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Twitter threads on why most GP's won't suggest low carb
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<blockquote data-quote="Scott-C" data-source="post: 1919474" data-attributes="member: 374531"><p>I think patients can play a part in educating doctors on this, for the simple reason that, though they are doctors and might even have worn libre for a fortnight, long term users have way more practical experience of its quirks.</p><p></p><p>I've told mine that libre is notorious for under-reading at low levels, and I've even taken a few pictures of it alongside a meter reading to prove it.</p><p></p><p>Blinging it with a transmitter and running it to xDrip+ improves the accuracy hugely, often to levels like 0.3 or 0.5, whereas libre read with the Reader can easily be 1 to 1.5 out.</p><p></p><p>XDrip+ has some useful statistics - time in range, high and low, averages, SD and RSD, and an AGP graph, so those give a much clearer picture of how the a1c is arrived at.</p><p></p><p>The doc just has the a1c number, and a preconception that a low a1c must mean lots of hypos, whereas we've got lots of more meaningful numbers to show that a low a1c is achievable through just avoiding going above 8 or 9 much.</p><p></p><p>I also tell them that with libre, we can spot dropping levels so easily that we can have a few dextrotabs to level things off, so most hypos tend to be "soft landings", technical nudges below 4, and most of that comes from libre exaggerating drops.</p><p></p><p>I've also told them that pre-libre, I'd quite often have situations, for a variety of reasons, where I was likely knocking around above 10 overnight. Whereas now, with having a hyper alarm at 7.6, I'll get woken and make a judgment call on whether a correction is needed, and/or a basal adjustment. I'm convinced that ironing out overnight highs which can last for hours plays a big part in notching down a1c.</p><p></p><p>To be fair, the docs I've seen have been fairly receptive to this new stuff.</p><p></p><p>I've got a vague recollection that even in T0s, levels will regularly fall below 4 when sleeping - why shouldn't they when the person is just sleeping and doesn't need much energy. I'm not certain about this, though, it's just a hazy memory, might google it.</p></blockquote><p></p>
[QUOTE="Scott-C, post: 1919474, member: 374531"] I think patients can play a part in educating doctors on this, for the simple reason that, though they are doctors and might even have worn libre for a fortnight, long term users have way more practical experience of its quirks. I've told mine that libre is notorious for under-reading at low levels, and I've even taken a few pictures of it alongside a meter reading to prove it. Blinging it with a transmitter and running it to xDrip+ improves the accuracy hugely, often to levels like 0.3 or 0.5, whereas libre read with the Reader can easily be 1 to 1.5 out. XDrip+ has some useful statistics - time in range, high and low, averages, SD and RSD, and an AGP graph, so those give a much clearer picture of how the a1c is arrived at. The doc just has the a1c number, and a preconception that a low a1c must mean lots of hypos, whereas we've got lots of more meaningful numbers to show that a low a1c is achievable through just avoiding going above 8 or 9 much. I also tell them that with libre, we can spot dropping levels so easily that we can have a few dextrotabs to level things off, so most hypos tend to be "soft landings", technical nudges below 4, and most of that comes from libre exaggerating drops. I've also told them that pre-libre, I'd quite often have situations, for a variety of reasons, where I was likely knocking around above 10 overnight. Whereas now, with having a hyper alarm at 7.6, I'll get woken and make a judgment call on whether a correction is needed, and/or a basal adjustment. I'm convinced that ironing out overnight highs which can last for hours plays a big part in notching down a1c. To be fair, the docs I've seen have been fairly receptive to this new stuff. I've got a vague recollection that even in T0s, levels will regularly fall below 4 when sleeping - why shouldn't they when the person is just sleeping and doesn't need much energy. I'm not certain about this, though, it's just a hazy memory, might google it. [/QUOTE]
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