How low can one go?

[mho357]

Hello all,

My mother-in-law called yesterday morning to say that she was "going crazy" and then dropped the phone. She is 83 and in an assisted living apartment.

We called the paramedics and they tested her when they got there - her BG was 28! She was lucid - knew her address, birthday, etc.

I was shocked that she was still awake.

I'm curious - how low can one go?

We are fortunate that she called us because it might have been hours before anyone missed her. She is type 2 and taking meds (I don't know what). She did not get any kind of education with her diagnosis.

After we got her home from the ER, I went shopping and bought her some crackers, yogurt, pretzels, and a few other snacks that she can have in the evening.

M

[BlueSky]

.... We called the paramedics and they tested her when they got there - her BG was 28! She was lucid - knew her address, birthday, etc.

I was shocked that she was still awake.

I'm curious - how low can one go?....
Most T1s would pass out if they go that low, mainly because of an increased level of stress hormones caused by a fast drop in blood glucose. But if blood glucose drops slowly, the stress response isn't as strong and doesn't feel so bad. When my blood sugar drops, it is usually very slow because of the way I eat. I have seen readings of 20 on my meter and still been able to deal with the situation. Apparently brain damage occurs if blood glucose drops below 10.

As your mother does not inject insulin, her blood glucose probably dropped very slowly over a long period of time, which is why she was still coherent at such a low level. Perhaps her medication needs to be reviewed. Apparently Januvia only increases insulin levels when blood glucose is too high, which would reduce the risk of going low.

[RobiJo]

I've seen plenty of numbers in the 20's and 30's by myself and many others. In my experiences with camp and also myself...if they were already awake when they are this low, they are conscious enough to swallow juice. However, when asleep we've had difficulty to wake them and had to use glucagon. Sometimes too it depends on how quickly the bg dropped to that number.

[Wildbill]

I heard of a guy who tested during sex......I don't understand that at all......

He was around 10. I just can't understand that. I have never been that low as far as I know.

Most people are not lucid below 40.

[gettingby]

I tested once and my meter only registered LO, which is below 20.
I passed out one other time and the paramedics said my bg was 17.
The time I got the LO reading, I was able to take care of it on my own.

[kgm0612]

About 7 years ago, my brother blacked out at the wheel and plowed into another car. By the time the EMT's arrived and tested his BS, he was 11. He didn't know his name, where he was, what had just happened....nothing. He was given a shot of Glucagon and transported to the hospital. To this day, he still can't remember much about it.

Karen

[Penny]

I have had a couple of "lo"s, and several times in the 20's. I feel confused even before I test, but seem to realize I need to test, and eat or drink something. I did wake really low in the middle of the night once and if my husband hadn't been awake, I am not sure I would have been OK.

[moorejames]

The margin of error for meters is around 20%, and I'd suspect that the error margin is greater as you get to the extreme ends of the spectrum of normal BS.

So, that means a 28 might have been a 33 (or higher), but it also might have been a 22 (or lower!).

I've only registered a "low" on my meter once, and it turns out it was a bad strip, but I'm a type 2 not on insulin, so lows aren't generally even a concern of mine.

[Dervish]

The margin of error for meters is around 20%, and I'd suspect that the error margin is greater as you get to the extreme ends of the spectrum of normal BS.

Close, but not quite on the requirement... The margin of error is 20% for 100mg/dl or higher and 20mg/dl under 100. When you're at 20, that means the allowed error is 100%... So, yes, your suspicion is correct. I don't know whether there's an official relaxation of the standard for very high readings, but I've often heard that most meters become substantially less accurate above the 250-300 range.

As far as the original question, I'm still fairly new to this, but I have a friend who's been t1 basically all her life (just over 1 year old at dx) and she's been conscious and able to carry on conversations with a BGL in the teens. It's not healthy to go that low, but you can...

[BriOnH]

I have been 11 mg/dl. I dont believe todays meters go to that like cndy pointed out, think they just say lo. When i got the 11 mg/dl I was on beta blockers (they can drop your gaurd on feeling lows) and mass amounts of insulin due to being on large amounts of prednisone. It was at the doctors office in UCSF when it happened and the doctor didn't believe it so he tested it on the office meter and it came back at the same number. I often ran in the 20s-40's (1.1-2.2) back then

Hitting the low quickly (<60 mg/d [3.0]) isn't what makes it so you need help from others and could potentitally sieze and pass out; instead, I believe, its staying at a low number for a longer period of time (the lower the number the shorter the time) which uses up all are rapid sugar conversion before it kicks into gluconeogenesis(creation of new sugars from protiens). Gluceneogenesis is to slow for us as the insulin it is out weighing what glucose we can produce.

I think this is why, for me, when I was younger I would sieze at 40, but I was at 40 for 3 hours and just didn't care. While other times I could sieze at 18 and that was usually from a large downward slope that NPH provided in 1.5 hours.

To answer your question though; One can go so low you die. That's how low, you could, go. Always keep glucose on you.

[octoberlily]

Well i'm a type 1 of 35 years, but in last 15 months have been having problems with hypo unawareness, dropping to as low as 1.3 1.4 and still carrying on as normal. Last tuesday i was at my hospital having the short test for addisons, they inserted the canular while i was waiting i decided to check my B.M it was 1.9 so i informed a nurse to let my nurse know, and carried on reading my mag. Next thing pandomonium, and me sat there thinking gee whats going on. They just couldn't understand how i was sat there large as life, reading a mag with a B.M of 1.9. They did check my blood on there metre and phoned my diabetic nurse who came up to ward to see me and explain to them that at moment this is normal for me, and that i'm waiting for my pump to arrive.

Julie

Type 1 diagnosed 6.12.74