How low should you go?

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NikyAndro

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Relationship to Diabetes
Type 2
I am T2 on Insulin (novomix 7 units am 6 units pm). Using a Freestyle Libre Sensor. I've learned so much from the sensor. I was wondering if anyone else used the data to keep really low and how low is really safe?
 
Being on insulin tread carefully going to low as hypo warnings signs can disappear by doing so, better to keep them intact my friend.
 
Thank you for your warning. How low do you mean? What do you mean that Hypo signs disappear?
 
NikyAndro said:
Thank you for your warning. How low do you mean? What do you mean that Hypo signs disappear?
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Not going to answer that question that is up to you, but going low to often or running low continously can make hypo symptoms reduce or disappear, its well known fact.
 
Oh that's interesting about disappearing Hypo symptoms I've never heard of that but it's good to know. I will read about that. Thanks
 
NikyAndro said:
Thank you for your warning. How low do you mean? What do you mean that Hypo signs disappear?
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Have you ever had a hypo? If so, warning signs will be things like your vision going funny(my peripheral vision goes blurry but other people see auras or sparkles or black spots. tingly lips and tongue, wobbly legs, sweating, heart pounding, feeling isolated, mild indigestion. There are lots and lots of hypo signs which warn you that your levels are dropping dangerously low and you need to take action ie. have a hypo treatment. These signs might start in the low 4s or even higher if your BG levels have been running high for a long time. These warning signs are much more important to us insulin dependent diabetics because we are at risk of the insulin in our system taking us too low. There is a fail safe system inbuilt which triggers our liver to release glucose to bring us back up and this works very well for people not injecting insulin but the problem we can have is that there is too much insulin in our system for the liver to overcome and we can become unconscious or even in extreme circumstance die as a result, so we need to preserve those warning signs at a healthy level ideally low 4s. If you persistently run your levels too low, your body gets used to low 4s being normal and it doesn't give you those warnings till you drop below 4 or below 3 or even below 2 and then you pass out and perhaps have a seizure. So preserving your hypo awareness is really important and you do that by not running your levels deliberately low.
 
Thanks that's very very helpful. I know what hypos feel like and what you have described has really given good insight. I've been hitting some low 4s recently and not having any symptoms of hypo. I eill talk to the Diabetic team now but I'm thinking a reduction in Insulin may be needed. Thank you for detailed answer.
 
NikyAndro said:
Oh that's interesting about disappearing Hypo symptoms I've never heard of that but it's good to know. I will read about that. Thanks
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It's well known. I had it for a while (resulting in nasty hypos), probably caused by going hypo most nights. After I started using a Libre I managed to reduce those dramatically and my awareness returned.

Hypo unawareness

Not being able to recognise the warnings of a hypo affects many people with diabetes. What is hypo unawareness? A hypo is when your blood glucose levels (also called blood sugar) are too low (below 4mmol/l). Hypo unawareness is when you can’t spot the signs you're going hypo. You're more likely...
www.diabetes.org.uk www.diabetes.org.uk
 
I would like to say that I don't always feel it in the low 4s. Sometimes I get down to mid 3s but the key thing is to understand why you went low and make some adjustment so that it doesn't happen again. It is usually easiest to detect it at low 4s if your levels have spiked quite high and then they are dropping fast, whereas if it is just a slow drift down to below 4 it can be harder to detect and more likely that you will be below 4 when you catch it.... and sometimes one of the signs of a hypo is that your brain gets stuck in concentrating on something you are trying to do and whilst you sub consciously recognise that you are having hypo signs you are so focused on the task in hand that you ignore it until it becomes too bad to ignore.
What I am saying is that I wouldn't panic or worry too much if you don't detect hypos until you are mid 3s but it may be worth making some adjustment to try to improve that by keeping levels a little higher for a few weeks. Unfortunately with your mixed insulin regime, you have much less adjustment available to you than if you were on a basal/bolus regime.
Interesting that you are Type 2 and yet need relatively small amounts of insulin. Have you been diagnosed long? Would you mind sharing a little of your story about how you came to be diagnosed.
 
rebrascora said:
I would like to say that I don't always feel it in the low 4s. Sometimes I get down to mid 3s but the key thing is to understand why you went low and make some adjustment so that it doesn't happen again. It is usually easiest to detect it at low 4s if your levels have spiked quite high and then they are dropping fast, whereas if it is just a slow drift down to below 4 it can be harder to detect and more likely that you will be below 4 when you catch it.... and sometimes one of the signs of a hypo is that your brain gets stuck in concentrating on something you are trying to do and whilst you sub consciously recognise that you are having hypo signs you are so focused on the task in hand that you ignore it until it becomes too bad to ignore.
What I am saying is that I wouldn't panic or worry too much if you don't detect hypos until you are mid 3s but it may be worth making some adjustment to try to improve that by keeping levels a little higher for a few weeks. Unfortunately with your mixed insulin regime, you have much less adjustment available to you than if you were on a basal/bolus regime.
Interesting that you are Type 2 and yet need relatively small amounts of insulin. Have you been diagnosed long? Would you mind sharing a little of your story about how you came to be diagnosed.
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My story is long and conveluted. I will make sure I stay above 4.5 from now on. Thanks so much for being interested in me.
 
We don't mind long and convoluted at all, if you would like to share, so don't let that put you off but also totally respect your right to keep it private. I was just wondering if you might be a misdiagnosed slow onset Type 1 (LADA) with having such such low insulin needs. Type 2 diabetics usually have a lot of insulin resistance and therefore need bigger doses.... Not always of course.... but it just got me wondering.
 
I'm not ready to share yet. I did talk about my amputation in another thread. I'm still in recovery with that and a foot ulcer at the moment despite my sugars being very good. Hba1c Av about 45 for the last 18 months my daily range between 4.5 and 9. I think I was tested for LADA.
 
NikyAndro said:
Oh that's interesting about disappearing Hypo symptoms I've never heard of that but it's good to know. I will read about that. Thanks
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If you have libre 2 set low alarm higher, mine is set to alarm at 4.8 to give me time to react depending on active insulin still circulating & which way trend arrows is pointing.

Tbh, since using libre 2 hypo's are very few & far between, so good news all round in preserving hypo warning symptoms.
 
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