Being low frequently

[shoop99]

Ok so i know constant high blood sugar can lead to several complications. But being low about 2 or 3 times a day going to have complications as well. I am usually around low 70s and mid 60s at least 2 or 3 times a day. Could this lead to any problems like high blood sugar leads too?

[KickStart101]

As long as you correct those 60's and 70's quickly they should not
cause you a problem. Have a few protein snacks during the day, that
should stablize your sugar level.

[KickStart101]

Oh by the way Shoop, I thought I would mention that I was severely
overdosed in Hospital for R & R for RA in 1990, which has nothing to do
with normal day life.

She was a newer young Nurse, she checked my sugar 1.5/24(I was unconscious),
gave me my full daily doses of Insulin. My Spirit left my body, I was sent back since
it was not my time but I lost alot of memories.
I did through the early year learn alot of my memories back from Family and Friends
which I am so greatful for. Be guarded in Hospitals. ;)

[KickStart101]

Ok so i know constant high blood sugar can lead to several complications. But being low about 2 or 3 times a day going to have complications as well. I am usually around low 70s and mid 60s at least 2 or 3 times a day. Could this lead to any problems like high blood sugar leads too?

60's and 70's are okay as long as you are aware of those blood sugars and correct. Do not be letting your sugars go lower or you will end up in an Insulin Reaction(assuming you are a Type 1). Too low of sugar will cause brain cell damage or brain cell loss.

Evdiently we have millions of brain cells that are never used. But is it the unused brain cells that are damaged and destroyed or the brain cells we actually are using??

I think an Insulin Reaction also badly effects the eyes, although they may recover
with good blood sugars.

[DeusXM]

Low blood sugar won't really lead to complications in the same way as high blood sugar. However in the short term they can really mess you up - they're far more dangerous that high blood sugars. High blood sugar will kill you in years, low blood sugar will kill you in minutes. If you're running that low frequently then you need to change your treatment plan.

[mark-TN]

Low blood sugar won't really lead to complications in the same way as high blood sugar. However in the short term they can really mess you up - they're far more dangerous that high blood sugars. High blood sugar will kill you in years, low blood sugar will kill you in minutes. If you're running that low frequently then you need to change your treatment plan.
I wholeheartedly agree with this statement.


You do not want to be flirting with uncorrected low blood sugars and any pattern of low blood sugars should be addressed with an immediate change to help avoid them.

The following from the latest ADA Scientific Session addresses your concern about lows and long term complications affecting the brain very well.

ADA: Cognitive Function Preserved with Tight Glucose Control
on Tuesday, June 20 @ 11:47:13 CDT

Researchers reported that concerns that hypoglycemia from tight glucose control could lead to impaired cognitive function can be laid to rest.

In a long-term follow-up of more than 1,000 patients with type 1 diabetes who were part of the cohort of the landmark Diabetes Control and Complications Trial (DCCT), investigators found no changes over time in any of eight cognitive domains that had been monitored.
"Now we know that patients don't have to worry about damaging their mental abilities as they work to significantly decrease their risks of developing diabetic retinopathy, neuropathy, nephropathy, and cardiovascular disease," reported Alan M. Jacobson, M.D., of the Joslin Diabetes Center in Boston at the American Diabetes Association meeting.
The DCCT, which ended in 1993, followed patients with type 1 diabetes for a decade, ending in 1993. The trial conclusively demonstrated the benefits of tight glucose control for preventing diabetes-associated complications.
In that trial, patients who managed to maintain glucose at a near-normal physiologic level had a threefold risk for severe hypoglycemia, leading to fears that frequent episodes of hypoglycemia and its attendant consequences (confusion, irrational behavior, convulsions, and loss of consciousness) could have a deleterious effect on cognitive function as patients aged.
In the current study, which is part of the DCCT follow-up called Epidemiology of Diabetes Interventions and Complications Study (EDIC), investigators looked at data on 1,059 of the participants in the DCCT, or about 75% of the original cohort.
Of these patients, 537 received intensive insulin therapy with either an insulin pump or three or more daily insulin injections, while 522 continued with what was at the time conventional therapy of one or two insulin shots per day.
During the DCCT the patients were evaluated with a battery of neuropsychological tests looking at cognitive abilities in eight domains, including problem solving, learning, short-term memory, delayed recall, spatial information, attention, psychomotor efficiency and psychomotor speed.
The authors used a stricter definition of hypoglycemic event, limiting it to episodes of diabetic coma or seizure, In the original trial the definition included any event that required the assistance of another person. During the 6.5 year follow-up period of the current study, 652 patients reported no hypoglycemic events resulting in coma or seizure, 348 reported having one to five events, and 59 patients reported having more than five events.
When the patients were followed with the same neuropsychological tests for the current study, the researchers saw no change in regard to hypoglycemia over baseline in any of the eight domains after adjusting for age, gender, years of education, length of followup and number of cognitive tests taken. The findings were true for patients in both the intensive and conventional glucose control groups.
When they looked at HbA1c levels, however, they found that higher levels (indicating less-tight glucose control) were associated with modest declines in motor speed and psychomotor efficiency in the conventional treatment group, but not significant changes in any of the other domains, and that there was a significant difference in this measure favoring the intensive glucose control group. The overall findings should be reassuring to patients who are zealous about controlling their blood glucose levels, Dr. Jacobson said.
"While acute episodes of hypoglycemia can impair thinking and can even be life-threatening, patients with type 1 diabetes do not have to worry that such episodes will impair their long-term abilities to perceive, reason, and remember," he said.
Office Pearls: Explain to patients that tight glucose control with frequent daily monitoring of blood glucose levels and adjustment of insulin doses accordingly can significantly reduce the risk of type 1 diabetes complications, and that episodes of hypoglycemia do not appear to harm thought or reasoning processes.
This study was published as an abstract and presented orally at a conference. These data and conclusions should be considered to be preliminary as they have not yet been reviewed and published in a peer-reviewed publication.
2006 American Diabetes Association Scientific Sessions: Jacobson AM et al. "Effects of Intensive and Conventional Treatment on Cognitive Function Twelve Years After the Completion of the Diabetes Control and Complications Trial."

[mark-TN]

You do not want to be flirting with uncorrected low blood sugars and any pattern of low blood sugars should be addressed with an immediate change to help avoid them. I now have a certain Molly Hatchet song that will be in my head the rest of the day. Take a guess before you click this link (http://www.mollyhatchet.com/) to the song.

Mark

[Cinnabon]

A hypo left intreated is not good. A recent research found this...


Hypoglycemic Episodes Won't Damage Brain
MONDAY, June 12 (HealthDay News) -- Although diabetics who keep their blood glucose levels at the normal level reduce their risk of complications, they may also increase their chances of experiencing hypoglycemia, or dangerously low blood sugar, a new U.S. study says.

But another new study presented at the American Diabetes Association's annual meeting, in Washington, D.C., showed that episodes of severe low blood sugar do not impair brain function or cause decreased cognitive function in type 1 diabetics.

"This study provides further support for the safety of intensive diabetes therapy and the benefits of maintaining good glycemic control," lead researcher Dr. Alan M. Jacobson, head of the Joslin Diabetes Center's Behavioral and Mental Health Research Section and psychiatry professor at Harvard Medical School, said in a prepared statement.

"While acute episodes of hypoglycemia can impair thinking and can even be life-threatening, patients with type 1 diabetes do not have to worry that such episodes will impair their long-term abilities to perceive, reason and remember," Jacobson said.

Patient data came from several trials, and insulin therapies varied between insulin pump injections, manual injections three or more times a day, or one to two daily manual injections. Researchers analyzed the patients' abilities in several areas: problem solving, learning, short- and long-term memory, spatial information, attention span, and motor skills. After adjusting for a number of factors, blood sugar control was compared to level of competency in these areas.

Diabetics with higher A1Cs -- meaning that they had less tightly controlled blood sugar levels -- experienced moderate declines in motor skills, but not in any other capacities.

"This is very good news for patients with type 1diabetes," said Jacobson. "Severe hypoglycemia can still be a very dangerous condition. But with proper education, self-care and close medical follow-up, the risk of severe hypoglycemia can be lessened. Now we know that patients don't have to worry about damaging their mental abilities as they work to significantly decrease their risks of developing diabetic retinopathy, neuropathy, nephropathy and cardiovascular disease."

[poodlebone]

Ok so i know constant high blood sugar can lead to several complications. But being low about 2 or 3 times a day going to have complications as well. I am usually around low 70s and mid 60s at least 2 or 3 times a day. Could this lead to any problems like high blood sugar leads too?

Before I started pumping I was having multiple lows every day, and not 60's/70's. More like 30's + 40's. They made my life horrible all the time but I don't think I've done any long term damage to myself.

Also, 60's + 70's are normal BGs for non-diabetics so while it may not be good for a Type 1 (only because you can drop even lower), those numbers shouldn't be doing anything to you in the long run. As long as you treat it so you don't drop any more you should be fine.

[shoop99]

thank you guys for your responses.

[KickStart101]

It would be Great if they get this PARP inhibitor drug fully tested,
FDA passed(if safe)and available to Hospitals and Diabetics in their
homes. Of course, it wouldn't be of much value to a person who
is at home alone and unable to give the (I assume it would be an
injection)shot to themselves.



Drugs Prevent Rat Brain Cell Damage after Insulin Shock
In a study in rats, scientists have determined that drugs that block the action of a group of DNA-repair enzymes can protect brain cells from damage triggered by an overdose of insulin.
If these drugs are shown to produce the same effect in humans, they could become the first tool available for prevention of brain damage that can result from hypoglycemic shock, also known as insulin shock, in patients with diabetes.
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The study was conducted by scientists at the San Francisco Veterans Affairs Medical Center (SFVAMC) and appears in the November 19 issue of the Journal of Neuroscience.
The drugs, PARP inhibitors, have already been shown to protect human heart and brain cells from damage following heart attack and stroke, and are currently approved for testing in phase-2 clinical trials for victims of heart attack.
"Every hospital emergency department sees one or more cases of hypoglycemic coma each year," says Raymond Swanson, MD, chief of the neurology service at SFVAMC and a professor in the Department of Neurology at UCSF. "Up to this point, we don't have any way to treat these patients except to give them glucose, which pulls them out of insulin shock, but doesn't do anything to stop the cell death process that is triggered by severe hypoglycemia. PARP inhibitors rescue neurons [brain cells] which would otherwise go on to die even though blood glucose is restored."
About five to six million people in the United States take insulin to control diabetes, a chronic disease characterized by the body's impaired use or diminished production of insulin, a hormone produced in the pancreas that regulates glucose (sugar) levels in the blood.
Diabetes patients monitor their blood sugar, often several times a day, and inject themselves with insulin to maintain appropriate blood sugar levels. However, calculating the correct dose of insulin can be difficult: The body's requirement changes depending on the content and quantity of food consumed, exercise, alcohol consumption and other factors. If insulin levels are too high, blood sugar can drop to dangerously low levels, producing hypoglycemia, which causes symptoms such as confusion, anxiety, shakiness, dizziness and difficulty speaking.
Diabetes patients can normally detect the onset of hypoglycemia and control it by eating small, sugar-laden snacks. But if not treated promptly, hypoglycemia can rapidly worsen, depriving the brain of needed glucose. When this happens, a person may experience seizures or lapse into a coma. This is the stage of hypoglycemia known as hypoglycemic shock or coma, or insulin shock, and when it occurs, a biochemical chain reaction is initiated that ends with the destruction of neurons, particularly in the hippocampus, a region of the brain instrumental in processing memories. Permanent memory impairment is a common and serious complication of severe hypoglycemic shock.
Intravenous injections of glucose can reverse insulin shock and rescue a patient, but they cannot prevent brain injury that already may have been initiated. The destructive biochemical pathway triggered by insulin shock shares some similarities to pathways that damage heart and brain cells as a result of heart attack and stroke.
From his previous work and that of other investigators, Swanson knew that PARP inhibitors -- which block the action of PARP, an enzyme that floods cell nuclei when DNA is damaged -- can inhibit these destructive pathways. To test whether they can also protect brain cells from insulin shock, he and his team examined the effects of the drugs in brain cell cultures derived from mice, as well as on rats subjected to induced hypoglycemic coma.
In the cell culture test, two sets of brain cells underwent five hours of complete glucose deprivation. One set had PARP inhibitors mixed into the culture at the start of the period of glucose deprivation; the other set did not receive the drug. Twenty-four hours later, only about 10 percent of the brain cells in the drug-free culture were still alive, while about 50 percent of brain cells survived in the culture with added PARP inhibitors.
For the rat tests, Swanson and his colleagues devised several scenarios that simulate the kinds of circumstances that might occur when a person goes into hypoglycemic shock.
In one experiment, rats were held in hypoglycemic comas for 30 minutes before being rescued by glucose injections. Some of these rats, the control group, did not receive PARP inhibitors following the glucose injections, while some rats received immediate injections of PARP inhibitors, and others received injections one, two, or three hours later.
Compared to controls, rats that immediately received PARP inhibitors experienced 85 to 90 percent reductions in brain cell death. Rats that received the drug one hour after the end of glucose deprivation experienced about 70 percent reduction in cell damage, and rats that received the drug two hours afterwards experienced about 50 percent reduction in cell damage. Rats that received PARP inhibitors three hours after the end of glucose deprivation experienced minimal reductions in cell damage.
Six weeks after these tests, rats that had been immediately treated with PARP inhibitors were able to complete memory and learning tests just as well as rats that had not been subjected to hypoglycemia, while rats in the control group (those that had not received PARP inhibitors following hypoglycemic coma) fared poorly in the tests. Neither the control group nor the PARP-treated group had impaired motor abilities, a confirmation that damage from hypoglycemic coma is primarily restricted to the brain's memory processing centers. (Swanson's team did not conduct these behavioral tests on the groups of rats that had received PARP inhibitors one, two or three hours after glucose rescue.)
In another experiment, Swanson extended the duration of hypoglycemic coma to 45 minutes. In rats that did not receive PARP inhibitors following the reversal of coma, about 70 percent of cells in two regions of the hippocampus died. But in rats that immediately received the inhibitors following the reversal of coma, brain cell death was reduced by about 85 percent in one of these regions, and 35 percent in the other.
"I was surprised by what a large effect we found," Swanson says. "There are already studies that have proved PARP inhibitor's efficacy in reducing cell death in heart attack and stroke, but what was most exciting here was that we saw large effects even when we delayed administration of PARP inhibitors up to two hours after reversal of hypoglycemia. This is the kind of time situation that can occur in real life."
Before PARP inhibitors can be used in practice they must first be tested in a clinical trial, but, says, Swanson, this won't be easy. Each hospital in the country treats only a few insulin shock patients each year, so a prospective clinical study would likely require participation by dozens of sites. "I'm very enthusiastic about the clinical potential of this approach and have begun discussions with the Juvenile Diabetes Research Foundation about possible ways to get this organized. Our study shows that it is possible to rescue neurons that would otherwise go on to die after severe hypoglycemia, and I think it is important to translate this approach to clinical practice as rapidly as possible."
Co-authors of the study are: lead author Sang Won Suh, MD, PhD, research fellow; Koji Aoyama, MD, PhD, research fellow; Philippe Garnier, PhD, research fellow; and Yongmei Chen, MD, PhD, research fellow, all with Neurology Service, SFVAMC and the Department of Neurology, UCSF; Elizabeth Gum, MS, research associate with Neurology Service, SFVAMC; and Yasuhiko Matsumori, MD, visiting postdoctoral scholar, and Jialing Liu, PhD, adjunct professor, both with Neurosurgery Service, SFVAMC and the Department of Neurosurgery, UCSF. The study was supported by the Juvenile Diabetes Research Foundation, the National Institutes of Health, and the Department of Veterans Affairs.

Source: Liese Greensfelder
http://www.jneurosci.org/

[sbuff28@charter]

Before I started pumping I was having multiple lows every day, and not 60's/70's. More like 30's + 40's. They made my life horrible all the time but I don't think I've done any long term damage to myself.

Also, 60's + 70's are normal BGs for non-diabetics so while it may not be good for a Type 1 (only because you can drop even lower), those numbers shouldn't be doing anything to you in the long run. As long as you treat it so you don't drop any more you should be fine.


My sister runs 60s-70s pre-meal ALL the time. She's Is not a diabetic. Shes really healthy and doing just fine. IT makes me wonder if running in the 70s aint all that bad. (or mabye even the occational 60s). Now i aim for 80 pre meal, its really hard for me to go hypo since im only on a 10 unit TDD. The lowest i've been this month is 68. (after playing soccer for 2 hours)

[poodlebone]

My sister runs 60s-70s pre-meal ALL the time. She's Is not a diabetic. Shes really healthy and doing just fine. IT makes me wonder if running in the 70s aint all that bad. (or mabye even the occational 60s). Now i aim for 80 pre meal, its really hard for me to go hypo since im only on a 10 unit TDD. The lowest i've been this month is 68. (after playing soccer for 2 hours)

In the past, when I've tested non-diabetics their numbers were always low. Several months ago I went to a class given by people from Minimed. One of the reps was wearing the Guardian real time system. She is not diabetic and was wearing it because she needs to know how it works, what it feels like etc in order to answer customers' questions. She passed around the monitor part that holds the readings. Scrolling through I saw almost all of the readings were 50's-70's. Some 40's even. Now, I doubt her BG was really 48 at any time, it just seems like the system reads lower than it should. The highest I ever tested a non-diabetic was at 98, within an hour after he ate.

The reason why we aren't encourage to have a target BG of 70 is because it is easy to drop even lower. Even with a small TDD you can still have lows, although it sounds like you're doing great.

[sbuff28@charter]

i also think that along with a diet. Running in the 70s is good for weight loss. I figure because there is a below average amount of carb energy, so wouldn't your body try and use fat stores also.


i think it makes sense. what do you guys think

[vvti-le]

I now have a certain Molly Hatchet song that will be in my head the rest of the day. Take a guess before you click this link (http://www.mollyhatchet.com/) to the song.

Mark
Speaking of Molly Hatchet, they were here last week for the Fourth of July celebration at Bayfest Hawaii 2006. Danny Joe Brown original singer of Molly Hatchet was a diabetic and passed on last year.