Ambulatory Glucose Profile

LittleGreyCat said:

Just checking - are these graphs a result of a Print Screen followed by cropping?

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I'm using Snip & Sketch in Windows 10 which basically means you drag the mouse over the area you want to capture and then just paste into the message.

This is the other part of the AGP report from LibreView.
I'm confused because the numbers on the left don't seem to match the graphics on the right.
For example the "Above 13.9" on the left says less than 5% 1 hour 12 minutes.
The graphic on the right shows 0% (which is good).
Is the LHS just the guidelines being explained in both columns?

98% in target range looks better than expected.

LittleGreyCat said:

View attachment 51142

This is the other part of the AGP report from LibreView.
I'm confused because the numbers on the left don't seem to match the graphics on the right.
For example the "Above 13.9" on the left says less than 5% 1 hour 12 minutes.
The graphic on the right shows 0% (which is good).
Is the LHS just the guidelines being explained in both columns?

Click to expand...

Yup, the table on the lefthand side is just detailing the targets. Mixed in awkwardly with your actual values for GMI, average glucose and variability to confuse you more. And as far as I can see you can't change them in any way.

The more I look at it the more that grey table annoys me, its just clearly in the wrong place and totally breaks the flow of the key summary information. The same data could be in grey italics on the graph on the left underneath each actual as a bracket i.e. Actual 1% (Target <5% or better)

LittleGreyCat said:

I'm confused because the numbers on the left don't seem to match the graphics on the right.
For example the "Above 13.9" on the left says less than 5% 1 hour 12 minutes.

Click to expand...

Those on the left are the targets for all diabetics in general. The figures on the right are your own figures. As I understand it, the AGP is a standard that defines these ranges and percentage levels. (So whilst on the Libre App you can set your range to suit yourself, with the AGP these are always the same for everyone).

The way I view the targets is : if I don't meet them, then I need to work very,very hard to improve and if I do meet them then I should work, but not quite as hard, to improve them. That is until I reach 100% Time in Range (if I ever do) at which point I should work hard to stay at that level.

Ronancastled said:

But he was able to generate a 14 day overlay as well
Did Abbott discontinue this feature at some point ?

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The screenshot is over 5 years old and they have changed some features.
It doesn't have the coloured lines for individual days anymore (but there are other graphs which make more sense to me than this spaghetti of lines), but still the dots for all measurements and 2-hourly averages.

(Mind, my Libres read significantly lower than blood, and I have touched some 8's and had a lot less hypos than libre thinks. Mainly hovering in the 6's at the moment.)

Ronancastled said:

While poking around today I found this graph of a non-diabetic Indian Blogger.

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Interesting to see a non-diabetic for comparison, but I notice the percentile range for the graph was 10% to 90% range and not 5% to 95% as it is now, so its not as easy to interpret. Still, its a good data source to see that everyone spikes, in some cases quite a bit.

Ronancastled said:

@Antje77 Your control is magnificent, you should be well proud.
Why do you set your upper range at 7.0 knowing as we know now do that non-diabetics exceed this daily ?
Does it help keep you focussed ?

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Thats the median goal line, not her upper line.
It turns out you can change it between some fixed settings, of which 7 mmol is the lowest, under the "Report Settings" button, under "Edit" option for Glucose Pattern insights.
I know because I was curious why hers was different from mine and went digging in Libreview.

KK123 said:

Hi there, I'm betting not many type 1s or insulin users are. There really is massive variability because trying to do the job of a working pancreas every second of every day is impossible. When you think that a working pancreas drips out insulin by the second exactly when it is required and cuts it off exactly when it is required. It responds to a body when it's exercising, walking, coming down the stairs, sleeping, working, shopping, sitting on the sofa, eating, not eating and on and on and on. Injected insulin is not great at doing all of that, what you inject is what your body is stuck with, too much and you're in trouble, too little and you're in trouble, and that's just the bolus. Add in the basal which can randomly drop some out and...you're in trouble. Even when you inject it travels a different path through the body each time so sometimes works very fast and sometimes it decides to take the scenic route and takes forever to kick in, so kicks in too late and well, you're in trouble! I think the issue can be that when people look at 'diabetes' they sometimes think it's just a question of working out a ratio, inject A and you'll get B. Oh I wish.

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Love this! Have chuckled loudly. So so true. I can have a whole week of halo inducing graphs. The following week without changing food or exercise patterns it all goes to pot. I have long stopped worrying about it. The good results will eventually return. I am still here and enjoying life which is the main thing.

Ronancastled said:

Why do you set your upper range at 7.0 knowing as we know now do that non-diabetics exceed this daily ?
Does it help keep you focussed ?

Click to expand...

Sax said:

Thats the median goal line, not her upper line.
It turns out you can change it between some fixed settings, of which 7 mmol is the lowest, under the "Report Settings" button, under "Edit" option for Glucose Pattern insights.
I know because I was curious why hers was different from mine and went digging in Libreview.

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Thank you for answering Ronancastled question, as I really didn't remember why or how I set those lines years ago!
I don't use LibreView often, if I do it's mainly to have a quick overview of how much insulin I've used to know how much to order. Or to try to find a pattern in 'high insulin need days' and 'low insulin need days', so far without result.

That graph also decided all by itself I go to bed at 10 and I eat at 8, 12 and 6.
Don't believe it!

On my phone app I change my goal depending on how much my diabetes is willing to play fair. I like to be within my chosen range around 80 to 90%, so I can easily see by the colour change where I might improve something, which doesn't work when it's either all green or all red.

For alarms I use DiaBox instead of LibreView, mainly because you can calibrate DiaBox. Currently I have the high alarm at 6.3, because I like to be alerted early so I can make a decision on correcting or waiting a bit longer before I am too high. If I'd only correct at, say 9, it would mean staying at 9 and likely rising more for at least two more hours before the insulin has got it down again.

Last week I had the alarm at 6.8 because I had one of those weeks where I kept rising. No use in having an alarm go off all day.
Occasionally I set the alarm at night at 8 to be sure of undisturbed sleep unless something really strange is going on.

LibreLink tends to read lower than blood for me by between 0.8 and 2.0 mmol/l, so it would alarm for hypos all the time when I was in the high 4's and 5's, and it wouldn't warn me until I was close to 8 on the lowest setting of the high alarm.
It also means this line at 7 in my screenshot is closer to a line at around 8.3, thanks to Libre not allowing calibration.
This is also the main reason I won't give my team access to my LibreView account, all those hypos-but-not-hypos would likely make my DSN very nervous.

From what I understand most AGP's look like this:



and this is a well controlled diabetic according to the A1C, imagine what an A1C of 14,3% looks like.

Still I like to see the profiles posted in this thread; I think we can learn from them and they may help us raise the bar.

Bubbleblower said:

imagine what an A1C of 14,3% looks like.

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Very much like this:

FYI. here is my AGP from first two weeks of starting a moderate low carb diet (<100 g per day, no potatoes, pasta rice etc, no wheat /oats /bread apart from a couple of failed experiments!) and lots of exercise (mix of medium and high intensity).

11% of the time above 10 average BG 7.8. The AGP summary smooths out the data a lot - the daily readings are more scary!



Very surprised to have an HbA1c of 45 just 5 days later -was expecting worse, but 1st Libre sensor did seem to overread compared to finger prick tests.

And here is AGP after weeks 9 and 10, having reduce carbs further (<70 per day).

Spikes have reduced, and at least staying under 10 now.

Average glucose has stayed the same for last 6 weeks (Average BG around 6.8) and Fasting glucose has risen a bit. I also don't have the same clear peaks and troughs after meals - BG doesn't always revert to fasting level. I guess my body is still adapting?

Comments/feedback welcome.

Here is another way of looking at the change from Weeks 1 and 2 (sensor 1) to weeks 9 and 10

Ronancastled said:

A


Well if that doesn't show the power of the CGM nothing does, amazing improvement by adjusting your carbs based on real time data.
Your next A1c should see a wonderful improvement

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Many thanks - yes, I'm really hoping my A1c will go down!

And if this isn't proof why each T2 should be prescribed a few months of a libre (or similar) then I don't know what is!
How can Dns and their colleagues say testing doesn't work? Let more of us try is what I say. Nothing helps my motivation more than seeing a spike, or a lowering in real time

Brilliant posr

Ronancastled said:

Pic not working, repost please

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Unfortunately I can no longer post it, I wish I had when I still could.

While looking up glycemic variability, which is a better predictor for diabetic complications than HbA1c, I came across some interesting research, like this study:
Glycemic variability and cardiovascular disease in patients with type 2 diabetes