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At what point do you typically start treating a low (assuming your blood glucose is not dropping rapidly)?
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This question is like a moving target. The true answer is, “It all depends.” I marked 85mg/dl. But, a lot depends on what I am doing at the time. Generally, I’m busy and will continue what I’m doing until there is time to take a snack. Often, I’m in the 70’s or below. However, If I am at 85, and know that my BG will continue to drop, I’ll take a small carb snack.
If it’s dropping slowly. I just shut my pump off for 15 minutes. instead of eating.
It really depends on my IOB (insulin on board), level of activity, the trend arrow from my CGM (steep or gradual) and FOB (food on board).
My endo medical staff told me when I got the cgm from Abbott, to watch the arrows on the reader. If I am home is different than being outside of my home. I treat if under 100 while driving or shopping.
I set my alert at 80 because I’m too late to properly treat at lower levels, regardless of the direction my arrow is going.
As no-one, apparently, thought of including those of us who suffer with Hypoglycaemia Unawareness [Hypoglycemia Unawareness] I opted for 59 mg/dL or below (below 3.3 mmol/L) when the truth is I rarely feel hypoglycaemic [hypoglycemic] events occurring.
Usually, the first I know about it is after I’ve been given a glucagon injection and I’m ‘coming round’. (I have a sleep disorder, called narcolepsy, where the sufferer frequently drops asleep … sometimes multiple times a day … so I often don’t hear the alarm from my pump that my blood glucose level has reached a low point.)
If it’s a slow drop then I’ll try to wait it out. The ones that usually get me are the long slow drops and there’s zero insulin on board. Of course T1d never is that simple, so many other factors affect sugars like stress, planned activity or lack of activity, and time of day
Agree.
T1D is easy. It’s like trying to accomplish a 7 – 10 split in bowling. 73 times daily.
It depends on my activity at the time, if I am exercising and plan to exercise for a longer period of time, insulin on board, how close I am to a meal and more. I am training to walk 73 miles in 24 hours- will set my low alarm at 100. Will need to be especially careful the last few hours.
One factor not mentioned in the other comments, all of which make good points about factors that influence the answer, is difference between waking hours and middle of the night. Like many older blokes, I typically get up to pee at least a couple of times during the night and check my Dexcom when I do; I’m very likely to eat something if it shows in the 90s before trying to go back to sleep, whereas during the day I would never do that — I answered 75 – 80 as a rough estimate of the average, recognizing all those other factors that influence reality.
As others have responded, it’s situation dependant. If I’m driving, I snack at 85. I usually carry a 30g cracker pack everywhere with me. If I’m sitting at the computer, reading a book or watching TV, I let go to 70. At night when the nagometer goes off I do it at first alarm or it will wake me again. 😔
During the day, if the arrow is straight across, I’m more likely to suspend pump action for a while. Anything over 65 tends to bump up enough to get me to the next meal. (unless I’m going to drive, then it’s time for a tiny taste of Nutella on a cracker to bump me back towards 100)
That’s tough one to answer due to the foods that I might have eaten before this episode occurs. Typically though I would respond if it hit the 4.1 to 3.9 area.
I let control iQ take care of most slow drops. Fast drops I have to intervene with glucose or food. But if it drops blow 70 I take care of things myself. I also have to see what iOB because that is a key factor of whether I might act sooner like even at above 100 or above. So many variables. Am I exercising? Or even just walking? Am I driving? I will act more quickly at higher numbers. I am always checking and assessing but in most situations I will let Control IQ do its job, if it is a slow drop and no IOB and I’m not exercising.
It depends. Am I about to leave the house or vacuum? Do I have a cat on my lap?
Yes, it all depends of the situation. I use Control IQ during the night and it takes care that I don’t go low, but I turn Control IQ
off during the day. So during the day, I consider all the things people mentioned above. Sometimes depending on what I ate, on IOB, exercise, or driving I might even turn off the pump for 15 minutes or so to avoid a low.
Trick question. If I’m exercising, I may start at 130 depending on how much longer I’ll be on my bike, at night I’ll treat below 80, during the day I’ll treat below 75. If I’m depending on my CGM, it could say 75 and finger stick could be 54. Also depends on iob and meal time. So really, like all things diabetes, it’s a crap shoot.
Agree. It is very situational. In addition to exercise I may correct at a higher bg if I have a lot of IOB
Every comment so far is ditto for me.
I ditto your ditto. 🙂
It is situation dependent and
time of day dependent.
Anything below 5 mmol/L, I would ‘treat’ – not necessarily with the typically suggested 15 mg Carbs – It all depends on what I’m doing at the time… but if, as your question suggests, the blood glucose is still dropping, even if not ‘rapidly’, if not treated it could become a problem if left unattended.
Also agree with all the circumstantial comments below (when I’m being a responsible, proactive T1D). Often on the middle of the night or when I’m busy at work (desk job) I hold off on treating until 59 mg/dl or below… Hoping the control IQ will kick in so I don’t have to get up or stop what I’m doing. Admittedly not the best strategy.
I have both my Dex and Tandem Smart IQ set at 90mg/dl. Most of my body sites are used up after 55 years, 39 of which has been on a Pump. So, after every site change it’s a Crapp-Shoot This may sound funny, but once in a while I hit a relative unused site, then all hell breaks loose. The Tandem X2 Smart-IQ does not any way, except using the Activity selection to set a long-term lower Temporary Basel.