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Type 2 learning about a CGM

R

Royjk

Well-Known Member
Messages
94
Location
Prague
Type of diabetes
Type 2
Treatment type
Insulin
So, I have been persuaded by my doctor to use a Libre 2+ CGM. I put it on and find there are three main spikes in the day, as expected, and saw that my evening units were not doing much to my evening food. I do the injection 15 min before eating, the BG rises for about 3 hours, and then spikes for another 1.5 hours before settling at about 13.5. The the only way to get it down is to do about 3 units of fiasp which brings the number down to BG 7.5. So my question is is it normal for digestion to continue for 4.5 hours, and does fiasp work for 4.5 hours.
 
Royjk said:
So, I have been persuaded by my doctor to use a Libre 2+ CGM. I put it on and find there are three main spikes in the day, as expected, and saw that my evening units were not doing much to my evening food. I do the injection 15 min before eating, the BG rises for about 3 hours, and then spikes for another 1.5 hours before settling at about 13.5. The the only way to get it down is to do about 3 units of fiasp which brings the number down to BG 7.5. So my question is is it normal for digestion to continue for 4.5 hours, and does fiasp work for 4.5 hours.
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As I understand it Fiasp works for around 5 hours in a bell shaped curve.

How are you caculating the number of units you need?

I also use Fiasp as my short term insulin and for meals with larger numbers of carbs I often find I need to do a top up dose of Fiasp two to three hours after eating (doing the same amount at outset will cause my blood sugar to go too low after 30 minutes or so).
 
Hello @Lakeslover , I have not found a way of calculating the number of units, I just wind up the pen till I see the BG at a good level, and the 25 units I take in the evening is not doing that. My regular evening readings are 11 - 15.5, which I correct with a 3 unit shot just before bed. It all goes down overnight and is ok in the morning. But I am not sure if the three unit shopp is the best way of dealing with it
 
When I first started on fiasp I spent some time calculating the number of carbs in a meal, and then seeing how many units I needed to deal with those carbs.

What dies your nurse/doctor recommend for calculating the dose?
 
hello @Lakeslover yes originally I tried calculating a dose base on how much carb there was on the plate, but found the amount of insulin changed dependant on what the carb was, and I could not find a simple units ti carb ratio. It seems to depend more on how quick the food is digested. So as breakfast is all digested in 2 hours I give it 15 units and lunch does not cause a spike, 15 units, then 25 for eveneng meal which digests for about 4.5 hours and always is left with BG high.
My doctor has said my units of fiasp are ok and A1c is ok, but when pressed for a number she said everything is good, wear the CGM sensor.
 
Just a thought but do you have an alcoholic drink with your evening meal? That can delay your liver releasing sugar into the bloodstream. The type of carbs can also make a difference, as can the food you eat the carbs with.

I actually don’t see anything wrong with injecting before the meal then adding a top up later. It works for me if I have a higher carb meal.
 
Hello @Lakeslover yes I can imagine alcohol delaying BG rise, but I saw that alcohol does not go well with diabetes, so I decided 9 months ago to cut all alcohol out of my diet. I am not so much a reformed alcoholic, rather a person who looks carefully at whats actually in the diet.
It is this idea of taking insulin an hour after food, or doing a second correction dose of 3 units if the spike does not go down after 2 hours, that I am concidering. My time in the green on the CGM shows 87% for the first 7 days of using it, so I am sure I have some kind of control. But spikes occur, between 3 and 4 hours after the evening meal, and will either come down overnight, or be brought down with a 3 unit dose before bed. Either options give me a about 1 hour in the red, lower than 3.9 between 3 - 4am.
 
Hello @Antje77 yes I did try moving the dose to 30 min before eating and that seemed to reduce the spike at breakfast, so I am adopting that for the start of the day. But the evening dose just seems to run out of effectivness and the spike just rises hours after the meal with no little snacks in between. It was not a problem before the CGM, as I did not test in the evenings, but I knew it was often too high before bed, but always just right in the morning at 6.2.
 
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