There was a time where the low alert on my CGM, or the mental indicator in brain, was set at 3.9. That was when I’d reach for some glucose tabs and do something to fix my low.
When my blood sugar was sitting in the low 4s, I’d be tempted to ride it out more often than not to see if I could avoid glucose tabs. Because honestly, does anyone really like eating glucose tabs? That strategy almost never worked, often leading to my hypo brain emptying the kitchen cupboards.
Let me say this. Lows are fatiguing. The longer I’m low, and the lower my low is, the more depleted I feel. It’s a link I’ve drawn this year, as I’ve been continuing to focus on sleeping well and feeling energised enough to get through my day. My lows definitely needed more attention than I was giving them. The attention that I can best describe with one number and one number alone.
That’s the low threshold which I have set for my CGM to alert me that my blood sugar is trending low. I’m ultimately setting myself up for more annoying alerts than what I’d like. But I can live with those extra alerts, because it’s a tactic that’s helped me massively in more promptly addressing my lows and reducing my time below target.
4.4 is like a cushion. A buffer. It buys me time to treat that low while I’m still feeling good, and technically not yet ‘below target.’
For reporting purposes, my low threshold is different to that on my CGM. In Dexcom Clarity, I’ve defined my low threshold as 3.9. That’s what I was educated with, and that’s also the consensus I’ve heard from CDE Jenny Smith on the Juicebox Podcast (which is well worth a listen).
At the end of last year, I’d typically be looking at least 4-5% below target. During rougher diabetes periods, that could even be as high as 8%. It was never something easy for me to bring down. But today, my most recent 30 days look like this.
I’ve rolled my eyes in the past at healthcare professionals and their ‘edginess’ around lows. I’ve had a plastic cup of hypo fluid thrust in front of me as soon I produce a 4.0 on the clinic meter. I still think that lows are not as scary when you actually have to live with them. But I’ve come to agree with my clinic nurses on treating them with urgency.
While I don’t treat my lows with a fear of collapsing at the forefront of my mind, I treat them for me.
Less time below target = greater energy and greater happiness.