A T2, Libre self funding, "What is going on?" thread with keto

[Mr_Pot]

Well, more interesting and confusing stuff. BG flat as a pancake overnight and no dawn phenomenon.

BG only started to climb after morning coffee.

I can't work out at the moment why there wasn't the usual climb of BG after midnight.
Should have avoided coffee, perhaps, but I was intrigued to see if my body could deal with it as I had a late coffee+cream+butter last night and that didn't seem to touch my BG levels at all.

I did drink quite a bit of wine, though, but I didn't think that would have continued working right through to 08:00 this morning.
Memo to self: there is a reason why you don't drink strong coffee in the evening. Like waking up at 03:00 wide awake and staring.

I was also wondering if my BG drop in the later parts of cycling had temporarily cleaned my liver out of spare glucose so there was nothing to dump. However this doesn't seem that likely.

Maybe the conclusion is that it is all too complex with too many variables to analyse using a single type of measurement. Like trying to monitor the performance of a car engine by just looking at the oil temperature.

 

[LittleGreyCat]

OK - first sensor has run out.
I decided not to fix the second one on 24 hours earlier so I have a night and day free from Big Brother watching.
Still being good, though.
Nanny has trained me not to be bad.

I do have about 4 hours overlap.
Taking the first sensor off was "interesting".
My partner kept pulling harder and harder but it wouldn't budge.
Eventually I was leaning away and pulling as well.
Eventually it came off, but that does suggest that all the extra precautions with the kinesiology tape might be over kill.

The new sensor is further round the arm towards the body because the first sensor was nicely sited and no problem, but was directly under me if I slept on my left side.
Moving the sensor round a bit more should, in theory, mean that I can lie on my left side without squashing the sensor.
We shall see.
We shall also see what it conflicts with instead.

This time we left some backing on the kinesiology tape where it is over the top of the sensor, to allow it to be removed without pulling on the sensor.
This may improve things, or may not.
It does give me the opportunity to see if I get different readings "tape on" and "tape off".

I've booked an HbA1c test in early August (3 months since the last one) so we shall see if this enforced virtue had improved my numbers.

If I get enough consistent results, I am tempted to ask for a consultation with an endocrinologist to discuss possible drug options. However most of my theories aren't fully consistent yet.

 

[LittleGreyCat]

Minor note.
I think a hot shower makes the sensor read higher.
I have a blip which seems to coincide with shower time.

 

[EllieM]

I did drink quite a bit of wine, though, but I didn't think that would have continued working right through to 08:00 this morning.

I can no longer use the libre (developed an allergy and the libre became completely inaccurate - varying from finger pricks by random amounts up to 5mmol/L). But finger pricks suggest a reduced DP after alcohol. I also find that I tend to need less insulin the day after heavy exercise.

BTW, the libre is notorious for under reading at night, something to do with pressure if you lie on it?

 

[LittleGreyCat]

Further minor note.
I weigh myself every day in the morning at the same(ish) time.
After coffee and bowel movement, before shower. [TMI]
Over the last two weeks I have lost 5 lbs.
This is after several years of struggling to control my wight, and varying between 12 stone and 12 stone 7 lbs.
I now weigh 11 stone 9 lbs and am just 2 lbs off my long term goal of 11 stone 7 lbs.
My waist has come down from borderline 36" to borderline 34" so hopefully some of the weight is coming off my belly.

My message to myself is that I'be been long term delusional in thinking that I have been managing my BG well and eating keto, and that my body "just didn't want to lose weight".

 

[LittleGreyCat]

Now on the second sensor. Started Friday 12th at about 17:00 after 24 hour plus bedding in.
I had a scary moment overnight when the phone App reported a sensor error and to try again in 10 minutes.
Thankfully it started reading again and seems fine so far.

This one seems to be reading high - possibly just under 1 mmol/L - which is disconcerting when the last one read low by the roughly same amount.

However I've just loaded the finger prick data from my meter and this shows as black dots against the graph, with sensor readings as white.

Looking at that, the finger pricks aren't that far from the line so the sensor seems to be a reasonable guide; just have to adjust to the fact that I may be seeing +/- 1 mmol/L depending on sensor.

However a 4.4 showing as a 3.4 can be a bit scary.
Also a 7.9 showing as an 8.9.

Anyway, rocking the new sensor; we shall see how it behaves long term. The lines are a bit jagged at the moment but the trends look familiar.

 

[LittleGreyCat]

Minor updates:

the second sensor is under my arm - that is, if I hold my arm out straight forwards and palm down, the sensor points at the floor. This seems a better orientation and I don't lie on it when I sleep on my side.

I've taken a slightly different approach with the Kineseology tape. The first strip still has the backing on where it goes over the sensor so it doesn't stick. This made it a bit "snaggy" so I have another fully sticky strip over the top at right angles.

This sensor seems more or less spot on (as far as I can tell with trying to match finger pricks and time delay). I don't know if this is because of the fixing method or because it is from a different batch.

I am now pretty certain that a hot shower raises the BG reading from the sensor but haven't get finger pricked to see if this is real or just a "hot sensor/dilated peripheral vascular system" effect.

I can confirm that the sensor triggers the scanners at the entrance of Superdug as well as Tesco. Confirmed this by going back after the beep and just putting my arm near the scanner. It beeped as the sensor went past it.

LibreView is predicting an HbA1c in the high 5s, but the first sensor was reading low. I have a blood test in a few weeks so that will be interesting. Certainly should be lower than the last test which was 7.2%.

 

[Larissima]

I can't work out at the moment why there wasn't the usual climb of BG after midnight.

I did drink quite a bit of wine, though, but I didn't think that would have continued working right through to 08:00 this morning.

I still remember reading in Dr Bernstein's book that alcohol "paralises" the liver, and that's why, the morning after, the DP is much reduced. He didn't recommend stopping the liver from doing its essential work on a regular basis!

BTW, thank you for sharing your experience with the Libre, I hope to try it out myself as soon as I get back home from the holidays.

 

[Scott-C]

I am now pretty certain that a hot shower raises the BG reading from the sensor but haven't get finger pricked to see if this is real or just a "hot sensor/dilated peripheral vascular system" effect.

The filament is coated with the enzyme glucose oxidase, which reacts chemically with passing glucose to produce an electrical current which is proportional to the amount of glucose. As it's an enzyme involved in a chemical reaction, heat makes it more active, hence the apparent bg rise. The sensor has thermistors which are meant to adjust for temperatur changes, but, as you've seen, they can have trouble with hot showers.

 

[Scott-C]

I still remember reading in Dr Bernstein's book that alcohol "paralises" the liver,

Bernstein has an unfortunate tendency to use deeply unscientific language to support his flawed, narcissistic views.

More reliable commentators like John Walsh describe how the liver, which normally multi-tasks on a grand scale, switches priorities around to metabolise alcohol, leading to the amount of glucose it releases to fuel background bodily processes reducing by about 50%.

 

[HSSS]

Mini-dip around midnight.
Sensor shows hypo but it is reading low.
Then a continuous slow climb which carries on right up to midday.

Unless I have my coffee when it leaps up a bit faster.

The rise throughout the night was something I identified too (much earlier than I’d expect dp to start, usually about an hour after falling asleep). In fact it was the main thing I was left curious about.

I’ve only used the one sensor so far.

 

[LittleGreyCat]

More updates:

My sensor seems spot on now.
BG been at 4.8 or 4.9 in the early hours through to 06:00 and finger prick was 4.9 so well within normal variation between finger pricks.

This gives credence to an overall trend I am seeing.
With minor variations due to food or not, and exercise or not (although I am starting to doubt my conclusions about some of these factors) I seem to have a 24 hour regular BG cycle.
06:00 to about 14:00 shows a steady rise in BG which ends up around or above 10 mmol/L. Sometimes even higher.
14:00 to midnight shows a steady drop to around 4 mmol/L, often dipping lower briefly into hypo territory.
Midnight to 06:00 steady or a slow rise up to around 6 mmol/L.

If I eat a protein heavy meal after 18:00 my overnight slow climb usually starts and ends at a higher level. However I still sometimes see that midnight hypo.

TMI below:

At the moment I am taking bowel prep for a colonoscopy.
Nothing major, but because I have active hemorrhoids the usual "defecate on a stick" test is useless because there is likely to be a trace of blood in the stool anyway, so they cut to the chase and go and have a look.
Minor polyps last time (which are benign but have the potential to turn malign in 5-10 years (as I understand it)) so I am on regular checks.
Anyway fasting on clear liquids since yesterday lunch, and my afternoon drop came down nicely to midnight hypo, then in the 4s until morning. No obvious reaction to the bowel prep although it tasted foully of artificial sweeteners.
However this morning my BG has taken off like a rocket after the bowel prep and hit 10.4 before starting to drop.
This is the same sort of profile that I was attributing to my bullet resistant coffee but unless the bowel prep this morning is laced with sugar or other carbohydrates this does look suspiciously like an extreme dawn phenomenon.
It isn't far from my cycle touring profile of a full English then 10-20 miles of cycling, which I had assumed to be a protein response.
So I am, as usual, baffled.
I also weigh 159.8 lbs, an all time low and below the 161 lbs (11 stone 7 lbs) which was my steady weight in my late teens.
However I think the bowel prep could be considered as cheating.

 

[LittleGreyCat]

In hospital waiting for my test.
Hospital machine shows 5.5 and sensor is reporting over 9.
Either my sensor is going haywire in the last 12 hours or something in the bowel prep is doing strange things to my interstitial fluid. That or hospital panic.
Must take testing kit out on bike rides to cross check high readings.

 

[Bluetit1802]

Just for information and appropriate to what someone said earlier in a post.
I activated my current sensor late Saturday afternoon. It is now Monday afternoohn, so approx 48 hours. I am currently running on 26% above target - target is 7mmol/l. Average is 6.5mmol/l. This is ridiculously wrong. My scans are around 2mmol/l higher than finger pricks at various times of day. All I can think of is this intense heat over 30 degrees. These high readings are so rare for me and out of sync with my finger pricks. A few scans have been 3mmol/l higher. I feel like ripping it off my arm and drowning it. I have had 16 sensors and none as bad as this. Mostly they read a bit low. I have changed nothing in my diet, although I am on holiday in Derbyshire. It has to be this heat.

 

[LittleGreyCat]

In hospital waiting for my test.
Hospital machine shows 5.5 and sensor is reporting over 9.
Either my sensor is going haywire in the last 12 hours or something in the bowel prep is doing strange things to my interstitial fluid. That or hospital panic.
Must take testing kit out on bike rides to cross check high readings.

Well, out OK. Just a single polyp so back in 3 years.
BG is also recorded as dropping.
It is cooler.
No doubt by the time I get home it will match the finger pick.

 

[LittleGreyCat]

Nope. Finger prick of 4.4 sensor reading of 6.9.

I'll give it over night and see if it has come back to its senses.

 

[LittleGreyCat]

Just for information and appropriate to what someone said earlier in a post.
I activated my current sensor late Saturday afternoon. It is now Monday afternoohn, so approx 48 hours. I am currently running on 26% above target - target is 7mmol/l. Average is 6.5mmol/l. This is ridiculously wrong. My scans are around 2mmol/l higher than finger pricks at various times of day. All I can think of is this intense heat over 30 degrees. These high readings are so rare for me and out of sync with my finger pricks. A few scans have been 3mmol/l higher. I feel like ripping it off my arm and drowning it. I have had 16 sensors and none as bad as this. Mostly they read a bit low. I have changed nothing in my diet, although I am on holiday in Derbyshire. It has to be this heat.

Just out of interest, how about holding a bag of frozen peas (or other cold object) against the sensor and see if this makes a difference.

Might try that here.

 

[Bluetit1802]

Just out of interest, how about holding a bag of frozen peas (or other cold object) against the sensor and see if this makes a difference.

Might try that here.

Good plan!

 

[LittleGreyCat]

Just had blood taken for an HbA1c so I should know soon how accurate the predicted HbA1c is from the software on the phone.

I am still terminally confused by the way that the same food will give different results on different days.

Also confused by the way my BG stays at the level it is around midnight, whatever that is, however high that is, and then climbs slowly overnight.

I may need to bend the ear of an endocrinologist if I can find a patient one.

 

[HSSS]

Also confused by the way my BG stays at the level it is around midnight, whatever that is, however high that is, and then climbs slowly overnight.

I may need to bend the ear of an endocrinologist if I can find a patient one.

Please share if you find suggestions what this is about, I’m baffled too