Yes. No. Maybe. Well, let me see. Yes, that one little question gets that many answers at once. That question, Is that a good number? is so irrelevant if there is no other information given.
80 is a great number upon waking up. 80 is not so great 1 hour after eating with over 3 units of insulin on board. 80 is not so great for a little one sound asleep at night with a plus/minus standard deviation allowed on meters and on basal rates. Our basal rate deviation that is acceptable to our endo is plus/minus 30 points. A basal rate is set right if my son does not go over 30 points from our starting number or below 30 from our starting numbers. So an 80 in the middle of the night could possibly go to 50 and still be in good basal range but in dangerous blood glucose range. That same 80 in the middle of the night could possibly got to 110 and still be in good basal range and an even healthy blood glucose range. That’s where the maybe comes in. And that’s where the tired mama comes in too.
I get stuck in the middle of the night if I see a number like 80. Do I treat it as a low? Or go back to bed and hope for the best? I never hope for the best, the real plan of action is I will continue to test my son every 1/2 hour while he sleeps to see where that number is going. But if I did decide to treat that 80 with some carbs, and if it were going up to 110 on it’s own, then my adding extra carbs could land us in the 190 range, which is a not a good number for waking up.
Now let’s talk about that 190. Diabetes experts, the ones that get paid, unlike the mom experts that I confer with on a daily basis, say that a good number for 2 hours after eating is 50 points higher than where you started. So if my son started his meal at 140 and I check him at the 2 hour point and I got a 190 then I would be thrilled. 190 2 hours after eating with about 1.5 hours of insulin left to work should give us a nice smooth landing into our decent blood glucose range by the next check.
Ah, 190 at night. Another one that gets a maybe. 190 is a bit high UNLESS my son was very active during the day and I know he is going to have a delayed drop from the previous day. Sometimes it takes 12 hours for a low to hit after an extremely active day. And yet again, another night where I check a couple more times every 1/2 hour to determine what is going on. Sticking at 190 overnight requires a correction (insulin), but dropping means it is okay for me to head back to bed. Unless of course it’s a big drop like 190 to 100 in 1/2 hour. A drop like that is NEVER good.
300, 400, 500, HI, 50, 40, 30, 20, and LO are NEVER good numbers. It’s those numbers in between from say 80 to 190, all 110 of them that leave me wondering if it indeed is a good number.
I wish there was something more concrete to this disease that weighs like a ton of bricks on my heart.
Our new endo puts 80 at the bottom range of normal (range is now 80-150- our range with the old endo was 70-150)- so I treat that as a low in need of a sip or two of juice at night..That’s because there is a plus minus 20 points error rate with the bg monitors, but MOSTLY because the endo told us that when they are going low they can drop fast. He rarely has lows and he really feels his lows. Thank goodness for that. Lately his tendency is to go down at night so I need a good snack and number buffer at bedtime. But we have had months of the opposite, where the tendency was to be around 200 at night, also annoying. His day numbers are great, but it is the tightwalk of night that never seems to end. I am doing great today- I had not one but TWO periods of three hours of sleep!!!! Woohoooo! Unreal! I needed that because too many of those crazy nights where you are checking every hour or two and you start to feel as if you are just going to drop from exhaustion. One thing I have been doing at night is giving a juice box slurp (not the whole 15 carb box, just a schlurp thru the straw, which he does in his sleep) if he is 80-100, which I know seems crazy but it has been working great- it does not send him up much at all, maybe 30 points tops if he was not dropping- and he he was dropping a bit it keeps him pretty much the same.
Thanks Leslie for taking the time and thought to give everyone, especially this social worker, more insight into a Mother’s world of diabetes.
Carol Porter
SO true!- had a 3am 87 the other night, totally mystified me- ended up overcorrecting and he woke up at 220 something. Do I just temp basal?- how long? do I treat? do I let it ride. So hard when seriously, the kid has no patterns to even go by. Totally a guess, maybe that’s where a CGM would come in handy-if I trusted it. Anyways, great post once again!
Thanks Jessica!!
Awesome Leslie! Totally know what you mean about the 80!!!