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Type 2 Do I Need Fgm Or Cgm For Type 2 Diabetes?

RealDeal

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Hi everyone, I am new to this forum, was diagnosed with type 2 diabetes 3 years ago.
Not much experience so far.

I have a simple question for you.

Do I need to monitor my sugar constantly with systems like Freestyle Libre or CGM devices?
Or should I just do my metformin pills and not to worry much about my sugar levels?

Talked to 2 doctors, one supports constant monitoring and the other one says that for type 2 diabetes FGM, CGM systems it's kind of overkill.

Luckily, so far I don't have a severe form of diabetes. My sugar rarely goes lower than 3.5 and not really often shoots above 12.0 mmol/L. I am 57 if it helps.

I hope my question doesn't sound too silly. :)
 
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Hi @RealDeal . Welcome to the forum.
As a type 1 diabetic I really wouldn't like to advise you on different monitoring systems for you as a type 2.
There is however one question I would like to ask you.
What do you consider to be a severe form of diabetes?
 
Hi and welcome
It kind of depends how much control you want (and whether you can afford to buy your own CGM or Libre).
Do you test anyway with a regular monitor and strips?
Also of course your blood sugar numbers will depend on what medication you are on.
I personally try to stay below 6 mmol/l at all times because I think it is better for me that way in terms of damage minimisation..I would be very shocked at getting anything near 12 and would certainly look very closely at what I had eaten that caused such a spike.
I'll tag @daisy1 for the brilliant intro to low carb in case you haven;t seen it already.
 
It depends how useful you feel it is to you, relative to cost. 12 is high, and people with T2D are at risk of getting complications like peripheral neurophathy quite early on, and if you're regularly reaching 12 that is a risk factor. Also hypos are good to avoid if you can.

If your blood sugars are covering a range of < 3.5 and > 12, then that's quite a wide range. It's only useful information if you act on it, but it does encourage people to try to stay more within a target range.

So if you can afford Freestyle Libre, and you'd use the information, I would say go for it. It's just a matter of time, in a few years, not having one will seem out of date, and uncivilised.
 
Hi @RealDeal . Welcome to the forum.
As a type 1 diabetic I really wouldn't like to advise you on different monitoring systems for you as a type 2.
There is however one question I would like to ask you.
What do you consider to be a severe form of diabetes?

I meant higher levels of sugar. A friend of mine was diagnosed with type 2 not long time ago. He had 27.0 mmol/L at the time
 
I meant higher levels of sugar. A friend of mine was diagnosed with type 2 not long time ago. He had 27.0 mmol/L at the time
That's what I was hoping you was meaning. All forms of diabetes have there severity.
 
I meant higher levels of sugar. A friend of mine was diagnosed with type 2 not long time ago. He had 27.0 mmol/L at the time
Hi and welcome, @RealDeal .
A level of 27.0mmol/L would certainly give cause for alarm, though I would not neglect
Monitoring my blood glucose levels with any diabetes type diagnosed.
As others have said Freestyle Libre gives lots of useful data, but it is only useful to those who will use that info to inform choices. At the very least, despite being advised to the contrary by NHS, using a meter to test blood glucose responses to various foods is what I would do.

By the way, have you read the information for new members from @daisy1 ? Now I have tagged her she will post that here for you soon.
 
Hi, @RealDeal , there's a lengthy and highly viewed thread called Life with Libre by @maglil55 at the link below, which looks at libre from a T2 perspective, so it might be worth having a look at that to get an idea of the ins and outs of it. It's got lots of info about the practical realities of using libre, what sort of information she got, how she used that information etc.

https://www.diabetes.co.uk/forum/threads/life-with-libre.118450/

Strips are ok, but you're still just getting little snapshots in time of what level you're at, whereas libre is giving you the full 24 hour show, so you can see what's happening inbetween the strip tests. There's sometimes some quite surprising stuff happening between bg tests which you simply wouldn't know about on strips alone.

Many T2s use libre occasionally to get an idea of general patterns and trends over a two week stretch, so if you sign up for it, you're not committed to a regular monthly outgoing.

Proper cgm like dexcom is extremely useful for those of us on insulin or hypoglycaemic meds, because the hypo alerts are a wonderful safety blanket, but it would probably be overkill to fork out for that if you're not on insulin or lowering meds.
 
I’m with @bulkbiker here, I try to keep under 6 at all times, I take Metformin and eat low carbs. Even 13 months from diagnosis I still test at least 4 times a day and input my results into the MySugr app to keep tabs on how I’m doing. I am curious to try a Free Style Libre one day just out of curiosity, especially to see what happens overnight. However I think personally that the cost is prohibitive and the HbA1c score on My Sugr has always been close to my lab results anyway.
 
Hi and welcome
It kind of depends how much control you want (and whether you can afford to buy your own CGM or Libre).
Do you test anyway with a regular monitor and strips?
Also of course your blood sugar numbers will depend on what medication you are on.
I personally try to stay below 6 mmol/l at all times because I think it is better for me that way in terms of damage minimisation..I would be very shocked at getting anything near 12 and would certainly look very closely at what I had eaten that caused such a spike.
I'll tag @daisy1 for the brilliant intro to low carb in case you haven;t seen it already.

Thanks. My doctor said it is okay to have up to 10 mmol/l after meal. Would be happy to have around 6.0 mmol/l as you do.
 
Thanks. My doctor said it is okay to have up to 10 mmol/l after meal. Would be happy to have around 6.0 mmol/l as you do.
Ask your doctor if they would be happy with 10 after a meal for themselves ( I think you would get a more truthful answer).
So are you testing at the moment and if so when? Are you learning anything about foods that spike you through your testing? and the avoiding those foods?
 
I’m with @bulkbiker here, I try to keep under 6 at all times, I take Metformin and eat low carbs. Even 13 months from diagnosis I still test at least 4 times a day and input my results into the MySugr app to keep tabs on how I’m doing. I am curious to try a Free Style Libre one day just out of curiosity, especially to see what happens overnight. However I think personally that the cost is prohibitive and the HbA1c score on My Sugr has always been close to my lab results anyway.

Thanks Rachox.
 
@RealDeal

Hello and welcome to the Forum :) Here is the Basic Information we give to new members and I hope you will find it interesting and useful. Ask as many questions as you want and someone will help.

BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 235,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.

There are two approaches to controlling your carbs:
  • Reduce your carbohydrate intake
  • Choose ‘better’ carbohydrates
Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes.

Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 8.5 mmol/l
Blood glucose ranges for type 1 diabetes (adults)
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 9 mmol/l
Blood glucose ranges for type 1 diabetes (children)
  • Before meals: 4 to 8 mmol/l
  • 2 hours after meals: under 10 mmol/l
However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:
  • structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
  • self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic.

Note: This post has been edited from Sue/Ken's post to include up to date information.
Take part in Diabetes.co.uk digital education programs and improve your understanding. Most of these are free.

  • Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why

  • Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.
 
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