoring hypo awareness is to “minimize” the amount of time you spend down thar. And I would tell you that a non-diabetic would be shakin and sweatin at 65 and there head would probably rotate like Linda Blair in the Exorcist at 55. That is not normal.
If you are really stable there, then you should be able to count out the right number of smarties and get yourself right to 80 and be stable.
You need to really treat every low below 70 mg/dl. And I don’t even want to talk about banking lows.
Ok. So, yes, I’m being stupid. I usually don’t ride them out, but I’ve just been all over the place for the past few days that even seeing that arrow pointing to the right on the Dex is beautiful. haven’t seen him so nice looking for days. (usually pointing straight up or straight down)
Far too low
PULL UP!!!
The danger is you become unable to respond, there is no time for any warning signal left. You are flying your “airplane” dangerously too low!!!
Stuart
You are NOT being stupid…
You like all of us just want the @#)*@#(@#&@ numbers to do what you’ve worked so freaking hard for them to do. O-B-E-Y your efforts.
Having your rear-end handed to you at every single opportunity, not getting the “perfect” number you worked hard to achieve but don’t … will break anyone. Fatal flaw in the approach IMO.
Stuart
Although I’m not on a pump (injections) …I would tend to think of the basics for low. If, the phone rings and I get busy visiting with my buddy from Florida…and someone’s at the door…then I forget about where I was 20 minutes ago…then I probably would be a low 20/30 something.
I agree with the numbers your doc told you…then check for tech problem. You are not stupid. Julieann
Yeah I compared and it’s been staying consistently at 55 for 4 or 5 hours. I’ve never kept it this low before, but I’ve worked so hard over the past few days to get my stupid numbers to stay in a straight line that I was afraid to mess it up again.
If you look at my photos, I uploaded a few of the CGM graphs these past few days. One looks like a perfect M, another looks like I’m getting my pulse checked. Nuts. I was just excited to see the straight line under the reading on the Dex. (not tilted down or up, not straight down or up… and not the double whammy of TWO arrows pointing down or up) haha.
Julieann- Thank you for telling me I’m not stupid. I’ve been at this game for 12 years and I STILL don’t have all the correct answers. haha. But, I love you guys and try to cumulate all of the info I get here into something that works for me. Thank you again. (I’m MDI too)
Stuart- great picture you’ve thought up here.
So, it’s like I’m flying within 1,100 ft of surrounding buildings in a city- where the limit is 1,000 ft.
haha.
Got it.
sigh thanks Stuart
Yes it’s too low to stay. Take a glucose tablet of 4 mg and bring it up and see how far it goes in 30 min. Then take the number of glucose tabs that will put you at 90 by doing the math. Now you’re ready to think clearly.
If your basal of _____ (whatever it is) is giving you 55, what will give you 90? That’s 35 mm/dL worth of insulin that you need to reduce by. Is it half a unit? What is it?
Marps, ya gotta get yourself up there! No one thinks clearly at 55! I kid you not!!!
Keep us posted on how you’re doing.
Thanks. I’ve never understood the math of the basal dosages. It’s always been “increase by a point or two” or "decrease by a point or two"
I’m on MDI, so I’ve been messing around w my basal for a few days, trying to get it right.
Doing better, but after I corrected I’m staying at 147. Which is now too high. Ugh.
I just took 2 units of Apidra to bring it back down. We’ll see what happens.
Been at this 12 years and some days I STILL feel entirely clueless.
If you’re taking 2 units Apidra for 57 mm/dL (147-57 = 90), then you’re figuring 1 unit insulin will drop you 23 mm/dL.
Now see where it takes you in 2.5 hours without eating and write it down.
Now figure how many grams glucose got you up to 147? And if you stick with glucose tabs to figure it out, it becomes easier.
If you’re a small person, it does not take much to move you up and down.
It takes me 1/2 of a glucose tablet to move me up 13 mm/dL. If I get down to 70, I can’t write - I’m so shaky. I have hypoglycemia awareness.
Work with small numbers of grams in and small numbers of insulin units for a few days to determine the exact mmdL a gram takes you up, and you’ll stop the swings. People at 105 lbs often find that 6 grams raises them 40 mm/dL. They therefore don’t need much to pull themselves out of the lows.
Keep us posted.
thanks!
Yeah, In the past I’ve seen 1 unit bring me down 25 mm/dL and 5g brings me up 25 mm/dL.
I think that’s how it works out. I’m one unit for every 5 carbs, so that means 5 carbs brings me up 25 mm/dL
Or something like that.
It’s harder to figure out at the moment because I’m fudging with my basal dosages. So, things are a little screwy
Marps,
When you fiddle with basal, remember that you need 2-3 days to know where it will settle. That means you have to keep it at one dose for a couple days to be able, through testing, to see where it keeps you. It means you have to refrain from eating for long enough to see where you are 3-4 hours after a bolus. No fair eating before then!!! Remember your CGM is 15 minutes behind your blood glucose.
I don’t know if you’ve got your basal in one dose or two, but I would see where it is at different times of the day and night, always 3-4 hours after a meal - even if it means missing a meal, and if you want to do it right, MISS the meal and see where you stay. Miss one meal on Day 1, Miss the next meal on Day 2; miss the third meal on Day 3. If you start going low, you have too high a basal.
The rule is change by only one unit if you are taking less than 10 units. Change by two units if you are taking 10 units or more.
If you find that you are peaking with your basal (e.g., going low 4-7 hours after taking the dose) go to two doses, generally 2/3 for 16 daylight hours and 1/3 or less for the 8 hours of night time. Once you have a basal that keeps you even around the clock, then you can fiddle with boluses if needed.
Note that if you go low, you apparently need 7-8 grams of glucose to bring you up 35-40 mm/dL. Use 8 grams and test in 15 min. Give more in 15 min. if needed. Use glucose tabs when testing this out or when endeavoring to cut out swings. They act immediately in the mouth with no digestion needed. I know, Marps, you’re experienced. But a lot of people don’t use glucose tabs, so I’m repeating it when you want to get rid of swings and you’re setting basals and boluses, only use glucose tabs and you won’t have to wait much.
Hope you tell us how it works out. - And keep your carbs when you do eat, small enough that you’ve got control of what they’re doing! At least for awhile.
No one should have to eat
Hey Marps,
Are you sure 5 grams only brings you up 25 pts? Since you’re pretty carb sensitive, this may not be accurate.
Easy to test this.
So what did you wake up with?
Have you pulled that long acting insulin down by 1 or 1 and a half units?
I’m pressing you to give up that ride at 55 -
A right arrow at 90-100 would be so much more reassuring!
By the way, you know that whether it’s long acting or short acting, if 1 unit insulin reduces you 25mm/dL, then reducing long acting insulin by 1.5 units looks like - at this point - it will do the trick. Just thinking …
And you’d better tell us where you’re at - don’t leave us hanging thinking you’re still at 55!
OK bsc…what do you mean by “banking lows”. I’ve never heard this term.