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help !

Discussion in 'Type 1 Diabetes' started by ohmylex, May 29, 2019.

  1. ohmylex

    ohmylex · Member

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    IMG_1418.jpg

    i got my first libre yesterday and this is what my sugars have been like ! i had no idea i was managing it that badly and it’s really motivated me to try harder.
    any tips?
     
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  2. Muneeb

    Muneeb Type 1 · Well-Known Member

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    I think most people were in the same boat after using the libre initially. It was a gradual process for me, learning what I was eating and when to bolus correctly for it, affect of insulin at different times of the day, how exercise affectes my levels etc. Its much more stable now.

    Best thing you can do is to understand why you are seeing the large peaks, and what you can do to avoid them. Are you eating very late? is it the carb ratio? is basal incorrect etc? so many questions but you have to assess one by one.
     
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  3. Deleted Account

    Deleted Account · Guest

    I would suggest starting with a basal test to check your basal dose is correct.
    This is much easier with Libre than finger pricking.

    Once you have your basal levels correct, you can start looking at your bolus dose and timing.
    I found my dose was correct but I needed to inject much earlier than I thought.

    Throughout all of this, you should be able to call upon your diabetes team for support.
     
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  4. Juicyj

    Juicyj Type 1 · Expert
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    Hello @ohmylex The libre does take a day or so to settle in, so it's best to check any highs/lows against your meter for more clarity.

    Also overnight lows can be caused by compression to the sensor so in effect reporting a 'false low' so you could of been ok, again would need to be checked against your meter.
     
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  5. kitedoc

    kitedoc Type 1 · Well-Known Member

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    Hi @ ohmylex,
    If you go to the Home page and type 'basal testing' in the question box upper right you will find a procedure described.
    This assumes you are prescribed a multiple dose injection regime or MDI whereupon you are giving your good self short-acting insulin before each main meal and one or more
    long acting insulin injections per day.
    If this is not what you are prescribed ( but instead ate prescribed mixed insulins etc,)then the basal testing as described is not appropriate).
    For the MDI as described above: and best done in conjunction with your DSN or doctor's input:
    Essentially basal testing is a way of seeing what effect your long acting insulin dose is having on your BSLs ( blood sugar levels).
    To make things easier and least disruptive, usually one meal and pre-meal dose of short-acting insulin is omitted per testing day. Say, breakfast and pre-breakfast short-acting insulin both omitted and BSLs performed with finger prick testing every 2 hours as the most accurate readings, you can also see how your Libre readings compare.
    The longest haul is when omitting dinner and pre-dinner short-acting insulin as you have two- hourly BSLs from say 6 pm til 6 am or so the next morning Perhaps best left to start for a Friday or Saturday 6 pm time slot.
    And if all the finger pricks required worry you, just see if they get you out of some household chores as compensation !
    Once basal testing is completed you have information to discuss with your DSN or doctor about any possible dose changes with your long acting insulin before looking more closely at what is happening with your meals and short-acting insulin doses.
    Please keep posting and asking questions !!!
     
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  6. endocrinegremlin

    endocrinegremlin Type 1 · Well-Known Member

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    Use finger checks to see where the highs and lows really are. libre is unreliable out of target. get a better look at it with finger pricks then go from there.
     
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  7. Dianemacfaden

    Dianemacfaden Type 1 · Active Member

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  8. Dianemacfaden

    Dianemacfaden Type 1 · Active Member

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    I have been using Libres for nearly 2 years now and agree that it is amazingly interesting at first to see the peaks and troughs we go through each day, I would suggest don’t over react. Get your basal right by having a couple of carb free days. Sometimes they read low when you are not as low as it says, so calibrate with blood readings. Then study the patterns with carbs and insulin. Mine shows how slowly my short acting insulin takes effect so I am better if I inject a good 20 mins before eating.
    Persevere. It’s interesting and worth it.
     
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  9. kitedoc

    kitedoc Type 1 · Well-Known Member

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    Hi @Dianemacfaden,,
    I gather that this site recommends only omitting one meal and pre-meal short-acting insulin for basal testing per day.
    Certainly if i fast for 18 hours i start to show ketones which can cause my long acting insulin or basal to become less effective, thus interfering with the basal testing results.
    So i am not sure that several carb free days will be helpful apart from putting one through the keto flu.
    I will do 12 hour fasts to speed up the basal testing but not longer than that time interval due to the above explanation,
    If i have misunderstood your post i apologise but the above is a response to how i read it.
     
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  10. emmay

    emmay Type 1 · Well-Known Member

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    Congrats on using ur first libre, I agree with what others have said, don’t over react to what ur readings show you. Which is a mistake that I first made and tried to change it all in one go which made things worse. Use the reminders when you eat as they will prompt you in seeing what is really happening for you to think about the next day at the same time.

    It will take awhile to get to grips with it all and be prepared for some things not to work, just remember your doing ur best and that’s the main thing
     
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  11. noyahO21

    noyahO21 Type 1 · Member

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    Hello
    I suggest you talk with your Endocrinologist and / or Diabetes Educator for advice. FYI, I’ve stopped using the Libre sensors after a year. I was disappointed when my Hba1c result went up to 7.5% from 6.7% after my Libre was showing I had 85% of my readings in target over the past 3 months.
    I did one month of paired testing, ie used Libre plus finger prick which showed the Libre is clearly inaccurate. Bsls were consistently anywhere between 2-5 mmol higher, average 3mmol higher. Hence reason my Hba1c increased after being no higher than 6.7% for the past 20+ years. I now check my blood sugar only using the Libre Reader which stores all my data. I’m very disappointed that I’ve had to revert to finger pricking but at least it’s accurate. I’ve had Type 1 diabetes for 52 years since age 3. My daughter, age 20, who was diagnosed with Type 1 diabetes a year ago also had the same experience with the Libre over the past 6 months. She has also reverted to finger pricking/bsl checking. Best wishes.
     
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  12. kitedoc

    kitedoc Type 1 · Well-Known Member

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    Congrats on your achievement, from me, another 52 years on insulin person.
    I have avoided the Libre on principle although others seem to find apps of various sorts help, although even they have their quirks. I see it as only helpful for trends nothing else and in Australia we have to pay outright for it.
    One's finger tips do take a beating over the years and i am tempted to look at the Dexcom with or without linking to my insulin pump ( using pumps for 7 years now due to night hypos when on 8 + injections Novorapid and Levemir) could not control them.
    But it is a fairly recent change in diet that has enable me to go from HBA1Cs of 6.4% to 5.9% (and the latter reading taken 3 months after the first but with only 6 weeks on the new diet). Not all 'beer and skittles' mind you but encouraging, I think!
    (Please PM me if you wish to know more about it)
    But expense for the Dexcom is an issue here unless one is pregnant ( male, so no go)!, under 21, or pensioner.
    i can imagine your daughter is grateful for all the changes in diabetes management for he past 50 + years! My Best Wishes to her also.
    So welcome and keep posting - all wisdom gratefully accepted!
    It is all about balance Nothing is impossible


    P4220890.jpg .................... P4220867.jpg
     
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    #12 kitedoc, Jun 2, 2019 at 2:51 AM
    Last edited: Jun 2, 2019
  13. becca59

    becca59 Type 1 · Well-Known Member

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    Just to say I am obviously lucky. 18 months in and the Libre is insanely accurate for me. It has enabled me to reduce my HBA1C to 48. Hopefully it will be the case for you too @ohmylex
     
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  14. noyahO21

    noyahO21 Type 1 · Member

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    Hello becca59, I'm very happy that the Libre has been accurate for you, that's fantastic. I've heard it is accurate for some people. I wish it was for me. It was such a luxury to wake at night and just grab my phone to check reading not to mention so much easier during the day and when travelling. I hope it continues to be accurate for you. Best wishes.
     
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  15. noyahO21

    noyahO21 Type 1 · Member

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    Hello
    I also buy my Libres in Australia! That's fantastic having an HbA1C of 5.9%. Well done; congrats. Mine has been in the 6s for 30 years, so very disappointed when it escalated to 7.5% after staring to use the Libre. I follow a very low carb diet which has also helped me to reduce my HbA1c and avoid night time hypos which I experienced a lot prior to doing the DAFNE course in Sydney in 2012. Is this the diet you follow? This changed my life. I don't use a pump, just injections and multiple bsl checking per day which I don't mind at all. Best wishes.
     
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  16. kitedoc

    kitedoc Type 1 · Well-Known Member

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    Hi @noyahO21, I am in Adelaide.
    I do very low carb diet and use a ratio of insulin to carbs to calculate bolus doses for meals, with more insulin needed for breakfast ( I unit per 6 g carbs = (carbs + 50% g of protein) vs 1 unit to 10 g carbs= (crabs + 50% g of protein) for dinner.
    The night time hypos I would have thought to be more related to long-acting insulin doses. And with very low carb diet both my bolus doses (as expected with less crabs than before) and basal ( low continual type doses of short-acting insulin sort of equivalent to what your long-acting doses do) reduced.
    I do not see what DAPHNE did for you but I would not expect the type of fluctuations seen on the Libre record you posted for someone on a very low carb diet (e.g. 30 g carbs per day) except if there were a lot of hypos and of course the Libre does have reported inaccuracies when used for some people.
    I thought DAPHNE tended to encourage hi carb diets, and eating what one likes and trying to match insulin to that.
    Very low carb diet to me is more about matching food type and intake and resultant slower and more gradual and less high BSL rise to the action of the short-acting insulin used.
    Best Wishes!!
     
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  17. noyahO21

    noyahO21 Type 1 · Member

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    I also follow a very low carb diet. I still need QA sometimes, despite eating no carbs sometimes. I use the DAFNE principles for ratios regarding carbs I eat / insulin. It's fantastic. Also teaches you how to correct if your bsl is high or low whether you're eating carbs or not. As long as the basal, i.e. long acting insulin, is correct, I do a morning and evening basal injection, you can eat whatever you like so long as you calculate the amount of quick acting insulin needed. For the majority of the time it works fine, sometimes not. That's the joy of having had Type 1 diabetes for 52 years. As you said, it's all about balance . And perseverance too. Best wishes.
     
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  18. becca59

    becca59 Type 1 · Well-Known Member

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    @kitedoc DAPHNE is not about eating a high carb diet. It is about adjusting for what you do eat. And for how to deal with illness, alcohol and much more. Best thing I did since diagnosis. I don’t eat low carb per se but do try and keep it under 100 daily. For me low carb doesn’t necessarily mean less insulin. On the days I eat a so called no carb meal I end up taking more insulin than when I eat a moderate amount of carbs. The Libre allows me to see that in a way that is quite an eye opener.
     
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  19. Jay_Loftus

    Jay_Loftus · Member

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    I personally don’t follow any specific diet and just count carbs and take basal at night and bolus as and when I eat.

    I noticed that shortly after a got the libre and continued my life as normal and monitored my blood sugar I noticed the same a high peak and I think due to the higher blood Andy increased bolus I would have the lows you see in your graph.

    Shortly after I kept noticing the trend I started to take my bolus around 15-20 mins before eating (if I knew what I was going to eat) and that seemed to have sorted it out for me.

    Possible that your bolus is wrong and you’re having hypos followed by the hyper? Something to contact your consultant about. If you share your data with your healthcare provider they can have a look when you contact them and provide some help and suggestions too help!
     
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