What’s your freak out number?

I checked my blood sugar in front of a coworker a few weeks ago after an especially heavy meal. The number 265mg/dL glowed from the screen, and her eyes locked on it. A concerned look fell over her face.

“That’s pretty high, right?” she asked

“Yes it is, that was a lot of food,” I replied. “I’ll bolus more now to bring it down.”

“Oh ok. That makes me worry when it’s that high” she said, still concerned.

“It doesn’t make me worry,” I said with a smile. “265 I can handle. It’s up in the 300s that I start to get a little worried.”

She smiled and said ok, but it got me thinking: What does actually get me worried?

We all have different thresholds of highs and lows that cause concern or anxiety. Some folks are perfectly fine at 75mg/dL, while for others that’s a panic-inducing number. Likewise, if I’m in the upper 200s, especially post-meal, I might be annoyed, but probably not worried. It takes rapidly-rising numbers in the high 300s before I start to freak out a little bit. And our personal thresholds are a completely separate entity from what everyone else THINKS the number should be. That, as we all know, is one of the great annoyances of living with Type 1 – people think we’re actually between 80 and 120¬†all the time, just like the guidebooks say (side note: HA! 80-120? I’d love to be in that range all the time). When we’re not, they panic or assume we’re doing something wrong.

High and low ranges are extremely personal for everyone. As I mentioned, I don’t hit the panic button until I get into the high 300s. Even then, if I know the high can be easily explained, I don’t freak out that much. I know I can bolus and get it down. It’s only when I have a high due to a malfunction or another mystery that I tend to worry. And when I get low, something about being in the 40s really gets my panic mode going. 50 is ok, but 49 makes an alarm go off in my head that says “SUGAR NOW YOU ARE REALLY FREAKING LOW.” But just because those are the numbers that set me off doesn’t mean other people have similar panic points.

What are your freak out numbers? Do the people in your life know these thresholds, or do most get concerned outside of the 80-120mg/dL range?

 

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Comments

Great topic!
On the high end, I think numbers in the 200s (actually, 190-290) tend to upset me, and numbers in the 300s (actually 290 and up) put me in “freak-out” mode. In the 200 range, I have to resist the urge to correct even if I have enough insulin on board, and in the 300s I’ll rage-bolus no mater what, and treat the low later. 300s also have me questioning what went wrong.

On the low end, there was a time in my life when I used to target numbers in the 75-85 range. I had a lot of lows during that time, some severe. Now, I’m a bit uncomfortable with anything under 100, even though I know a 95 is perfectly acceptable (I see a 95 and wonder “how did I get here, and where am I going next?)

Related story: I work in a laboratory (I get to see everyone’s A1c’s!), and so my co-workers know what glucose levels are ok and what aren’t… for a “normal” person (w/o D). My friend saw a 160 on my glucometer an hour after a potluck dinner. I was pretty proud considering it was all super-carby, cooked at home, SWAG Christmas foods. She was freaking out like my kidneys were about to pop off and I was going to go blind that very second. :)

Freak-out mode for me starts around 300. Like Scott, I start rage bolusing and hope I don’t go low later. Not very logical… but definitely emotionally driven.

On the low side, I get nervous below 55 and freak out in the 40s too. In 17 years, I’ve been lucky never to have had a low that required assistance, and I’d like to keep it that way.

I have to admit that I’m a little…odd?…weird?…unusual????

I don’t ever freak out or panic if I’m too high or too low. I start to feel bad in the mid 200s and I’ll bolus. After 45 minutes to an hour I’ll check again and if I haven’t dropped I’ll rage bolus (seriously, if I go from 250 to 275 an hour after bolusing 4 units I’ll probably bolus 10 units – I figure I’m going to be checking my BG every 30 minutes or so anyway so if I start to precipitously drop I can snack to keep my BG up and if I don’t precipitously drop I know there’s something wrong with the pump I’m wearing and I’ll change it ASAP). If I’m still hovering or climbing after my rage bolus it’s back to the insulin pen I go – as you pointed out in an earlier post they NEVER fail. But all of this bolusing and checking is done in my normal matter-of-fact manner. If worrying about it or getting upset about it isn’t going to do any good then why should I bother? Why not just try and focus my efforts on doing what I can to prevent it from happening again.

As for lows, as long as I can think straight I’ll 1) get some fast acting carbs in my and then 2) try and figuring out what, if anything, I did wrong to bring on the low. I woke up at 5:00 AM this morning and thought something felt off…so I tested – 38. Not fun but I ate 35 grams of carbs worth of dark chocolate covered blueberries (hey, when you’re 38 and looking at glucose tabs or chocolate covered blueberries there’s a certain appeal to the blueberries). I woke up a couple hours later perfectly happy with my BG of 77. As for what brought about the low? The most likely candidate was a recent drop in steroids used to treat my OTHER chronic endocrine disease, primary adrenal insufficiency. Lesson learned – drop nighttime basal and see how things settle out.

I guess my point is we’re all different and we all think and react differently. What’s important is to honestly try and do your best to manage this disease and live as healthy as possible for as long as possible. If freaking out and worrying helps you deal, or if it’s just part of who you are and you can’t/don’t want to change then accept yourself for who you are and try and live life to the best of your ability!

These are fascinating responses you guys! Agree with John that freaking out doesn’t really do any good, but sometimes we all do it anyways! And I think it’s interesting that all of us get annoyed when we’re out of range – freak out is different than just plain annoyed. And Lauren, I feel like what heppened with your 160mg/dL after a carby meal happens ALL THE TIME! You’re super proud of the number considering the meal you just bolused for, but to someone else that’s a cause for concern – kinda rains on the parade! Thanks for these comments guys, really interesting and as usual with diabetes – highly indivisualistic!

My “freak out” threshhold is probably lower than most (minor freak out in the 160s and major ones starting in the 170s) and my low levels are bad in the 40s but don’t reach freak out until I hit the 30s. It is hard to balance and figure out what is an appropriate level to worry for your body – something I still struggle with.

Before pump I would start feeling ill around 18mmol/L(320′s), but now since the pump I start feeling it around 13mmol/L(230′s). I’m just never there any more. If I see 18 now I am overriding and dealing with the extra insulin later with something good.

Low’s it depends on the time. Need to get me a CGM, so that if I am around 4.5-5mmol/L(80′s) at bed I know which way I am going, up or down.

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