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Feeling a bit disheartened...

R

Ranting1200

Newbie
Messages
1
Type of diabetes
Type 1
Treatment type
Insulin
Hi all,

This year I decided to turn over a new leaf. I have been ignoring the fact I am diabetic for too long. I was diagnosed in 2014 and to be honest I was very well behaved but over the past few year I have just stopped paying attention, acting like I am "normal".

I wanted this year to be "the new me" (don't we all, right?) so I decided that this time next year I would take control of my health. I started:
  • Monitoring my blood sugars almost intensely.
  • Dieting
    • Calorie counting and ensuring I am in a calorie deficit.
    • Understanding my carbohydrate intake and adjusting my insulin in line with the requirements.
    • Fasting and missing breakfast.
      • To be honest, this is just a side affect of not wanting to go over my calorie count for the day.
  • Changing my insulin regime:
    • Actually taking insulin, I often just went without (please don't poo poo me here, just laying my cards on the table).
    • Ensuring that my Bolus insulin is administered almost exactly 20 minutes before I eat (this was advised by my diabetes specialist).
    • Using the formula I was given by health professionals:
      • Take one unit per five grams of carbohydrates.
      • Add a correctional dose to bring you to less than 7mmol/L.

Don't get me wrong, all of this has helped. My Freestyle Libre 2 sensors used to measure around 12mmol/L whenever I checked, even in the morning before food / drink and was predicting an A1c of around 8.9%.

After what is realistically only three weeks of a life changing regime, I am seeing vast improvements with the sensor normally not going over 10mmol/L even after eating and generally sitting in the 4mmol/L - 7mmol/L. The estimated A1c has also dramatically improved showing a new estimated value of 7.9% (this is a huge deal to me, this was a stepping stone target to get to where I need to be).

So, after all this, why am I disheartened? Well, as part of "the new me", I started checking my Glucomen Areo 2K sensor and comparing it to my Libre 2 and have found that the Glucomen sensor always reads higher that the Libre 2. Sometimes by quite high numbers such as:
  • Libre 2: 6.1mmol/L
  • Glucomen Areo 2K: 12.1mmol/L

I did a fair amount of reading and realised my Glucomen Areo 2K test strips were quite out of date and ordered new ones. Alas, while they were more accurate, the reading above is from this new set or test strips.

I know a fair few people won't have gotten this far into this post but I am truly at a loss. I don't really know how to get better at this from here on out... The ideas I have at the moment are:
  • Maybe it is the Glucomen Areo 2K sensor itself?
    • I do leave it in the car most of the time, could the weather have damaged it (hopeful thinking I know)?
      • Note: It now lives in the house to prevent the cold affecting it.
  • Maybe it is the Freestyle Libre 2 sensors?
    • Seems odd if so, both my new sensors have been the same.
    • Maybe I just need to learn that they measure a few units too low?

If you have made it this far, thank you. If you have any experiences, advice or just want to drop a funny comment / picture in here, that is also appreciated. Either way, have a great day!
 
First of all, good for you for cracking on and starting to get things fixed :)

It's likely the libre2 which is under-reading. Are these differences when your BG is roughly stable? Assuming so, with such a large discrepancy it's probably faulty and you can ask for a replacement - you will be asked for 3 comparison readings (at vaguely different times/values, if possible) and with the arrow flat (i.e. not during a large change in BG as the libre will often not see such high/low values if your BG is changing rapidly.) I have had runs of sensors which have failed in this way - 3 was the longest run and it did make me wonder quite what was going on!

In the past I often had libres which would under-read (which is fail-safe in the short-term - it avoids you going low if you use it to check BG before driving, etc., though not so great long term), though as I mentioned above such a large discrepancy would mean a replacement. An offset of ~1 or 2mmol/l was quite normal. The current sensors are much better than they were and rarely require calibration (which I used to do using XDrip+, which was the only way to make the libre1, alongside a Miaomiao2 reader, into a true CGM - I've stuck with XDrip+ as my logger/display it as the shows a combined graph of insulin, carbs, and predicted BG is useful, but that is an aside)

One thing I find with the new sensors is that if you have a very steep change in BG (whether up or down - e.g. I shouldn't have had that ice cream, or I took too much insulin and then went for a bike ride) it forces the sensor to recalibrate (I assume), which either generates or removes a small offset.
 
Just wanted to give you a well done!
and you said it yourself.. after just 3 weeks of your new regime.. you can see big improvements.
keep going and see how things are after say 6 months.
have you been having annual diabetes check ups?
went to my first one last week and wondered why the doc was telling me to take my shoes and socks off…ahh the neuropathy test!
trying not to be patronising - just so you can see there are people cheering you on out here.
 
Hey @Ranting1200 - Incredible effort, don't be so hard on yourself ! Seriously count the small wins, the fact you are taking insulin correctly now is a massive leap into great glucose management.

As Simon has pointed out - there will be differences between the 2, one is measuring real time and the other is lagging by 20 mins so forget using 2 devices, just use the libre as you will get disheartened, the libre gives an actual movement of glucose but the meter is just a fixed point in time and you need to know what direction your glucose is travelling in to understand how your insulin is responding to food eaten.

Start to focus instead on TIR - Time in range is the method by which we can see over say 7 days how well we are keeping our levels in range, it will give you a much better idea of how well controlled your levels are.

Come and chat if your feeling down about things, but give yourself a massive pat on the shoulder, you're doing brilliant.
 
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I can relate to this. The libre 2 is great most of the time, but my most recent one is giving me lower readings. Like others have said, it's usually a time lag. If you try to compare when things are stable you will get a closer match.
I have decided to focus on the libre and not worry if they don't calibrate unless it's really wildly out and suggests a malfunction.
I aim to get my time in range over 80% rather than the recommended 70% to allow for the lower readings.
 
Well done on making the changes needed. I find if I place sensor on 24 hours before it’s actually required it’s far more accurate as I tend to check bs using monitor for first 24 hours to ensure accuracy between sensor readings and monitor. Well as much as you can ! My last clinic appointment showed the predicted HBA1C on sensor matched the one taken by hospital clinic so seems to be working out. Maybe worth a try. I also prefer to use the time in range as a guage to manage my diabetes and was 90% in target range at last clinic pump appt which I was delighted with. Like everyone else I have good days as well as rubbish days when nothing seems to go well however there are so many variables at play and it’s just not an exact science we are trying to manage. Keep going as the end result will be worth it
 
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