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GCM spikes and drops

C

ConcernedRelative

Member
Hi all, just joined to try help a dearly loved one with ongoing issues.

Since he's been using librelink GCM we'd hoped to see some progress in understanding and managing this (T1 condition) but currently the device is still seen as a bairn of his existence. Am hoping to understand enough to help positively influence the situation

⚠️ Last reading was a 29 after 9units for his daily Weetabix. Wanna make sure every recommended reactive action is taken, to mitigate, whilst in medium-long term help prevent this hypo/hyperglycaemic episodes, wherever Possible. Knowledge is Power!

For now I'll just say hey, thanks in advance, and best wishes to you all.

¡Feliz Navidad & Namaste!
 
Welcome to the forums @ConcernedRelative

The libre is a marvellous device but it isn't error free. With a really high or low reading I'd do a back up glucometer test to see whether the reading really is that high. ( And if it really is that high I'd also test for ketones.)

Can I ask how old your family member is and how long they have been T1? Would they like to join the forums themselves?

Once more, welcome.

Edited to add, what was the bg before the weetabix ? What kind of insulin regime is he using ?
 
Thanks

The user is 70, and none technical (no mobile/online presence or interest). The NHS provided the device used to scan, so the data may not be readily/ever available for carer analysis (am trying to get regular and detailed recordings of food and insulin metadata, but this may be unrealistic)

Good shout re reading reliability, have learned today about the lag vs older prick readings*, and the ketones test is also worth checking - this was "0 2" (I'm told)

He's had diabetes for more than half his life now, but seems to be struggling more and more to be in the desired range (an acronym I think the diabetic dietician referenced during last involvement- TBC)

Think the BG was ~7.6 before weetabix (around 11)

Have just reminded the user during discovery that his lantis is due / overdue ('4 in PM, 5 in AM')

Hope this is coherent, and thanks again.
 
Are you with the user every day?
Do you have a smart phone?
If so you should be able to start the sensor with your phone, then read and record.
The Reader should also be able to read the sensor.
Noting that I haven't tried this.
 
Thanks, & Merry Xmas!

The user is using a device to scan and record (it looks like a phone but is locked down to only allow Libra app), and is very private about data, and anti tech, so expect resistance to him using additional scanners, and also infrequent scans on a secondary device won't be as useful, but it's a good idea (thanks:)

Having said that, I think the user would be willing and grateful for us to be able to see the readings (synced data)

"Went to bed with reading around 7, dropped to 3 by morning reading, so had dextrose"

Reading and learning lots, user may be unknowingly acting against recommended (stacking insulin, maybe taking daily lantis when hypoglycaemic)

Will gather more intel and data and hopefully help the user see they CAN manage as currently they're self diagnosed as a "medical anomaly", and readings are increasingly unexpected, and bad
 
ConcernedRelative said:
Reading and learning lots, user may be unknowingly acting against recommended (stacking insulin, maybe taking daily lantis when hypoglycaemic)
Click to expand...

So if your relative is T1 I'm assuming he's on a basal/bolus regime and the lantus is his basal? That's meant to be taken at the same time every day and is supposed to keep his levels steady when he isn't eating (eg overnight). Most of us on this type of regime start by attempting to get the basal dose right, and then adjust the bolus to both take care of meals and possibly a correction dose.

A bedtime reading of 7 followed by a morning reading of 3 suggests the basal lantus may need adjusting. You want it at a level where night and morning readings are roughly the same (with the proviso that the night reading is long enough after the evening meal and fast acting (bolus) insulin for that to be out of his system.

Is he getting any help from his team in calculating doses? As a long term T1 myself I adjust my own pretty readily, but they do give me some pointers at my reviews and if you're not confident to change your doses you do need to contact them for advice.

My suggestion would definitely be to start with some basal rate testing to get the lantus dose right. (That assumes he is on a basal/bolus regime and I haven't misunderstood),
 
You've understood perfectly, thanks.

There was contact with A team including a physio and diabetic nurse, but nothing recent.

The basal was adjusted (from just an evening dose to half evening half morning), but not tweaked recently.

This morning the reading was reportedly ok (~10),
but we'll monitor this, to see if theres a trend of low AM readings.
 
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