Freestyle Libre teaching me sooo much about my T2 and RH

Hi All,

I have posted this in the RH (Reactive Hypoglycaemia) forum, because i think it might be interesting to fellow RHers. No idea if it will be of any interest to anyone else!

I got the Libre on Monday (early xmas pressie to self). I am thinking that the wee graphs are going to be fantastically motivating over xmas.

In case anyone doesn't know, the Libre is a widget that sticks to your arm and reads the glucose level in the interstitial fluid under the skin. For me, as an unmedicated T2, it is less about the numbers and more about the peaks, troughs and the speed of the highs and lows, allowing me to understand the effect my current eating has, and how to tweak it in future.

I consider myself well controlled (by very low carb/usually ketogenic diet) and until i saw these graphs, i thought my RH was virtually a thing of the past. Turns out, even as a T2, it is still going strong.

Screenshots and comments to follow.

Day 1



The blue zone is my self-selected target range. I have chosen 4.5-7.5 for my range.
Note the low point at 2am? And the subsequent rise?
That is a 'low' of around 4mmol/l it isn't a hypo, but it did trigger a liver dump (the rise) that takes me up to over 6mmol/l and jiggles around, up and down for the rest of the night.

As you will see, a variation of this happens nearly every night.

The gentler curves between 6am and midday are due to a coffeencream for breakfast followed by a 9bar

The hump at 1pm is from hummus, eaten as lunch, with a teasp.

The lower carb supper 7pm onwards, had protein and green veg. So v slow release carbs

Lesson for the day:
All readings were in my target zone
But the carbs in the 9bar and the hummus definitely resulted in lower bg at the end than at the start.
= Very mild RH reaction.
If i had eaten more carbs, the RH reaction would have been bigger.

Day 2.

The gentle drop at midnight-2am is after 2 tsp peanut butter at 11pm.
The minihump at 4am was an emergency trip into the garden with a dog with diarrhoea. Mini liverdump quite understandable, in the circs!
The high at midday was the effect of 2 (yes, just 2!) milk choc digestives. All in the interest of science, you understand.
Lunch and dinner were both VERY low carb, but that biscuit high left me unstable for the rest of the day = knock on effect, in action!

Lesson for the day:
Biccies are bad news and have a knock on effect!

Day 3

A much steadier day. Managed to resist any scientific experiments today
Until i got too hungry before evening meal, and ate 1 biscuit (10g carbs approx, i think) while preparing the food. The meal was vlc, but that 1 biscuit bounced me right up to top of my range. Should have had a slice of cheese, instead.

Lesson for the day:
No signs of RH at all. Presumably because of staying vlc, and burying the biscuit under my evening meal.

MellitusTrap said:

It's a great tool for someone with RH!
The best bits probably are
- being able to know if you are having nighttime hypos
- knowing if your number now (say 4mmol/L is trending up or down
- being able to test as many times as you want

Con
- shame one can't alter the Y axis gradient (so the top was 12 or 15 and not 21)
- £50 a sensor (about £100 a month)

Click to expand...

Absolutely. The cost is prohibitive. I can't possibly fund it the whole time.

At the moment, i intent to use a sensor (£50) maybe 4 times a year.
It should highlight any carb creep, and help keep me on track during holidays.

I will post 1 more day, then leave you in peace - i just thought you might be interested to see my bg 'in action' as it were, over several days.



Day 4

Note the usual low and liver dumps during the night.
The 6am surge was another emergency dash to the garden with a dog.
The 3pm spike and drop was a small (very small) portion of homemade pork and cider stew, with homemade cauli cheese.
See the RH reaction?
No idea how many carbs were in it, but i wouldn't have expected such a spike.
The evening meal was vlc again.

As @nosher8355 always says, we are better off fasting, than eating the wrong things - as soon as we go 'off piste' it is downhill from there!

Lesson for the day:
Don't assume that your spikes will be predictable!
And
Don't even start with the carbs!

Overall lessons (so far):

- basic diet is fine
- its the discrepencies that are causing the spikes
- even these spikes are OK. They don't trigger bad hypo RH reaction, they last less than an hour, and are back in target before 2 hrs. But bear in mind, these are SMALL carb doses. I rarely go above 50g carbs a day, because the moment I do, RH comes back in all its horrible hypo hell glory.
- the nightly lows, liver dumps and dog poo trips are kind of surprising. Dawn phen and stress hormones are throwing a party.
And
Apart from switching to a very low carb diet, i think this may be the best thing i have ever done, to inform my T2 and RH

Lol.
Actually, i have just had a look at these graphs again, and decided that i look rather like a goody-two-shoes with my 'in range' numbers.

- no proof at all that i would spike with high carbs, is there?

Tell you what, one day, over xmas, i will eat a couple of mince pies and post the results.
Just to prove how bad it can get.

you know, @nosher8355

It occurred to me, this evening, how amazingly simple it would be to use this as a diagnostic tool for RH.

Stick a sensor on someone.
Send them off for a fortnight, with instructions to download their readings every 8 hours, and keep a food diary, with instructions to eat carbs.

One glance at their daily graphs, and you would instantly see whether their readings were consistently lower after food.

Simples.

So much cheaper than taking up a hospital bed for 72 hrs for an OGTT.