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October 1, 2001


Question from Magnolia, Mississippi, USA:

How low is too low for someone with type�1 diabetes?


Less than 4 mmol/L [72 mg/dl].

Additional comments from Dr. David Schwartz:
A normal blood glucose is between 60 and 125 mg/dL. Your Diabetes Team has likely given you a target glucose range, to allow some “cushion” to fall back and allow some wiggle room on days the glucose may be a little low. I think you have to be practical about your management. I would love my patients to have glucose readings in the normal range as often as possible. A blood glucose of 60 mg/dL just before lunch or dinner would not bother me nearly as much as that same value upon awakening or last thing before bed.


[Editor’s comment: As Drs. Robertson and Schwartz indicate, some physicians use very clear guidelines, but also there are some very personalized ones. Another example — during pregnancy, the cutoff value would probably be different for a woman with type�1 diabetes than when non-pregnant.

It’s probably safe to conclude that the decision of how low is too low should be decided by the patient in conjunction with his/her diabetes doctor.