If you keep your levels lower, you won't. That requires heavy monitoring, which they now have continuous monitors that are $75 a month. That means you can see when you go about 200 and get a unit of fast acting to counter act that. For someone like me that was 300 while fasting and in ketosis (hence they dubbed me type 1 since I was not ill) this is a life saver. Used with my Freestyle Libre 2, my averages are below 180. I have even gone too low before for the first time in decades. After going through all my files, they said I had diabetes since I was a child that was completely untreated. To be truthful it's a miracle I haven't lost a foot or eyes yet. So this is giving me another 10 or 20 years, I would never have with my children. For that I am thankful. I was supposed to be on Lantus, but that is a no-go. My insurer does not pay for that and I don't have 1k per month for it. Some of it is down to exercise too. I had no feeling in my right foot...none and could barely use it. I started the insulin in August and started exercising. I am getting feeling back in my foot and I can use it better now. My doc said I might regain most of that function and feeling since I am young enough.