Fixated on scores

[zoombapup]

Hi all,

I'm new to the forums. Got diagnosed a little over 3 weeks ago, rushed into hospital on an insulin pump for 2 days. This was from only being on the edge of pre-diabetic a year ago. The 4 days I was in hospital were hellish for a bunch of reasons, but now I am VERY motivated to get my BG levels down.

When I got out I started low carb pretty much instantly.

So now, I'm testing with my meter and I'm watching those scores slowly go down. I'm on a small dose of insulin (the type where its just once a day background) and metformin. But I'm bloody obsessed with getting my scores lower.

Question is, is that a healthy obsession? I mean, what is the minimum score I should allow? I know the insulin I'm taking can knock me lower than is safe. But I'm kind of confused on what the lower limit is. Apparently for driving you are meant to be over 5? But is that the lowest safe limit?

I'm storing my tests in a spreadsheet so I can graph all sorts of different data about times of day and the like. Mainly because that's my kind of coping mechanism. But I'm reading all sorts of conflicting information on different levels on the internet, usually from BG testing companies.

What is actually considered a "safe" score? I mean what band is considered non-diabetic and what is the minimum safe BG score? Because some of them say 4, my nurse in hospital said 5-7, but most of the info I've seen suggests that 7 is in the prediabetic range.

Sorry, just obsessed 🙂 thanks for reading.

 

[JTilley2000]

My nurse said 4-7.
And if i go below 4 I need to eat 4 jelly beans or a sugary drink to bring it back up, followed by a banana or a slice of toast to stabilise it.
I don't have a link as its just what I've been told.
I hope you find this useful.

 

[ianf0ster]

Hi all,

I'm new to the forums. Got diagnosed a little over 3 weeks ago, rushed into hospital on an insulin pump for 2 days. This was from only being on the edge of pre-diabetic a year ago. The 4 days I was in hospital were hellish for a bunch of reasons, but now I am VERY motivated to get my BG levels down.

When I got out I started low carb pretty much instantly.

So now, I'm testing with my meter and I'm watching those scores slowly go down. I'm on a small dose of insulin (the type where its just once a day background) and metformin. But I'm bloody obsessed with getting my scores lower.

Question is, is that a healthy obsession? I mean, what is the minimum score I should allow? I know the insulin I'm taking can knock me lower than is safe. But I'm kind of confused on what the lower limit is. Apparently for driving you are meant to be over 5? But is that the lowest safe limit?

I'm storing my tests in a spreadsheet so I can graph all sorts of different data about times of day and the like. Mainly because that's my kind of coping mechanism. But I'm reading all sorts of conflicting information on different levels on the internet, usually from BG testing companies.

What is actually considered a "safe" score? I mean what band is considered non-diabetic and what is the minimum safe BG score? Because some of them say 4, my nurse in hospital said 5-7, but most of the info I've seen suggests that 7 is in the prediabetic range.

Sorry, just obsessed 🙂 thanks for reading.

Hi Zoombapup,
We all vary in out reaction to Low(er) Blood Glucose. A friend who is a Type 1 says he is fine at levels where others would be passing out!
The figure of 5 in order to drive is meant to be a very safe level. Remember you are not supposed to drive when taking something as mild as an anti-histomine if it males you drowsy - a reaction to a lowe(er) BG can do a lot more than just that!
If you are Low Carbing and getting readings in the 5.0 to 6.0 and are on Insulin, then I feel you need to talk to your doctor about it, so they can either adjust your Insulin dose, or get you off Insulin altogether. Because unless you are very careful, the Insulin can knock your BG too low.

Ultimately there is no reason why a Type 2 with good Blood Glucose control by diet (plus exercise/ plus metformin or similar) need be on Insulin.
This is NOT the case for Type 1's or LADA.

 

[Drummer]

An ordinary type two like me, who is lucky too, would see levels around seven and a bit after meals once settled on a low carb diet.
That results in Hba1c just at the top end of normal - which seems fine.
If you are type two then you might be a bit lower when using the insulin, so possibly you'll be advised to stop it, before too long.
You need to be a bit wary of numbers quoted without units, as Hba1c is sometimes given in small numbers which can be confused with blood glucose in mmol/l.

 

[everydayupsanddowns]

When diagnosed with T1 I was given ‘4 is the floor’ as a mnemonic.

Readings lower than 4.0 put you at immediate risk of hypoglycaemia - particularly if you are on injected insulin where the action can’t be ‘switched off’ by the body. Some medics count 3.9 and below as hypo, others say that the warning signs at/around that level are to get you to act and use 3.5 below which the brain is physiologically unable to function properly.

General guidance is 4.0-9.0 (T1) or 4.0-8.5 (T2), though 4.0-10.0 is also used for ‘time in range’ guidance with continuous monitors.

As to whether you are over-checking or becoming obsessive, I would simply ensure that you occasionally consider whether you are getting negative feelings or feeling a burden from it, and (importantly) able to take action or receive useful information from every single check you make.

 

[Docb]

The OP asked about being fixated on scores. To me, getting fixated on single readings is not a good thing. Scrutinising the numbers from different directions looking for patterns which can help to manage your diabetes is a different thing altogether. Some might call that being fixated, I would not.

So my thought on numbers is to collect them for a week or so before you even think about them too much. Obviously does not apply if numbers are very high (heading for the 20's) or very low (under 4) - yell for help from a professional if they are. Just make sure you get a representative set covering different times of day, before and after meals and waking and bedtime. If you can put them in a spreadsheet then excellent - saves a lot of work when it comes to interpretation.

Things to look for.

What is the overall average? This will give you a guide to where your HBA1c might be. If it is below about 8, then your HBA1c should be there or thereabouts.

What is the range and are there any numbers which are well outside it? Generally, your BG will be higher after meals and lower before. My target range is 5-10. Sometimes I get an odd reading (a spike) above 10 and those I think about. Usually traced to a specific food and I cut that out of my diet.

Then just keep collecting data. After a few weeks you will see whether the average is dropping (best with a running average) and whether the range is changing and whether you are getting fewer spikes.



After a year or so you might get a graph like mine. Big overall drop to start with which I ascribe to cutting carbs. Once down to sensible levels medication was reduced and I have kept well within my range on the high side at the expense of letting the low side slip below 5 which I can do without heading for low 4's. The block in red is interesting. That is when I stopped taking gliclazide. Range went up quite distinctly and so I went back on it. The spikes I could trace to individual foods.... a cake, a cappuccino, some muesli with dried fruit in it.

I have put this graph up to illustrate the point that you need to persevere and look at long term data to get full value from testing as a T2 controlling by diet and minimum medication. Fretting over individual numbers just leads to more fretting.

 

[grovesy]

As you are newly diagnosed I would do what are you are doing, and review and reevaluate along the way.

 

[Ljc]

When you are on insulin or other medications that can cause hypo’s, it is not a case that the lower we get the better . I was told 4.0 to 9.0 on finger pricks with 4.0 being the floor and to treat as hypo.

They also don’t want to bring our levels down quickly as that can cause some unpleasant symptoms, such as very blurred vision and false hypo’s.
Do you mind telling us what levels you are achieving

 

[zoombapup]

Thanks for the information everyone.

Ljc: So currently I'm averaging around 6.0, here's the graph of the last 3 weeks or so since I got diagnosed.

It does look like I'm slowly trending down now. You can see I'm currently hovering around the 5-6 range with the occasional blip up to 7 or so. But I'm wondering about the lower ranges really. I'm just curious about where the lowest I could get is. Does this just keep trending ever lower if I'm on insulin? even a small dose? I don't dare imagine what my levels were like before the hospital and the insulin pump, I'm guessing they were seriously dangerous. I do remember a 23 being in there somewhere.

 

[Ljc]

It looks like you are doing extremely well and in my non medical opinion are around about where you should be.
We all have peaks but so long as we are mostly within range we don’t worry too much .
I reckon they will soon start gradually lowering some of your meds

When I was at my I worst, was in hospital luckily , my glucose levels were usually in the 20s until they put me on insulin.

 

[Docb]

Recognising that all our opinions are non medical, I agree with Ljc in that it looks like you are doing OK. Your body has natural mechanisms for stopping your blood glucose going too low and providing you are not on insulin or taking medication which promotes natural production of insulin then you will not go much below 5 and certainly not go to dangerously low blood glucose levels.

Moral is to keep up the good work!

By the way, it is useful when recording data to record time of day as well as date. You can then fix the time of the test as date&time and this will then plot dates on your x axis. If that does not make sense then say so and I (or somebody) will try and help you to sort it. What spreadsheet are you using? Does not look like a standard format from Excel.

 

[zoombapup]

Using google sheets, to be fair, I do have the time, I just record it in a different column, I'll do a combined column graph over the weekend. I did manage to make sheets draw the date in, but I want times in there too.

Thanks for the help though, makes me feel better to know that I'm not being too nerdy with this. Seems important enough to me to actually be taking care of the figures right now. Considering the dire consequences of ignoring it (which I saw in hospital and it kind of shocked me into taking this seriously).

 

[Docb]

Dont think you are being too nerdy for a couple of not so obvious reasons.

First off, when you see the DN or GP you can take graphs with you and it makes it easier to establish a rapport. Having something to look at means they don't listen to you and interpret what you are saying. Makes their life easier.

Second, you are showing your DN/GP that you want to take a lead in managing your diabetes. If they are any good they will appreciate that because in reality, you are the only person who can manage it, they can only advise.

 

[zoombapup]

Second, you are showing your DN/GP that you want to take a lead in managing your diabetes. If they are any good they will appreciate that because in reality, you are the only person who can manage it, they can only advise.

I did get the feeling from the diabetic nurse in the hospital that they liked that kind of thing. I think he could see that I was definitely the type to do it (yes, I'm a control freak 🙂). Honestly though, I was scared into action, so much so that I realized that without drastic measures I was in for a world of hurt. So this is something that I can see changing my lifestyle long term, which I guess is the point, this is a lifestyle issue (type 2) so it needs a lifestyle changing response.