CGM Time in Range 3.9-10.0

[Art Of Flowers]

For those Type 2 Diabetics who have a CGM, what is your Time In Range using the default values 3.9-10.0 mmol/L

Mine is 99% with 1% high, 0% very high (>14) and 0% low. I control type 2 using a LCHF diet

 

[Chris24Main]

That's an excellent result - congrats.
Just - don't put too much store in the default range - the default is what the medical establishment consider safe for them in terms of controlling people who aren't too keen on doing much to look after themselves.
On the other hand, from your tagline, it looks like you know all you need to know... I have about a year to go before I can say I've reversed mine...

(to answer your question directly, I set my range to 7 max and was 100% in range before I stopped wearing a GCM. I was fasting every other day at the time, so not entirely unexpected, I would guess I pop over that limit every now and again right now...)

 

[Taighnamona]

That's an excellent result - congrats.
Just - don't put too much store in the default range - the default is what the medical establishment consider safe for them in terms of controlling people who aren't too keen on doing much to look after themselves.
On the other hand, from your tagline, it looks like you know all you need to know... I have about a year to go before I can say I've reversed mine...

(to answer your question directly, I set my range to 7 max and was 100% in range before I stopped wearing a GCM. I was fasting every other day at the time, so not entirely unexpected, I would guess I pop over that limit every now and again right now...)

I’ve kept the standard settings too and am usually around 99% in range. I follow a low carb diet, around 60-80gms daily but also take a low dose of basal insulin (18 units of Xultophy) each morning. My last A1c was 41.
I tried stopping the insulin hoping, as my diet/ control was so good, I could manage without it. Unfortunately my glucose levels started to soar.
I don’t understand enough about my physiology to work out why I would need to continue taking that insulin dose. Maybe someone could advise.

 

[Deleted member 527103]

Just - don't put too much store in the default range - the default is what the medical establishment consider safe for them in terms of controlling people who aren't too keen on doing much to look after themselves.

That seems a very narrow view.
1. There are other types of diabetes apart from type 2 which can be more challenging to manage.
2. it is important to manage all of your body not just your diabetes. The mental capacity required for tighter control can have a significant impact on mental health.
3. if you look at Libre graphs from people without diabetes, you will see their BG can rise close to 10mmol/l.
4. you are suggesting that someone only maintaining the recommended target is not looking after themselves. After more than 20 years managing my Type 1 mostly without a CGM (so very unlikely to be within the range), I have no complications.

 

[Melgar]

I had mine set to 4.5 - 10 mmol/s . The 4.5 as I can start dropping and my liver doesn’t always step in and correct my falling blood sugars. So the 4.5 alerts me , so I can keep an eye on my levels. I will finger prick just to see where I’m at. I would say I was around 90% in range. I made the decision to tighten up my range so I now have it set at 4.5 - 7.5. I am now 70% in range. I’m hoping to improve this, although my CGM accuracy was off. My HbA1c was a bit higher than the predicted HbA1c from my Libre. So likely I was further out of my TIR than I thought. I’m seeing how this goes, but I don’t like all the orange bars on the bar graph this tighter range generates.

 

[Melgar]

I’ve kept the standard settings too and am usually around 99% in range. I follow a low carb diet, around 60-80gms daily but also take a low dose of basal insulin (18 units of Xultophy) each morning. My last A1c was 41.
I tried stopping the insulin hoping, as my diet/ control was so good, I could manage without it. Unfortunately my glucose levels started to soar.
I don’t understand enough about my physiology to work out why I would need to continue taking that insulin dose. Maybe someone could advise.

I’m going to have a stab at answering your question @Taighnamona . Even though your HbA1c levels are good at 41. Im assuming those are the results whilst on Your basal insulin. So I assuming from that your background insulin is high without the insulin. The very things that are causing your blood sugars to be high (without the insulin) are still there. Namely, your insulin resistance and an inability for your pancreas to produce enough insulin to overcome your resistance to insulin and whatever carbs you are consuming. Your pancreas’ inability to produce enough insulin may be down to genetics and or your beta cell mass might be depleted or some other insult. Hence even though you have great control of your blood sugars, the basal insulin you are taking is helping your body keep your otherwise high blood sugars down. Those are my thoughts . Edited to correct an autocorrect.

 

[HSSS]

That seems a very narrow view.
1. There are other types of diabetes apart from type 2 which can be more challenging to manage.
2. it is important to manage all of your body not just your diabetes. The mental capacity required for tighter control can have a significant impact on mental health.
3. if you look at Libre graphs from people without diabetes, you will see their BG can rise close to 10mmol/l.
4. you are suggesting that someone only maintaining the recommended target is not looking after themselves. After more than 20 years managing my Type 1 mostly without a CGM (so very unlikely to be within the range), I have no complications.

Whilst the points you raise are technically correct I think it’s a pretty negative interpretation of what @Chris24Main was suggesting.

1. This thread was by a type, 2 addressed to type 2’s in that subsection and specifically in the opening post. Not a diminishment of how other types are different or have different challenges. Managing type 2 by diet alone is no easy feat either btw.
2. No argument here - a valid consideration
3. So all that means is even non diabetics are not within tight “non harm” limits 100% of the time. Surely how much time you spend outside these is what’s relevant rather than if brief and occasional forays are made
4. Not what I took his comment to mean. More that the medical profession assumes many type 2 do little (often based on the minimal guidance they get given!) and as such set higher targets than would be set if the “ideal“ was set rather than what they see as “achievable“.

 

[Taighnamona]

I’m going to have a stab at answering your question @Taighnamona . Even though your HbA1c levels are good at 41. Im assuming those are the results whilst on Your basal insulin. So I assuming from that your background insulin is high without the insulin. The very things that are causing your blood sugars to be high (without the insulin) are still there. Namely, your insulin resistance and an inability for your pancreas to produce enough insulin to overcome your resistance to insulin and whatever carbs you are consuming. Your pancreas’ inability to produce enough insulin may be down to genetics and or your beta cell mass might be depleted or some other insult. Hence even though you have great control of your blood sugars, the basal insulin you are taking is helping your body keep your otherwise high blood sugars down. Those are my thoughts . Edited to correct an autocorrect.

Thank you for taking the time to respond. Yes that A1c result was while taking the insulin. Previously it had gone up to 67.
I’m 75 and for many years had fairly good control on tablets, then Victoza until it became unavailable and for several weeks I was on no medication because of NHS mix ups. My levels soared hence the move to insulin around 6 months ago. It’s been steep learning curve. I was diagnosed T2 in 2002 so possibly have exhausted beta cells but also over 50 years ago as a very skinny petite young woman I suffered crippling attacks of pain which eventually was diagnosed as gall bladder stones and surgically removed.
I’ve often wondered if the very painful spasms and inflammation could have affected my pancreas.
I’m happy to be alive and reasonably fit enough to walk my dog about 5 miles daily. Long may that continue.

 

[Melgar]

Thank you for taking the time to respond. Yes that A1c result was while taking the insulin. Previously it had gone up to 67.
I’m 75 and for many years had fairly good control on tablets, then Victoza until it became unavailable and for several weeks I was on no medication because of NHS mix ups. My levels soared hence the move to insulin around 6 months ago. It’s been steep learning curve. I was diagnosed T2 in 2002 so possibly have exhausted beta cells but also over 50 years ago as a very skinny petite young woman I suffered crippling attacks of pain which eventually was diagnosed as gall bladder stones and surgically removed.
I’ve often wondered if the very painful spasms and inflammation could have affected my pancreas.
I’m happy to be alive and reasonably fit enough to walk my dog about 5 miles daily. Long may that continue

I believe there are a number of reasons why one’s pancreas is unable to secrete enough insulin. As you mention exhausted beta cells , genetics , autoimmune and other insults which may include gall stones causing inflammation in the pancreas. I am just a lay person with an interest and not a Dr, so give that answer the weight it deserves, but it does make sense to me, anyways.

 

[Chris24Main]

I should learn that I really need to be more clear about what I actually mean.

I simply meant use the monitor to better understand your own body and how it reacts to different foods - don't be bound too much by what the "limits" are ...

<my experience when I tried to get a simple answer to what I should be aiming for, was that the answers were confusing and sometimes contradictory, and I think that you get much more out of the experience by learning what your body does - then when you feel like you get what's going on, set your own limits>

 

[Chris24Main]

That seems a very narrow view.
1. There are other types of diabetes apart from type 2 which can be more challenging to manage.
2. it is important to manage all of your body not just your diabetes. The mental capacity required for tighter control can have a significant impact on mental health.
3. if you look at Libre graphs from people without diabetes, you will see their BG can rise close to 10mmol/l.
4. you are suggesting that someone only maintaining the recommended target is not looking after themselves. After more than 20 years managing my Type 1 mostly without a CGM (so very unlikely to be within the range), I have no complications.

I spent some time diagnosed as type 1, and it is a totally different mindset. I don't want to go off on too much of a tangent, but I understand your reaction, and I should have been more careful with my words. I don't disagree with anything you say.