5 days with the Libre 2

[Royjk]

So, it is 5 day of CGM and what have I found?
First I needed to get rid of the red warnings of low events, for the first couple of days I had 4 warnings with a total of 10 hours below 3.8mmol/l. I know that these were not blood glucose but they are interstitial fluid readings, and I have no way of knowing if they are false readings or real. So to get rid of them I cut down on my evening meal fiasp, by 3 units, and my basal by 4 units, and started eating a ham roll at 10pm each evening. This has moved the graph from the red up into the low yellow still less than 4.8mmol/l through the night but within some kind of control. But I still only get a total of 60% in the green,4.8mmol/l - 7mmol/l with 40% now in the low yellow.

So my next step will be to reduce my already low dose of breakfast fiasp, down to 1 unit to see if I can lift morning yellow levels up into the green control area by perhaps also having a slice of toast with my breakfast.
I can now see clearly why some people here said that random testing was not good, and throughout my changes I still get the same good results for finger blood tests.
So I am disappointed that I have left my strict adherance to a low carb diet which I had maintained for the past 6 months, But it has been giving me an unkown low blood glucose level for perhaps a long time, and my morning good tests may have been due to the inrease in blood glucose that comes with movement.
I still have a week before I see the doctor, and will be interested to see what else comes up in the second half of this monitoring.
Royjk

 

[grantg]

i don't understand when on insulin that you don't also have a blood glucose monitor? libre instructions clearly state to check against both highs and lows before making any treatment decision. For me the libre consistantly reads lower around 0.8 to 1.4 mmol. There are others who it will consistantly read higher for. The other issue with the 'real time readings' is that it is based on prediction. you can litterly if for instance do some exercise for 20-30 minutes, then watch the graph on the libre change in front of your eyes as the data changes.

Not too sure why youve set low at 4.8mmol and your high as 7mmol. thats an EXCEPTIONALLY TIGHT range to try to adhere to of which a non diabetic would'nt stand a chance of.

for a non diabetic they can frequently go above 7mmol especially shortly after a meal. try change the range and see what % time in range increases to 4mmol-10mmol/l is default setting.

my best guess of why you've chosen the range, is perhaps as told to aim for no more difference than 3mmol from first bite until 2 hours after food which is fairly standard advice then you've narrowed down that slightly.

I've enclosed a couple of screenshots from mine so you can compared. much more useful data would be from the daily pattern. at the end of the 15 days it will likely be worth while to go onto libreview website and print off a report.

despite the quirks/limitations of libre i have a lot of love for it

 

[saucequery]

Always check your low libre readings with a fingerprick, as you can get false low readings with a CGM.

 

[Rokaab]

I had 4 warnings with a total of 10 hours below 3.8mmol/l. I know that these were not blood glucose but they are interstitial fluid readings, and I have no way of knowing if they are false readings or real

I'm afraid you really do need to verify these with a blood glucose meter, its entirely not uncommon for all the CGM's to show lower than you are when less than 5 - in fact I think most of them even say you should check when it shows less than 5 - it could also be a faulty sensor - that does also indeed happen

 

[grantg]

going to the opposite direction on the screenshot front. Here's a few others where read low for various reasons (insertion trauma being on) various compression lows and some I simply can't make heads or tails of. You'll see on the daily graph when I checked and made a note... The graph then changed a while later which is why some dots appear not be on the graph.

 

[Royjk]

Hello @grantg , @saucequery ,@Rokaab
Thanks for the advice.
So the CGM reads .6 lower than finger prick test on the meter when I sit or sleep, but when I walk to the other room they read the same. 3.1 = 3.8 and 4.9 = 4.9. by taking action I have eliminated the red warnings. I understand that the CGM monitors in relativly still interstitial fluid and the finger prick tests in active flowing blood. So my interstitial fluid is at 3.1 when the CGM says 3.1mmol/l.
So I understand that the process is food - blood glucose - glucose in interstitial fluid - cells.
Due to my low carb diet, and my basal Fiasp insulin, I have lowered my blood glucose too low. so to correct this I have added a bit of carb, and reduced insulin and can monitor it to watch what happens.
As for the limits they came with the monitor, and match the limits in my diabetes diary that I have been sticking to since I started insulin.
When I first had the monitor fitted my plan was just to watch but the monitor showed several low points and over 5 hour a night in the red.
Royik

 

[Royjk]

So the reason for the CGM is that just few weeks ago I was at 40 units a day of fiasp and 18 units of Tresiba. Something happened overnight, dont know what, but my insulin dose needed changing to 15 fiasp and 12 Tresiba. Today it is a total of 12 fiasp and 8 Tresiba and the finger prick tests are still showing 5.2 in the mornings and 5.4 before evening meal. I feel the insulin need to go down further but I will see where it goes with finger prick tests.
Royjk

 

[grantg]

sort of same boat here with reductions. type1 diagnosed as. originally 18 toujeo units per day and 5 units with meals. i've now been off insulin entirely for just over a month. been told its honeymoon period type1. was chasing insulin with food took a good while and many arguements with both dsn and dietician. supposed to get a blood test tomorrow (needlephobic) hopefully they'll be able to draw and lipid profile behaving itself enough for the lab not to reject bloods for umpteen times in a row for some more tests. hopefully tomorrow evening i might sleep better been having nightmares about it everytime nhs sends letters/txt messages alongside received a few phone calls ontop of GP surgery harrassing me to get bloods done there too I refused gp bloods last week as hospistal tomorrow. :/

part of advice when they finally listened to the issue i had was to ensure make changes gradually. tried various insulin to carb ratios 1:10 1:12 1:15 then 1:20 then i went against advice thought sod this lets see was fed up eating jellybabies what felt like all day long ... then every 2-3 days lowered toujeo by a couple of units until zero.

presuming dsn/consultant set the app for you. I'd still try 4-10 range just to see, then set back again and lower the alarm from 4.8 to 4 or or something at least for the evening.


best wishes.

 

[Royjk]

Hello @grantg

So, diabetic nurse put the sensor on and said, see what it does. I will see the doctor in another week. I have been 'ill' for 5 years now and diabetes is just something I picked up on the way through the hospital. My feeling is that 4.8mmol/l - 7.2mmol/l is a good range and thats what I aim for. At the moment my CGM says 3.7mmol/l and finger blood says 4.2mmol/l. So you are correct that the CGM reads low. But I want my BG to be above 4.8 so to do that means a ham roll and reduced basal, that will keep me above the red and still below 4.8 I may be in the yellow until 11am tomorrow. But I want the green. Low BG can cause eye problems and as I already have diplopia, ptosis and macular odema, I want to make sure that diabetes is not adding to my problems.

I have not found any carb ratio's my insulin has little correlation to the insulin I must cast the bones to decide what dose to take. So I am nibbling away to find something that will give some kind of control.
I have all alarms turned off, but I cannot find the one that comes on when the sensor disconnects.
Like you I have an allergy to needles, but endure them because I must. Good luck with the blood test tomorrow, I look out of the window, and try to ignore what the nurse is doing.