Not at 8:30 – although we have done that at other times. But here we were really trying to bring him down before he generated too many ketones. He took some carbs around 9:00, then again around 11:00pm.
These drops can be pretty impressive when you are in the middle of them – I was checking his track every 5 minutes…
He did. We pumped a huge amount of insulin into him (10U, I think the most we have ever injected). I was watching his drop like a hawk because I felt he could get in trouble with such a steep drop. But we wanted to make sure that he would not stay high for obvious reasons.
I’ll clarify - the discussion I was having with the doctor was around food and mismatching the insulin to carb estimate. The context was not high BG in the 400 range.From time to time, I go high to about 250 post meal. He mentioned that going up and down from 250 to 80 may not be good for the body. I’ll ask him again the next time that I see him.
I am not sure what the numbers are. Obviously, 350 to 40 is bad, but I am not sure where the steady number is better. Personally, I don’t like 160 at all. I am not sure at what point it becomes better to be steady. Is there any documentation that gives us numbers?
well, obviously if you’re steadily at 140, that corresponds to an A1C of 6.5, and that has associated health risks which are quantifiable from DCCT and other studies. If you’re at the same A1C but with more lows, then you presumably you have at least the same risk from hyperglycemia but also add the risk associated with hypoglycemia, so in that instance the swings are worse than a steady BG at 140.
I guess the underlying question is whether it’s better to tradeoff a lower A1C more more stability at a higher number, but I think that’s a little bit of a straw man in that huge variability often goes hand-in-hand with a higher average BG as well. For instance, I think it would be tough to get much lower than 6.5 with frequent swings between, say, 250 and 50, without tons and tons of lows. I know that we hit about 200 almost every day, but 250 only once a week, and my son’s A1C is probably somewhere between 6.5 and 6.3. I suspect it would be impossible to have an A1C much better than that if you’re not either spending hours low or swinging much less.
But I agree the notion that swings in BG are inherently worse than a high but steady BG comes from the “it stands to reason” logic more than anything else. There are some cell culture studies showing that exposing kidney cells to a constantly elevated BG is better for them than wildly fluctuating numbers. But the results have not been borne out in human studies really.
@Michel, the research on 180 as the threshold for damage is, also, I believe, either in animal studies or in cell culture – again, really difficult to translate to humans.