What levels are hyper?

[spence]

Hi guys. I know a hypo is below 6 mmol but what levels are hyper? Or does it depend on the individual.? Sorry I am new to all this. Still trying to figure it all out. Regards spence.

 

[Bruce Stephens]

Hi guys. I know a hypo is below 6 mmol but what levels are hyper? Or does it depend on the individual.? Sorry I am new to all this. Still trying to figure it all out.

Actually a hypo is more usually below 4, I think. (Though I think there's also some support for below 3.5 if I remember correctly.)

In range is between 4 and 10, so above 10.0 seems like a reasonable condition for being hyper. (Except for some categories of people who are advised to keep a tighter control.)

(The idea is that as an addition to considering HbA1c, it's also helpful to consider how much of the time we spend "in range" and how much below and above. And there the usual target is >70% in range, <5% below. Though the targets are tighter for some groups of people. This is probably practically useful only for people with continuous monitoring of some sort, obviously.)

 

[rebrascora]

I think it is all a bit open to interpretation, so whilst hypo is generally considered below 4 for those of us on insulin and gliclazide, this is more for the purposes of treating it and maintaining our hypo awareness rather than it actually risking causing any damage in the mid to high 3s.
Many non diabetic people or even diabetics who are not on those medications, can drop below 4 but not be considered hypo because they will not drop dangerously low as their liver will release glucose to bring them up again. It is only when too much insulin is in the system that levels can plummet quickly before the liver can deliver enough glucose to counteract it and we risk going so low that our system starts to shut down to conserve the remaining glucose for essential functions.... ie heart, lungs and brain.

Like Bruce, I consider above 10 to be hyper and need correcting unless I know that there is still active insulin in my system which will bring it down.

 

[Inka]

Hi guys. I know a hypo is below 6 mmol but what levels are hyper? Or does it depend on the individual.? Sorry I am new to all this. Still trying to figure it all out. Regards spence.

There’s no fixed number but I’d say somewhere around the 13-15 mark when ketones might appear. Are you having issues with high sugars @spence ? Don’t worry about moderate highs. You’re very newly diagnosed. Do you have Ketostix?

 

[everydayupsanddowns]

In an ideal world your clinic would give you an individualised set of target ranges based on your particular circumstances.

The general suggestions are:

5-7 before breakfast
4-7 before other meals
no higher than 9 by 2hrs after meals

But it’s important also to recognise the International Consensus on Time in Range (from continuous sensors) which sets 4-10 as its range and suggests you can have approx 25% of time above 10 and still have an on-target HbA1c.

So there’s no need to aim to avoid elevated BGs at any cost. Better to aim for as consistent and stable BGs as you can manage for as much of the time as you are able, and try not to overreact to any wobbles 🙂