Glucose target range on Libre 2 CGM?

[EmilyMay11]

I’m setting up my new free trail of the Libre 2 CGM. This is purely to get a better understand of what foods are spiking my blood sugars as currently using a glucose monitor nothing (carbs) is spiking my blood sugars.

I did an econsult from my surgery and they just replied with a paragraph basically saying Libre 2 isnt recommended to type 2 diabetic who’s don’t take insulin. So I’m stuck in limbo.

Just for some background, I’m 28, newly diagnosed with a HBA1C of 7.1

Does anyone have any ideas what my target should be?

 

[Rachox]

Hi @EmilyMay11 . I’m type 2 and use a Libre, I learn a lot from it, which is something health care professionals don’t appreciate. They are used to type 1s tailoring their insulin/hypo treatments according to the readings. Type 2s can observe their reactions to food, stress, exercise etc…. You can continue to use one but will have to fund it yourself.
Once in use you can set the target range to whatever you like. Personally I have mine set to 4.00 - 8.00 mmols/l. One of the great things about the libre is you can see clearly when a spike occurs, unlike finger pricking which only catches your reading at that moment. If you are testing 2 hours after eating you will probably be missing any spike.

 

[TheSecretCarbAddict]

There are some standard ranges for CGM monitoring and related time in range metrics. These are set on the basis of increased risk of long-term complications if you stay outside these for prolonged periods of time.

3.9mmol/l - 10mmol/l is a general recommended one, and 3.9mmol/l - 7.8mmol/l is tight range if you are looking to achieve even lower risk profile.

Full scientific breakdown around, for those who are interested, can be found below. A bit wordy and scholarly, but quite an interesting read: https://diabetesjournals.org/care/a.../International-Consensus-on-Use-of-Continuous

 

[TheSecretCarbAddict]

Just to add to the previous comments , I'm Type 2, I self-fund my CGM, and it has been a lifechanging piece of technology alongside all other tools to measure feedback of lifestyle interventions on my health.

I'm a bit of a control freak and am targetting 3.9mmol/l - 7.0 mmol/l with low alarm set at 3.5mmol/l (I no longer have hypos since stopping some of my diabetes medication, so this is not that relevant) and high one is at 7.8mmol/l (tells me take my dog for extra walk).

 

[Deleted member 527103]

As you are using the sensor to test you reactions to certain foods, unlikely to get a hypo, have no insulin to inject if your BG is high and only using it for 2 weeks, the ranges are not anything to worry about. In your situation, I would just leave them as they are.
I notice the higher readings are above 13.3. Bear in mind all CGMs (not just Libre) are less accurate when in double figures.
I also recommend reading about the limitations of CGMs which are repeated throughout the forums. If you do not understand about things like compression lows and insertion trauma, you may find the sensor very frustrating.

 

[EmilyMay11]

Hi @EmilyMay11 . I’m type 2 and use a Libre, I learn a lot from it, which is something health care professionals don’t appreciate. They are used to type 1s tailoring their insulin/hypo treatments according to the readings. Type 2s can observe their reactions to food, stress, exercise etc…. You can continue to use one but will have to fund it yourself.
Once in use you can set the target range to whatever you like. Personally I have mine set to 4.00 - 8.00 mmols/l. One of the great things about the libre is you can see clearly when a spike occurs, unlike finger pricking which only catches your reading at that moment. If you are testing 2 hours after eating you will probably be missing any spike.

I’ve applied for 2 free trails so will be only monitoring this way for 4 weeks.
This is exactly why, I want to see what happens to my BG after carbs as I think I’m missing the spike, 2 hours after and my readings are back down to nearly pre meal readings (which doesn’t seem right?) also want to see what happens after eating at certain times and I’m definitely a late eater.
I will set my range from 4-8 right now and see how we go.
Thank you.

 

[EmilyMay11]

Just to add to the previous comments , I'm Type 2, I self-fund my CGM, and it has been a lifechanging piece of technology alongside all other tools to measure feedback of lifestyle interventions on my health.

I'm a bit of a control freak and am targetting 3.9mmol/l - 7.0 mmol/l with low alarm set at 3.5mmol/l (I no longer have hypos since stopping some of my diabetes medication, so this is not that relevant) and high one is at 7.8mmol/l (tells me take my dog for extra walk).

I’ve got 2 free trail sensors so 4 weeks worth. If I really does make a difference I may look into buying privately. I will try 4-8 and might adjust 4-10. Depending on readings (currently am still waking up in the 8’s)

Thanks for your reply.

 

[ianf0ster]

I’ve applied for 2 free trails so will be only monitoring this way for 4 weeks.
This is exactly why, I want to see what happens to my BG after carbs as I think I’m missing the spike, 2 hours after and my readings are back down to nearly pre meal readings (which doesn’t seem right?) also want to see what happens after eating at certain times and I’m definitely a late eater.
I will set my range from 4-8 right now and see how we go.
Thank you.

Readings 2hrs after eating (first bite rather than the end of a long meal) is what you would see in somebody without diabetes. So it is what I and many other T2D's in here aim for by adjusting the carbs or portion sizes in our Low Carb way of eating.

 

[EmilyMay11]

Readings 2hrs after eating (first bite rather than the end of a long meal) is what you would see in somebody without diabetes. So it is what I and many other T2D's in here aim for by adjusting the carbs or portion sizes in our Low Carb way of eating.

My readings after 2 hours were also nearly the same pre meal (or always under 2.0 mmol rise) even after eating rice, potatoes, pasta, bread. Which is why I was wondering if I was missing the spike. Seemed to good to be true being able to tolerate all these carbs) I don’t want to cut carbs completely so want to see which ones I can tolerate in moderation.
Diabetic nurse said 2 hours post meal reading is fine as even non diabetics blood sugar rises after meals and 2 hours after is accurate enough, but forums and on here say I could be missing the spike and to get a CMG to measure more accurately.

 

[ianf0ster]

There are a lot of advocates for CGMs these days. I didn't need one to work out which foods are best for me and use that knowledge to get into T2D remission.
While it's true that some foods are digested a lot faster than others, 2hrs after 1st bite is generally good enough unless you know you have eaten something you know to be both carby and quickly digested without something else to slow the digestion down. This is chosen because in a non-diabetic, after that time the insulin response will have returned the Blood Glucose to the level it was before eating.
Examples might be bread without the butter (or spread). mashed potato without the butter or mayo etc. Although it can only be used as a rough guide (our metabolism differ) the higher the GI, the smaller the time interval, so as bread (and mashed potato) both have a higher GI than table sugar, you may want to test those after only 1hr then at 1 1/2hrs. Conversely if you eat a lot of fat in a meal, you may want to test at 2 1/2 and at 3hrs.

The main thing is that even non-diabetics get Blood Glucose rises from eating, because there is no way that your body knows how much natural insulin your will need for that food you just ate until it is already raising your BG - so the insulin response is always somewhat lagging.

Personally, I never bothered testing at shorter and longer periods because i soon stopped eating carby foods with a high GI and didn't care much if what I ate was low GI and so my BG response was flatter and longer lasting!

 

[ianf0ster]

I forgot to add:
CGM's are designed predominantly so as to warn those on glucose lowering drugs of the probability of an impending hypo.
Those who are not on such drugs may use a CGM, but there is the danger that they become obsessed by the short-lived highs which are quite normal for non-diabetics. Any blood glucose monitoring BG meter of CGM should only be done to a purpose. If it doesn't fit that purpose, then there is no point in testing.

I find myself having to mention this quite frequently even to those using an ordinary BG meter when they start doing completely random tests because they don't know for what precise purpose they should be testing.

 

[Melgar]

I‘m all for CGM’s . I self fund mine. I only started using them after a friend donated me 16 Libre 1’s a couple of years back when she started using the Libre 2’s instead. I personally find them amazing. Before this I finger pricked and thought everything was fine. It was only after wearing the cgm’s that I found I was having some serious hypos , which previously thought were nightmares or panic attacks. I also had no idea that my blood sugars would be in the 15mmol/l range. The cgm’s have helped me control my blood sugars better. By that I mean my blood sugars don’t spike like they did. I also find the Time in Range feature especially useful.

I had mine set at 4.5 to 10.3 but I have recently dropped it to 4.5 to 7.5 just to tighten my blood sugar range, but now I‘m always startled by all the yellow bars in the average glucose feature!

I think you will find it very useful, if only to see how food spikes your blood sugars.

 

[Melgar]

There are a lot of advocates for CGMs these days. I didn't need one to work out which foods are best for me and use that knowledge to get into T2D remission.
While it's true that some foods are digested a lot faster than others, 2hrs after 1st bite is generally good enough unless you know you have eaten something you know to be both carby and quickly digested without something else to slow the digestion down. This is chosen because in a non-diabetic, after that time the insulin response will have returned the Blood Glucose to the level it was before eating.
Examples might be bread without the butter (or spread). mashed potato without the butter or mayo etc. Although it can only be used as a rough guide (our metabolism differ) the higher the GI, the smaller the time interval, so as bread (and mashed potato) both have a higher GI than table sugar, you may want to test those after only 1hr then at 1 1/2hrs. Conversely if you eat a lot of fat in a meal, you may want to test at 2 1/2 and at 3hrs.

The main thing is that even non-diabetics get Blood Glucose rises from eating, because there is no way that your body knows how much natural insulin your will need for that food you just ate until it is already raising your BG - so the insulin response is always somewhat lagging.

Personally, I never bothered testing at shorter and longer periods because i soon stopped eating carby foods with a high GI and didn't care much if what I ate was low GI and so my BG response was flatter and longer lasting!

I would probably feel differently if I had spent years using a glucometer , but I am a fairly new diabetic so I have got accustomed to just glancing at the Libre phone app to see what my blood sugars are doing. The addictive pull of technology I guess.