TIR or Hba1c?

[Marie 2]

@s10042

I prebolus so that I have some insulin working for when I am actually eating. People that have used Fiasp have had varied results, I know one person that when they haven't used it for a while it works fast and great but as soon as they constantly use it they have to increases their dosing and it just stops working well.

Hopefully Apidra is working better for you. If it is still taking 3 hours for insulin to work, you also probably have insulin resistance. and will want your question moved so people can help you better.

It probably will get more attention if you started a thread with your question. One of the moderators can move it if you want?
@Antje77 or @Diakat ???? If this doesn't answer your question then you might request your question be moved.

 

[Marie 2]

@Glucobabu It honestly comes down to a matter of timing for me and alerts on my Dexcom to let me know what's going on so I can act on it before it's an issue. Plus a pump to respond with small adjustments as needed easily. You can get a Miao Miao to add to your Libre for alerts. Alerts are very helpful!

 

[bsinatra]

I am new to this, Could somebody please advise how I measure my TIR.

 

[Antje77]

I am new to this, Could somebody please advise how I measure my TIR.

You can only see it when you use a continuous glucose monitor (CGM) or Freestyle Libre. If you use finger pricks you cannot know what your time in range is because you won't be measuring all the time.
Those devices are usually used by people with T1 diabetes on insulin. You can fill out your profile to state type of diabetes and diabetes medications, it's very useful because answers to your questions may vary depending on that.

 

[Marie 2]

TIR. Experts think we all should be between 75-180. Some of us have stricter numbers than that . Mine is 65-160 or 65-140.

When you wear a CGM, a continuous glucose monitor it tells you your numbers 24/7 . So a 90% TIR would mean that 90% of the time you stay within those numbers. It’s a more accurate number. In some respects because while an A1C is an average , you can get the same average with some high highs and low lows. Whereas if you stay in range you stay more even keel and it’s supposed to be better for you .

Think of CGM as a movie versus a meter which is a snapshot of a certain time. But TIR is dependent on a continuous 24/7 reading.

 

[Glucobabu]

@Glucobabu It honestly comes down to a matter of timing for me and alerts on my Dexcom to let me know what's going on so I can act on it before it's an issue. Plus a pump to respond with small adjustments as needed easily. You can get a Miao Miao to add to your Libre for alerts. Alerts are very helpful!

I have read Libre2 has an alert system. I have been waiting for it to come to UK but it seems to be taking for ever. I shall certainly look into Miao Miao. Thank you.

 

[bsinatra]

You can only see it when you use a continuous glucose monitor (CGM) or Freestyle Libre. If you use finger pricks you cannot know what your time in range is because you won't be measuring all the time.
Those devices are usually used by people with T1 diabetes on insulin. You can fill out your profile to state type of diabetes and diabetes medications, it's very useful because answers to your questions may vary depending on that.

Thank -you.
If I am diagnosed with T2, will I not be entitled to CGM on NHS? I suffer from lots of hypos which seems to affect my heart as well as head. They are scary so an advance warning would be very helpful.
Any suggestions how I might go about monitoring this??

 

[MeiChanski]

Thank -you.
If I am diagnosed with T2, will I not be entitled to CGM on NHS? I suffer from lots of hypos which seems to affect my heart as well as head. They are scary so an advance warning would be very helpful.
Any suggestions how I might go about monitoring this??

You’ll need to speak with your consultant or endo at a hospital for a CGM, there’s a criteria for it.

 

[bsinatra]

You’ll need to speak with your consultant or endo at a hospital for a CGM, there’s a criteria for it.

I did and they said I don't meet criteria as not T1, yet they see that I would benefit from it.
So I am not sure where to turn.

 

[KK123]

That is absolutely amazing. No matter how hard I try the best I can manage is 65% between 3.9 and 7.7 which is my Target Range. Around 6% is below 3.9. The estimated A1C by Libre is 46. But the blood test at the hospital came up with 52 which the consultant said is more accurate and good enough. You just can’t win!

Hi Glucobabu, I don't know about Marie but I am also a slow onset type 1 (aka LADA) and my numbers are similar to hers. I strongly suspect I am still in the honeymoon period so that goes some way towards stabilising my levels. I do work hard at it all but YOU sound like you are doing well and as we are all very different and at different stages, it's no good comparing yourself with others. I know that eventually any insulin reduction will stop or vastly reduce and then I will simply do my best, just like you. x

 

[MeiChanski]

I did and they said I don't meet criteria as not T1, yet they see that I would benefit from it.
So I am not sure where to turn.

For libre, there are very very few type 2s on insulin that were able to get it prescribed but that’s not a CGM. Criteria for that is testing 8 times a day or you are self funding it and there’s a hba1c improvement. For CGM, the criteria is hypo unawareness and give up your driver’s license. But some CCGs won’t fund CGMs because it is expensive.

Unfortunately I don’t know who you can turn to As type 1, my consultant did all the funding and got it approved.

 

[Marie 2]

@bsinatra What is weird is your profile says you are on no medications, diet controlled but suffer from hypos??? That is very uncommon and I think maybe you should read about Reactive Hypoglycemia. If you can afford to self fund a Libre, many people do. It's not that expensive. The knowledge you gain is extremely helpful.

@Glucobabu I am an LADA/type 1 for 17 years now. Experience helps with this disease. But I still say the most important thing is timing and the proper dosing. But I also watched my numbers go down with each tool I used too. The other thing that helped is finding what other people do that works for them.

I literally eat what I want as long as it's vegan for me, and most of the time I do pretty good with always some hiccups along the way. I am really not saying everyone can do as well as me, we are all different and have different circumstances that can affect us. I am retired now and that has helped a lot. I am not on a schedule that I have to eat at this time etc. But I also know that good control can be achieved in many different ways. And I also know that without knowing what others had achieved I might not have even known I could.

 

[SalRead1]

I had to phone my diabetes team and they commented on my HbAiC results, saying how good they were. Next question was were the results masking hypos in particular? They were indeed. I was so pleased that they picked up on this, but at the time we couldn't relate it to TIR as I hadn't then got the Freeestyle Libre. I find it invaluable to look at where my sugars are going and an average over various time spans. Am considering getting the Miao Miao but don't know whether to hang on till the new Freestyle pump collaboration with Insulet is available as I much prefer the thought of being tubeless.