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Observations on Libre CGM, feedback needed
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<blockquote data-quote="Deleted member 527103" data-source="post: 2681178"><p>[USER=472768]@nsh2111[/USER] welcome</p><p>You mention that, following use of the Libre, you are confused but have not explained what has confused you. </p><p>As others have said, there is nothing to worry about from your graphs. </p><p></p><p>However, have you considered the frequently mentioned limitations of all CGMs including Libre?</p><p>- insertion trauma - it is common for our body to react to the trauma of having an alien object inserted in our arm which can affect the readings for the first 24 to 48 hours after insertion. These may appear random. Some people have no issues with this but others find it useful to activate the sensor the day after applying it. </p><p>- compression lows - I have not spotted any of these in your graphs but still worth being aware of these - if pressure is applied to a sensor, it can block the flow of interstitial fluid which can result in false lows being recorded. This is most common at night when you lie on your arm as you turn over in our sleep. These are easily spotted on your graphs because they are a sudden drop followed by a sudden rise when you turn over again. </p><p>- ISR delay - CGMs do not read Blood Glucose (BG) they read Interstitial Fluid Readings (ISR), Changes in BG are reflected about 15 minutes afterwards in ISR. Libre accommodates this delay within the algorithm it uses to convert form ISR to BG by extrapolating the current trend. This works most of the time unless the trend direction changed in the last 15 minutes. This can result in a delay to detect change of direction and an over estimation of the high or low which is later corrected.</p><p>- normal readings - Libre is factory calibrated to be most accurate for "normal" readings which are between about 4 and 9 mmol/l. Outside of this, Libre have a tendency to over report highs and lows. </p><p>- factory calibration - whilst out bodies differ, it was decided to factory calibrate Libre and unlike other CGMs not allow calibration against finger pricks. However, some of us find that our bodies differ significantly from ""factory man" and find large discrepancies between what Libre reports and what finger pricks report. </p><p>- 15% accuracy - all meters must comply to a standard of 15% accuracy. Therefore, if you do compare Libre with a finger prick, you need to consider that one could be 15% high and the other could be 15% low which can show a significant absolute difference, especially at high levels. </p><p></p><p>The other thing I would mention is that you are checking BG whilst exercising. Please bear in mind that exercise has different affects on BG depending upon type, duration and fitness at that activity. Resistance exercise, short exercise, stop-start activities and anything which makes you uncomfortable are likely to make your BG rise whereas longer term steady cardio is likely to make your BG fall. </p><p></p><p>Finally, be aware that other things such as stress and illness can affect BG.</p></blockquote><p></p>
[QUOTE="Deleted member 527103, post: 2681178"] [USER=472768]@nsh2111[/USER] welcome You mention that, following use of the Libre, you are confused but have not explained what has confused you. As others have said, there is nothing to worry about from your graphs. However, have you considered the frequently mentioned limitations of all CGMs including Libre? - insertion trauma - it is common for our body to react to the trauma of having an alien object inserted in our arm which can affect the readings for the first 24 to 48 hours after insertion. These may appear random. Some people have no issues with this but others find it useful to activate the sensor the day after applying it. - compression lows - I have not spotted any of these in your graphs but still worth being aware of these - if pressure is applied to a sensor, it can block the flow of interstitial fluid which can result in false lows being recorded. This is most common at night when you lie on your arm as you turn over in our sleep. These are easily spotted on your graphs because they are a sudden drop followed by a sudden rise when you turn over again. - ISR delay - CGMs do not read Blood Glucose (BG) they read Interstitial Fluid Readings (ISR), Changes in BG are reflected about 15 minutes afterwards in ISR. Libre accommodates this delay within the algorithm it uses to convert form ISR to BG by extrapolating the current trend. This works most of the time unless the trend direction changed in the last 15 minutes. This can result in a delay to detect change of direction and an over estimation of the high or low which is later corrected. - normal readings - Libre is factory calibrated to be most accurate for "normal" readings which are between about 4 and 9 mmol/l. Outside of this, Libre have a tendency to over report highs and lows. - factory calibration - whilst out bodies differ, it was decided to factory calibrate Libre and unlike other CGMs not allow calibration against finger pricks. However, some of us find that our bodies differ significantly from ""factory man" and find large discrepancies between what Libre reports and what finger pricks report. - 15% accuracy - all meters must comply to a standard of 15% accuracy. Therefore, if you do compare Libre with a finger prick, you need to consider that one could be 15% high and the other could be 15% low which can show a significant absolute difference, especially at high levels. The other thing I would mention is that you are checking BG whilst exercising. Please bear in mind that exercise has different affects on BG depending upon type, duration and fitness at that activity. Resistance exercise, short exercise, stop-start activities and anything which makes you uncomfortable are likely to make your BG rise whereas longer term steady cardio is likely to make your BG fall. Finally, be aware that other things such as stress and illness can affect BG. [/QUOTE]
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