What is this grey line?

[plantae]

Screenshot from libreview. That grey line doesn't match my alarms at all. Is is what is Libre or someone else considers "normal"?


3AM low shows. Nearly every night at 3AM I drop below 4. Other than that it's nice and flat hahaha

 

[plantae]

I must have woken up because there is a dot at 3:45 (about) and checked. I don't remember waking up at all. I should have treated that I think but I just don't remember. As far as I know I slept all night but the graph says different

 

[plantae]

I'm setting an alarm for 2:45AM on my phone to have something to eat. Just looking through the graphs nearly every night at exactly 3AM I go low. So I'm going to eat at 2:45

 

[EllieM]

Not a libre user, but pretty sure that the grey band (between 4 and 10) is because T1 insulin users are encouraged to use that as the default range.

Lots of people have a different range. When I last had a severe hypo my endocrinologist encouraged me to aim between 6 and 12 for a while. ( Mind you, I dodn't have a cgm then.)

Libre is renowned for reading low at night if you are lying on it. If you are going to set your alarm, I suggest that you do a glucometer check as well.

Are you still using lantus and if so when are you injecting it?

 

[AndBreathe]

I'm setting an alarm for 2:45AM on my phone to have something to eat. Just looking through the graphs nearly every night at exactly 3AM I go low. So I'm going to eat at 2:45

With that regular, almost repeatable low, do you cross check with your meter?

The Libre is a marvellous thing, but it has me being extremely vulnerable Low-2.2 almost every night. Hey ho.

 

[plantae]

Not a libre user, but pretty sure that the grey band (between 4 and 10) is because T1 insulin users are encouraged to use that as the default range.

Ah, yeah. That makes sense. I guess that's where it gets my "time in range" value from as well

Libre is renowned for reading low at night if you are lying on it. If you are going to set your alarm, I suggest that you do a glucometer check as well.

Are you still using lantus and if so when are you injecting it?

Yeah, they're not compression lows. I didn't get up last night to do a finger prick, I can't even remember doing the scan but I obviously did. They've reduced my lantus but I'm still on it. I take it at between 9 and 9:30PM... I aim for 9PM but sometimes I'm watching youtube and have it a bit late. I don't think I've ever had it later than 9:30 though. The choice of 9 PM is pretty arbitrary.... shift changes at the hospital were at 9:30PM so they gave it to me at 9 and I've just stuck with that time

With that regular, almost repeatable low, do you cross check with your meter?

The Libre is a marvellous thing, but it has me being extremely vulnerable Low-2.2 almost every night. Hey ho.

I cross-check anything below 4 with my contour next. I obviously didn't last night because I can't even remember scanning with the reader but the graph says I did. Usually (not always) they're similar. My libre just said 4.4 and Contour Next 4.8... close enough. I just don't understand how I did a scan towards the end of the low last night... I'm 99.9% sure that no alarm went off (it wouldn't have because I was not above the threshold to "re-arm" it all night)... and why I didn't treat it. That line from 4Am to 10AM is, for me, scarily low even disregarding the 3AM regular. Can low BSL cause memory loss? (I had breakfast at 10:30; I'm a night owl)

 

[plantae]

Are you still using lantus and if so when are you injecting it?

I don't want dosage advice (I haven't even given my dose amount for that reason), but have you heard of any stories of people being on bolus only, without lantus? My dose is so low I'm starting to suspect I don't even need it at this point in time, just the novorapid. Yet another question to ask my DN

 

[EllieM]

Can low BSL cause memory loss?

It can if it's low enough. I have no memory of my most extreme ambulance inducing hypos, though they traumatised my poor husband. Night hypos also tend to give me very dramatic dreams.

I don't want dosage advice (I haven't even given my dose amount for that reason), but have you heard of any stories of people being on bolus only, without lantus? My dose is so low I'm starting to suspect I don't even need it at this point in time, just the novorapid. Yet another question to ask my DN

Not something I have personal experience of (childhood T1s tend to stop producing insulin fairly fast and I was diagnosed before basal/bolus regimes were used) but logically if you are producing some of your own insulin it wouldn't at all surprise me. I have heard that some T1s have insulin free periods during their insulin honeymoons.
I think you need to talk to your DN. They must be nearly as sick of your hypos as you are. Good luck.

 

[oldgreymare]

Just to answer the original question, this article explains the adoption of the 10 - 3.9 mmol/L band as desirable limits to assess 'Time in Range' targets.

Time in range: A best practice guide for UK diabetes healthcare professionals in the context of the COVID-19 global pandemic - PubMed

The emergence of continuous glucose monitoring has driven improvements in glycaemic control and quality of life for people with diabetes. Recent changes in access to continuous glucose monitoring systems within UK health services have increased the number of people able to benefit from these...

pubmed.ncbi.nlm.nih.gov

Edit: these are internationally agreed ranges

 

[plantae]

Just to answer the original question, this article explains the adoption of the 10 - 3.9 mmol/L band as desirable limits to assess 'Time in Range' targets.

Time in range: A best practice guide for UK diabetes healthcare professionals in the context of the COVID-19 global pandemic - PubMed

The emergence of continuous glucose monitoring has driven improvements in glycaemic control and quality of life for people with diabetes. Recent changes in access to continuous glucose monitoring systems within UK health services have increased the number of people able to benefit from these...

pubmed.ncbi.nlm.nih.gov

Edit: these are internationally agreed ranges

Thanks!

I think you need to talk to your DN. They must be nearly as sick of your hypos as you are. Good luck.

Oh, I think she probably is. I had a phone appointment today and am now on the lowest lantus dose possible. The only thing I'm worried about (sort of) is how my BSL will react to snacks. I had to turn my libre alarm off last night because it was going off every hour. I can probably have a a close look at the graph and tweak the threshold but it was going 0.5 mmol over and 0.5 mmol under (roughly) every hour so the alarm would go off and wake me up. So in the end I just got out of bed. It's probably lucky I work from home and as long as my targets are met nobody cares what hours I actually do the work in because I'm doing most of my work in the middle of the night because the alarms have disrupted my sleep patterns

 

[plantae]

Just to answer the original question, this article explains the adoption of the 10 - 3.9 mmol/L band as desirable limits to assess 'Time in Range' targets.

Time in range: A best practice guide for UK diabetes healthcare professionals in the context of the COVID-19 global pandemic - PubMed

The emergence of continuous glucose monitoring has driven improvements in glycaemic control and quality of life for people with diabetes. Recent changes in access to continuous glucose monitoring systems within UK health services have increased the number of people able to benefit from these...

pubmed.ncbi.nlm.nih.gov

Edit: these are internationally agreed ranges

From the paper: "Overall, the target that people with type 1 or type 2 diabetes should aim for is TIR >70% (16 h 48 min/day)."

I'm doing ok then! My TIR is > 95%. Now to just fix these hypos