Newly diagnosed, up and down like a yo-yo

In range 99% of the time. That's exceptional. Your blood sugars will rise and fall, like even non-diabetics do. Injected insulin doesn't match what we eat, hence the rocky mountain range, but as long as they return to pre-meal levels 5 hours after eating, your doses are correct.

Are you finger pricking if lows or highs just my libre can be out by alot

Brookemurph said:

Would the fluctuations be helped possibly by a pump in the future?

Click to expand...

For some a pump helps immensely (for myself in fact), but as already mentioned 99% in target range is very very very good, many of us will never get that even with all the help in the world.

Even with automode I don't get that, I absolutely celebrate if I get a day at 100% in target (could probably count them on my fingers)

Brookemurph said:

Thanks everyone, my libre experience has been shocking to say the least. I’m always comparing to finger pricks so managing both is quite draining. Just as I feel it’s starting to read well it starts falling out! Would the fluctuations be helped possibly by a pump in the future?

Click to expand...

You could post a picture of your Libre graph in here so we know exactly what you're describing. But got to agree with the others, 99% in range is amazing.

@Brookemurph I recommend Googling something like "Libre graphs for people without diabetes" and you will see that everyone's blood sugars go up and down like a mountain range even when they have an organ almost entirely dedicated to managing it unlike those of us who have to inject insulin whilst living a full and active life.

Rather than thinking about how to control your blood sugar even better, I recommend living your life. Talk to someone about your worries at your next hospital appointment but, with an insulin pump, I would be overjoyed to be 99% in range.

That said, nearly 20 years after my diagnosis, eating what I want, exercising and travelling a lot whilst having a busy and sometimes stressful job, I have no complications from diabetes.

You are doing an amazing job - be proud of yourself and remember you are managing your diabetes, not controlling it.

Brookemurph said:

Thanks everyone, my libre experience has been shocking to say the least. I’m always comparing to finger pricks so managing both is quite draining. Just as I feel it’s starting to read well it starts falling out! Would the fluctuations be helped possibly by a pump in the future?

Click to expand...

Hi there, what strikes me is that you seem to think a rise and fall is somehow unusual or not normal. It is normal so trying to 'correct' it is a futile exercise unless of course it is way out of range or 2 one minute and 15 the next.. We have all been through the same when first diagnosed, we think that the line should be straight and smooth etc, well that is not true. As others have said, everyone's glucose levels rise and fall during the day, 24/7, every second of the day. Of course there can be issues with variability but if you are within range (is your range 4 to 10?), then you are on a hiding to nothing by expecting to keep your levels at an even 5 or 6 for example. I know you are learning but I really think you need to research how it all works because setting yourself unrealistic goals or thinking somehow you are 'failing' given your fantastic achievement so far is exhausting. What are the 'fluctuations' you mention, can you give us some numbers? Again, a libre is great but not so much if you are checking it every 5 minutes as that is when you will see a 'fluctuation' and the tendency then for a newbie is to panic. Don't forget also, that a normal working pancreas is able to drip out and stop insulin constantly, you are trying to emulate a pancreas and on MDI there is no way that you will be as efficient, hence the altered targets for those with insulin dependent diabetes. Of course you can strive to manage it (and you are) but please, don't be too hard on yourself.

Hi @Brookemurph Welcome to the forum

Wow 99% is pretty incredible, I have to admit I am about 10 years diagnosed and I have never achieved this, nor do I strive to, it's setting realistic targets which I know I can hit, so my time in range is around 60-75%, depending on time of month (as hormones impact my control), as well as stress, illness and other life factors which affect glucose levels. My advice to any newly diagnosed is take it day by day, don't set yourself up for unrealistic targets, only you will know in time what's right for you, yes our graphs look like mountains and valleys, but don't stress about it, it's simply a guide however you will see and learn in time that you can manage it more easily with experience and knowledge.

I’m attaching a couple of my Libre graphs from last week, which are completely typical for me. I don’t know if by “yo-yo” you mean this sort of thing. If you do, then I promise that is not out of the ordinary. Some people may have smoother graphs than this, others more bumpy, particularly Type 1’s (I’m a Tablet and low-carb Type 2). I am in range 100% of the time, which is I think much more difficult for a Type 1 to achieve. Comparing graphs isn’t necessarily a useful thing, but I just wanted you to see that if what you were “expecting” was a flat line, that isn’t realistic.

Brookemurph said:

Thanks everyone, my libre experience has been shocking to say the least. I’m always comparing to finger pricks so managing both is quite draining.

Click to expand...

An example plot, corresponding finger prick values (for highs and lows if you have them) and what you had been doing before or during rapid rises and falls might help us see whats going on.

Yes both of those look normal. The second one shows that you have a mini “second spike” with meals which I also often get - I *think* that’s cos insulin comes in two bursts - an initial one when you first eat and a second “mopping up” one. Obviously that doesn’t apply to people taking exogenous insulin

Brookemurph said:

Hi all, I was recently diagnosed type 1 in December and fortunate enough to have started the libre 2 process. I’m on MDI with lantus and novorapid, injecting for every main meal. However the libre has highlighted that my BG’s are up and down like crazy! I’ve worked hard to prevent lows and keep highs at bay so stay in range 99% of the time but my libre graph looks like a Rocky Mountain range. I’m not sure where I’m going wrong. Any advice?

Click to expand...

Thought you may be interested to see the profile of a non-diabetic. I asked my brother to wear a freestyle libre for comparison of profiles. As you can see even non-diabetics have large spikes in blood glucose, the large spike here (image with black background) was after he had a jacket potato. For comparison I have also put my daily graph, I am a T1D too (image with white background).

Your control looks exceptional for a T1D, this could be due to the honeymoon effect (you're still producing some endogenous insulin) and your insulin regimen.

Initially after my diagnosis I was too hyper focused on keeping my blood sugars in the normal range and started taking too much background insulin everything was going fine until I started playing 5 a side football every Thursday and my background insulin requirements plummeted, but because I was a diabetes noob I didn't adjust my background before I started football and I ended up very unwell after multiple hypos. So if you suddenly become unwell having hypos, first thing you should consider is potentially lowering your background dose of insulin. I found that my pancreas still decides it wants to come back life and start producing insulin again which lowers my insulin needs, so that is something to look out for. I wasn't warned about this when I was initially diagnosed so thought I'd give you a heads up just in case.

After a lot of faffing I decided my best bet was to reduce the amount of insulin I need to take as much as possible because when I was eating carbs my margin for error was huge because I took larger insulin doses. Now I eat a low carbohydrate diet (approx 30g carbs per day) and I only need 0.5 units of background insulin per day and approx 4 units fast acting per meal. This makes management so much easier as I am using the law of small numbers. Less insulin injected and less of an effect on my blood sugars.

I would definitely read Dr Bernsteins Diabetes Solution, Dr Bernstein is an 87 year old type 1 diabetic who still practices as a physician in the US and is fitter than most people 10 years younger than him. He advocates a low carb diet for diabetes management and he really understands the disease on a level that most Dr's and Nurses do not. His advice might even contradict that of your own doctor on occasion but he knows what he is talking about and will give you a really good insight into how to manage your blood sugars.

Sorry to have to Welcome you to the T1D club!

There is no perfect scenario unfortunately, you look like you're doing great

When I started this journey like you I tried to get that straight like as I am a perfectionist and love a challenge but experience has taught me not to be controlled by T1...continue to live a normal life as best you can.

If you can get as much data as possible on what foods you like do what to your levels you'll be come more accurate and more comfortable with your doses without panicking too much.

My levels below, today has consistented of a subway for lunch, snacks consist of carrots and nuts....just deciding dinner but will probably nail a pizza

Keep going the way you are, you're doing great

Brookemurph said:

Hi all, I was recently diagnosed type 1 in December and fortunate enough to have started the libre 2 process. I’m on MDI with lantus and novorapid, injecting for every main meal. However the libre has highlighted that my BG’s are up and down like crazy! I’ve worked hard to prevent lows and keep highs at bay so stay in range 99% of the time but my libre graph looks like a Rocky Mountain range. I’m not sure where I’m going wrong. Any advice?

Click to expand...

Hi,.

So yeah BG levels vary naturally, even in people without T1D. For those with T1D, perfectly matching the performance of a non-T1D person is going to be hard for a number of reasons. The pancreas is constantly managing hormones to keep BG's in check where as we're faced with some disadvantages:

- we have to inject insulin sub-dermally, so it takes some time for it to get to work.
- artificial insulin doesn't act as fast as natural insulin and has a different profile.
- we have to count carbs and estimate insulin requirements instead of 'sensing' it directly in the blood.

All in all, I'd say we shouldn't expect non-diabetic levels of BG control but what we should aim for is a level of control that keeps us physically healthy and mentally happy. And judging by your graphs, it looks like you're about there. Might be time to try and stop sweating the small stuff. You're doing great.

Hi welcome

Wow you guys have amazing control, seriously unhappy with myself now lol

Brookemurph said:

Thanks everyone, my libre experience has been shocking to say the least. I’m always comparing to finger pricks so managing both is quite draining. Just as I feel it’s starting to read well it starts falling out! Would the fluctuations be helped possibly by a pump in the future?

Click to expand...

I was also recently diagnosed with T1 and was eligible for a libre 2, I’m not sure how many sensors you have gone through so far however my very first sensor was all over the place and was extremely incorrect compared to my finger prick. However as time has gone on the sensors have gotten more and more accurate. However just remember that the libres are at least 15mins behind your BGM and in my experience are more up and down compared to your BGM. For example my Alarm might go off saying I’m low, I wait 10mins and scan my arm and I’m already back up to 6.5, and my BMG never showed a low reading throughout. The best advice I can give is don’t rely solely on the libre and still keep using your BMG from time to time. Take your libre readings with a pinch and use them to sort of get a ball part figure of where your readings are currently at.