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Freestyle Libre teaching me sooo much about my T2 and RH

Discussion in 'Reactive Hypoglycemia' started by Brunneria, Dec 19, 2015.

  1. Brunneria

    Brunneria Other · Moderator
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    He might need to see the graphs to understand fully.
    A picture says a 1000 words!
    Just point him at this thread.
     
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    #21 Brunneria, Dec 19, 2015 at 9:04 PM
    Last edited by a moderator: Dec 20, 2015
  2. MellitusTrap

    MellitusTrap Type 2 · Well-Known Member

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    There are a few reviews that mention below a certain range the margin of error seems to increase.

    For example, see the section called "how accurate is it" on this page;
    http://ninjabetic1.blogspot.co.uk/2014/09/freestyle-libre-flash-glucose-technology.html

    I can list more - but I'm not here to hate - just mentioned something I've seen some comments on.
     
  3. misswhiplash

    misswhiplash Type 1 · Well-Known Member

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    Libre is a great tool (I've had mine for more than a year now and I love it lots) and it's really good that you are also learning so much from it. Your graphs look great - I saw a collection of CGM graphs from non diabetic people a little while ago and they looked very similar in terms of bendiness but staying within the lines. We all strive for the elusive straight lines, but often forget that "normal" people don't get anything remotely straight
     
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  4. Hiitsme

    Hiitsme Type 2 · Well-Known Member

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    Thank you @Brunneria for sharing this. As a type 2 (but not RH) I am fascinated with your results. I am sure you will learn lots and be more able to control your RH as well as your Type 2. Thank you again for sharing.
     
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  5. Jey

    Jey Other · Well-Known Member

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    Wow that is amazing, very interesting. Thanks for shering that, Brunneria. It would make life so much easier and understandable. It is expensive but probably with that u wouldn't have to test as much with the strips!
     
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  6. AndBreathe

    AndBreathe I reversed my Type 2 · Expert
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    Thanks for clarifying your view. Similarly, I was just reporting some of my personal experience.
     
  7. AndBreathe

    AndBreathe I reversed my Type 2 · Expert
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    Can you recall where you saw those non-diabetic profiles @misswhiplash ? I would be fascinated to see them.

    Thanks, in anticipation. :)
     
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  8. misswhiplash

    misswhiplash Type 1 · Well-Known Member

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    No - but I'll have a hunt!
    I'm pretty sure there were a few people that tried Libre on the FB group (are you on it?) before their children started with it too - I'll see whether I can find any...
     
  9. AndBreathe

    AndBreathe I reversed my Type 2 · Expert
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    Thank you. I'd be grateful if you find anything. There's very little academic stuff on Normoglycaemia, which is irritating, if understandable, to an extent.

    I'm not an enormous FB fan to be honest.
     
  10. Hiitsme

    Hiitsme Type 2 · Well-Known Member

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    Hi @AndBreathe
    This was something I found using continuous glucose profiles in healthy subjects which I found interesting and bookmarked the page
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769652/
    I think this must be from America as units are mg/dl so need converting.

    I would also like to see anything else people find.
     
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  11. Brunneria

    Brunneria Other · Moderator
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    A T1 would still have to use strips regularly (for driving, etc), and Abbott say the Libre shouldn't replace finger pricks - esp for hypo testing. The libre tests interstitial fluid not blood glucose and it runs a few mins behind blood.

    However, I did 6 big tests during the first day alongside my SD code free, and my Freestyle Neo and the Libre.

    The comparison was fascinating. They all gave different numbers (of course), but they were all very consistent about it. The Libre ran consistently 0.5-7 below the neo. The SD was approx 0.2 above that. They rose and fell in steady synchronicity.

    From what I have read, each individual libre sensor runs at its own level - you just have to find out what that level is.

    So I decided to stop wasting strips. As a diet controlled T2 it doesn't matter to me what the number says (within reason!). What I need is an accurate method of plotting the height and depth and length of my glucose reactions to food. So the libre is perfect.

    :D
     
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  12. AndBreathe

    AndBreathe I reversed my Type 2 · Expert
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    I must admit, I do a calibration exercise with each sensor, and some have been very "off". I've had a number replaced, so perhaps I've been unlucky somehow. I've wondered if being very skinny affects the accuracy, but if that were the case, I doubt it would be embraced so enthusiastically by the parents who have adopted it for their children. Hey ho.

    But, the calibration helps make sense of the numbers, but like @Brunneria , the trends and peaks/troughs are more important to me. I also cross test if I see something very unexpected.
     
  13. AndBreathe

    AndBreathe I reversed my Type 2 · Expert
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    Thank you. I'll have a good read through that in a while.
     
  14. Brunneria

    Brunneria Other · Moderator
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    I copied the Results from the study above (normal bg reactions to meals containing fast absorption characteristics - which I assume means quick release carbs!), and have added (in green) the numbers translated into mmol/l for us Brits. Basically, this is dividing the number by 18.

    Also worth remembering that this is with standardised meals.

    Fascinating.
    Thanks @Hiitsme !

    Results
    The mean 24-hour interstitial glucose concentration under everyday life conditions was 89.3 (4.96mmol/l) ± 6.2 (0.34mmol/l) mg/dl (mean ± SD, n = 21 (1.16mmol/l)), and mean interstitial glucose concentrations at daytime and during the night were 93.0 (5.16mmol/l) ± 7.0 (0.38mmol/l) and 81.8 (4.54) ± 6.3 (0.35) mg/dl, respectively. The highest postprandial glucose concentrations were observed after breakfast: 132.3 (7.35) ± 16.7 (0.93) mg/dl (range 101–168 mg/dl (5.61-9.33)); peak concentrations after lunch and dinner were 118.2 (6.56) ± 13.4 (0.74) and 123.0 (6.83) ± 16.9 (0.94) mg/dl, respectively. Mean time to peak glucose concentration was between 46 and 50 minutes. After ingestion of standardized meals with fast absorption characteristics, peak interstitial glucose concentrations were 133.2 (7.4) ± 14.4 (0.8) and 137.2 (7.62) ± 21.1 (1.17) mg/dl, respectively. Meals with a higher fiber, protein, and fat content induced a smaller increase and a slower decrease of postprandial glucose concentrations with peak values of 99.2 (5.51) ± 10.5 (0.58) and 122.1 (6.78) ± 20.4 (0.11) mg/dl, respectively.
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769652/



    In Summary (mmol/l):

    mean 24-hour interstitial glucose concentration under everyday life conditions was 4.96 ± 0.34
    daytime 5.16 ± 0.38
    night 4.54 ± 0.35

    The highest postprandial glucose concentrations were observed
    after breakfast 7.35 ± 0.93 (range 5.61-9.33)

    peak concentrations
    after lunch 6.56 ± 0.74
    after dinner 6.83 ± 0.94

    Mean time to peak glucose concentration was between 46 and 50 minutes. After ingestion of standardized meals with fast absorption characteristics

    peak interstitial glucose concentrations were
    after lunch 7.4 ± 0.8
    after dinner 7.62 ± 1.17

    Meals with a higher fiber, protein, and fat content induced a smaller increase and a slower decrease of postprandial glucose concentrations with peak values
    lunch 5.51 ± 0.58
    dinner 6.78 ± 0.11


    Hope that clarifies!
     
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    #34 Brunneria, Dec 20, 2015 at 12:53 PM
    Last edited by a moderator: Dec 20, 2015
  15. Hiitsme

    Hiitsme Type 2 · Well-Known Member

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    Many thanks @Brunneria
    I had been looking at it with a conversion chart beside me but that is really helpful. I found it a few months ago when I was trying to find out what was normal for a non-diabetic as that was what I wanted to aim at. I do feel that there must be a lot more studies now so I will watch with interest if anyone else comes up with more research. I am aware that RH puts a very different perspective on things.. Good luck on your trials of the device which seem already to be helping.
     
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  16. tim2000s

    tim2000s Type 1 · Expert
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    Hi @Brunneria, you might find the following interesting. These are the graphs of a non-diabetic adult female. There's a lot more time spent in the high 3s, especially overnight, than you might expect. It is not an abnormal state (and the CGM traces on non-D children seem to agree with that!).

    [​IMG]
     
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  17. Brunneria

    Brunneria Other · Moderator
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    @tim2000s

    That is brilliant, thank you!
    And it bears out @AndBreathe 's experience. She now spends a lot of time in the 3s, I think.

    My body just liver dumps me back up if i drop into the 4s, no matter what i do... Well, except for masses of exercise. Never tried that ;)
     
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  18. AndBreathe

    AndBreathe I reversed my Type 2 · Expert
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    On the Libre, my average comes out at 4.5, which is when MrB is at home, and therefore I eat a few more carbs. When he's away, for example, I just don't bother making roast potatoes with my roast, so sort of gravitate downwards. When that is the case, my average is about 4.3, so it isn't massive.

    Of course, how my HbA1c comes out where it does is the perennial mystery, but right now, I can't lose any sleep over it. My head space is full of all sort of more interesting things.

    Thanks for posting that @tim2000s . Where did you find it (since I notice it's in mg/dL)?
     
  19. tim2000s

    tim2000s Type 1 · Expert
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  20. AndBreathe

    AndBreathe I reversed my Type 2 · Expert
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    Thanks.

    I really am not a fan of Facebook..... :oops:
     
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