Recommend Blood sugar levels

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Steambuff

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Relationship to Diabetes
Type 2
I am 70+ male with type 2 and inject about 26 units of 50/50 mix per day. What should the ideal BS be. My nurses keep saying this and that and seem to change the goal posts to suit my readings. Unfortunately I get low BS of under 5 and as low as 3.2 with no symptoms for no apparent reason even when I watch my diet and insulin strictly.
Would I be better aiming for a higher average BS reading.
Thank you
 
Welcome to the forum @Steambuff

Sorry to hear you’ve been having some low BGs without getting any warning signs. That must be quite a worry.

Over time, and with exposure to low blood glucose (below 4), our brains can adapt and change to ‘do better’ at those lower levels. Unfortunately this can mean that the warning signs intended to give us time to react to falling levels don’t kick in until later - by which time BG levels can be worryingly close to the point where the brain simply cannot function, making more severe events including siezures and unconsciousness more of a risk.

Minimising exposure to readings below 4.0 can help to reset the ‘glucose thermostat’ so that your warning signs fire in the mid-high 3s again.

The recommendations for levels for those with T2 should really be agreed and individualised with your HCP, depending on your age, history and any risk factors. The generic ones are No lower than 4.0, 4-7 before meals, and no higher than 8.5 by 2hrs after meals.

If you are getting hypos, it might help to move to a more flexible basal:bolus insulin regime rather than a premixed insulin where you can’t adjust for meals without messing up your background dose?
 
everydayupsanddowns said:
Welcome to the forum @Steambuff

Sorry to hear you’ve been having some low BGs without getting any warning signs. That must be quite a worry.

Over time, and with exposure to low blood glucose (below 4), our brains can adapt and change to ‘do better’ at those lower levels. Unfortunately this can mean that the warning signs intended to give us time to react to falling levels don’t kick in until later - by which time BG levels can be worryingly close to the point where the brain simply cannot function, making more severe events including siezures and unconsciousness more of a risk.

Minimising exposure to readings below 4.0 can help to reset the ‘glucose thermostat’ so that your warning signs fire in the mid-high 3s again.

The recommendations for levels for those with T2 should really be agreed and individualised with your HCP, depending on your age, history and any risk factors. The generic ones are No lower than 4.0, 4-7 before meals, and no higher than 8.5 by 2hrs after meals.

If you are getting hypos, it might help to move to a more flexible basal:bolus insulin regime rather than a premixed insulin where you can’t adjust for meals without messing up your background dose?
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Thank you for your reply, l must say it has helped enormously in the understanding of basal/bolus regime. I had been reading all the pros and cons in recent weeks and was beginning to understand more regarding this insulin program as I can never get near 8.5 BG after two hours, its usually about four hours before the BG is normal again, hence my diabetic team changed the goal posts pre and post meal target of 7 to 11.5. I now feel that a basal/bolus insulin would better suit my needs. Thank you again.
 
I do think there is much confusion about what blood glucose level is recommended. The 4-7mmol/l before meals and no more than 8-8.5 mmol/l 2 hours after meals for Type 2, I think is when only dietary or diet and oral meds managed and as soon as insulin is in the mix then the criteria may be different as the profile of the insulin will be different to how one's own insulin works.
Your diabetic team may determine personal ranges depending on a number of things like the type of insulin, your diet, level of exercise, any other medications, your HbA1C, etc, etc.
You are right to be asking questions so you can get the right regime for you and your lifestyle.
It is tricky when what they say is out of step with what you read, but remember everybody is different and what works for one person will not necessarily work for another, hence some tweaking may be needed.
 
offspin said:
Hi , when I had my annual blood test the A1C result was 84.

I have been taking Metformin ( 2 X 500 per day ) for couple of weeks now.

I have managed to obtain a reading from my Navii machine ( I now know how to use the tester ! ) but will do a proper test at 3.00pm.

All body functions are within specification

I have not strayed of the straight and narrow since the annual test so I am hoping for a good result.
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So what is the 3pm reading going to represent?
2 hours after your lunch? if you didn't test before lunch it will not tell you if your lunch has been tolerated.
If 2 hours after lunch and the reading is below 8-8.5mmol/l than it will indicate your lunch was OK
Testing needs to be meaningful otherwise just a waste of strips.
 
Hi Leadinglights, thank you for your reply. I have wasted a many strips because it took me ages how to produce enough blood to make my machine work.

Clearly I cannot multi task !!

I am sure that my problem that I don't understand diabetes and that does frustrate me.

Once again thanks for my wake up call
 
Well @offspin - why don't you register for the Learning Zone (top of every forum page, bright orange tab) and start learning more about your diabetes?
 
offspin said:
Hi Leadinglights, thank you for your reply. I have wasted a many strips because it took me ages how to produce enough blood to make my machine work.

Clearly I cannot multi task !!

I am sure that my problem that I don't understand diabetes and that does frustrate me.

Once again thanks for my wake up call
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As mentioned, look at the Learning zone but this link also has a good explanation as well as some menu ideas. https://lowcarbfreshwell.co.uk/
 
Hi , I am male 72 years old and been type 2 for 6 years.

I purchased a Gluco Navii mmol/ L BG monitoring system.

Had a breakfast consisting of grapefruit , low gi break and scrambled eggs and decade coffee.9.00am

12.45 took my bg and level was 11 !

Any suggestions ?
 
offspin said:
Hi , I am male 72 years old and been type 2 for 6 years.

I purchased a Gluco Navii mmol/ L BG monitoring system.

Had a breakfast consisting of grapefruit , low gi break and scrambled eggs and decade coffee.9.00am

12.45 took my bg and level was 11 !

Any suggestions ?
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What was your BG before eating your meal? I'm also curious what you meant by "low gi break" - cereal? GI as I understand it is about how fast a certain amount of glucose is released from a food (weightof food to be the amount which releases a set amount of glucose), I thought it was GL (glycaemic load) that looked at both how fast the glucose in a food is released  and how much glucose a typical portion contains.

So for instance, whole grains may have a lower GI than processed grains, but still contain about the same amount of glucose once fully digested - I.e. may only delay BG peak rather than reduce it
 
offspin said:
Hi , that was the level just prior to much lunch.
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Having a pair of readings, one immediately before eating, and another 2hrs after the first mouthful can be very helpful this context. Because your reading at 12.45 is only half the story.

If you were 10.8 before breakfast, and were 11.0 2hrs after eating then you could see that your body coped brilliantly with the breakfast you had.

However if before breakfast you were 4.5, and rose to 11.0 2hrs after that would be quite a jump (‘spike’) in your levels, and you might either rethink your breakfast choices, or conclude that your liver had dumped glucose after you got out of bed to ‘fire up the burners’. Sometimes called Dawn Phenomenon or Foot on the Floor. It’s a natural part of the circadian rhythm, but can be a nuisance if you have diabetes!

Forum members who use this pair-of-readings approach generally aim for a rise of 2-3mmol/L or less after the meal.

@42istheanswer I wondered if break might have been meant to be bread?
 
everydayupsanddowns said:
Having a pair of readings, one immediately before eating, and another 2hrs after the first mouthful can be very helpful this context. Because your reading at 12.45 is only half the story.

If you were 10.8 before breakfast, and were 11.0 2hrs after eating then you could see that your body coped brilliantly with the breakfast you had.

However if before breakfast you were 4.5, and rose to 11.0 2hrs after that would be quite a jump (‘spike’) in your levels, and you might either rethink your breakfast choices, or conclude that your liver had dumped glucose after you got out of bed to ‘fire up the burners’. Sometimes called Dawn Phenomenon or Foot on the Floor. It’s a natural part of the circadian rhythm, but can be a nuisance if you have diabetes!

Forum members who use this pair-of-readings approach generally aim for a rise of 2-3mmol/L or less after the meal.

@42istheanswer I wondered if break might have been meant to be bread?
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Hi , Thank you very much for your help , very much appreciated.

As it happens the figures you quoted were very similar to my results.
 
offspin said:
Hi , Thank you very much for your help , very much appreciated.

As it happens the figures you quoted were very similar to my results.
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It is worth keeping some good records of your before and after meal readings and exactly what you ate and drank as well as the time as the same things at different times of the day can make a difference to how well they are tolerated.
Hope fully you will identify some meals which are safe but others you may need to tweak a bit.
I am pleased you have cracked getting you blood sample. I was renowned when at work for being able to get 500 microlitres of blood from a finger prick, that is 100x more than you need for your monitor.
 
Hi , Thanks for your reply. I record the test results on my Fitbit but that only records levels.

Have to find a programme that records foods.
 
offspin said:
Hi , now that's a really good idea !
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Or perhaps even better a stack of cards and a similar sized ring binder then you can file the details in a logical, thus findable, manner. I've lost my way with my notebook, too much thumbing through looking for the last time I had "that" meal and what was the outcome.
 
Have had a revised plan from my diabetic team to get my BG on a better footing with a BG target of 7 to 11 which takes my age and other health issues into account. I have been on the revised plan for just over a week and have seen my BG figures improving with no serious lows. I have been advised that I am to get a Freestyle Libre which should help keep my blood glucose in check, will keep my fingers crossed and see how it all pans out.
 
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