BG PATTERNS FOR TYPE 1 - HELP WITH

[mum2westiesGill]

Because you are waking up with hypos.

I reduced it from 21 units to 20 units on Tuesday 18/5/2021

 

[mum2westiesGill]

After taking the 4 units at 9.02, did you keep continuously monitoring your levels, as @rebrascora suggested, until they started to drop? Not sure why you waited until you were at 4.8 to start eating.
It looks like you've waited too long to eat.
You'll need to tweak that.

The next time I tested with a finger prick was at 9:34am - I between 9:02am & 9:34am I was doing a few things in the house ie making toast, putting pots in the dishwasher etc.

When you say monitor continuously how often do you mean & also do you mean by finger pricking?

 

[mum2westiesGill]

With humalog it can take 10 - 15 minutes to start working so ideally whatever my bg is and whatever meal I'm having I should be injecting
- definitely no longer than 15 minutes before I eat
- ideally 10 minutes is the best amount of time or
- straight away if having to eat straight away can't be avoided - like when the hubby shouts out tea is ready so I then have to inject straight away!

 

[rebrascora]

The next time I tested with a finger prick was at 9:34am - I between 9:02am & 9:34am I was doing a few things in the house ie making toast, putting pots in the dishwasher etc.

When you say monitor continuously how often do you mean & also do you mean by finger pricking?

No this is the beauty of Libre. You don't need to keep finger pricking so often you can just keep scanning with it every few minutes. It only takes seconds to swipe your reader or phone over your arm and look at the reading and see if it is lower than the previous reading, even when you are busy, to see when the insulin starts to kick in and then eat your breakfast as soon as it starts to work.
As @pm133 says, you waited too long this morning. Maybe try just 20 mins between injecting and eating breakfast next time but do scan every few mins during that time with the Libre to look for it starting to work and your BG levels starting to drop and eat as soon as that happens, even if it is before the 20 mins. You are looking to match the majority of the Humalog hitting your blood stream at the same time as the carbs by doing this so that your BG levels don't spike.

Why not stop finger pricking on a morning when you wake up and just scan with the Libre instead. If the Libre says you are hypo or hyper then check with a finger prick but there is no need to be doing both and part of the benefit of the Libre is to reduce the amount of finger pricks you do, to make life easier. Some people still finger prick to get a reading to calculate their meal boluses and corrections but I usually don't and I often go several days without ever doing a finger prick, just using my Libre reading for everything.... unless it doesn't match with how I feel. Can you imagine not finger pricking even once in a day

It looks like your Libre readings are matching your finger prick readings pretty well apart from showing you lower at low levels like that 3.7 when your finger prick was 4.9, which is common with Libre. Mine reads consistently 1mmol below my finger prick when levels are below 5. If Libre shows you are hypo then you should double check with a finger prick anyway and be guided in your actions by the finger prick reading rather than the Libre.

 

[rebrascora]

I would also be looking at my basal.

Gill has already reduced her basal because of that hypo but with Tresiba you need to wait 3 days before making any further adjustments, so she has already "looked at her basal" and taken the appropriate action.

Just clarifying so that your comment doesn't make her think she needs to do something more.

 

[mum2westiesGill]

No this is the beauty of Libre. You don't need to keep finger pricking so often you can just keep scanning with it every few minutes. It only takes seconds to swipe your reader or phone over your arm and look at the reading and see if it is lower than the previous reading, even when you are busy, to see when the insulin starts to kick in and then eat your breakfast as soon as it starts to work.
As @pm133 says, you waited too long this morning. Maybe try just 20 mins between injecting and eating breakfast next time but do scan every few mins during that time with the Libre to look for it starting to work and your BG levels starting to drop and eat as soon as that happens, even if it is before the 20 mins. You are looking to match the majority of the Humalog hitting your blood stream at the same time as the carbs by doing this so that your BG levels don't spike.

Why not stop finger pricking on a morning when you wake up and just scan with the Libre instead. If the Libre says you are hypo or hyper then check with a finger prick but there is no need to be doing both and part of the benefit of the Libre is to reduce the amount of finger pricks you do, to make life easier. Some people still finger prick to get a reading to calculate their meal boluses and corrections but I usually don't and I often go several days without ever doing a finger prick, just using my Libre reading for everything.... unless it doesn't match with how I feel. Can you imagine not finger pricking even once in a day

It looks like your Libre readings are matching your finger prick readings pretty well apart from showing you lower at low levels like that 3.7 when your finger prick was 4.9, which is common with Libre. Mine reads consistently 1mmol below my finger prick when levels are below 5. If Libre shows you are hypo then you should double check with a finger prick anyway and be guided in your actions by the finger prick reading rather than the Libre.

Hi @rebrascora I think waiting 20 minutes between injecting and eating is a bit too long for me to wait.

When you say stop finger pricking in a morning when I wake up - do you mean to do a libre scan when I wake up usually around 7am - 7:30am then around 9am sometimes a bit later do a finger pick before my breakfast so I can use my mysugr bolus advisor for my meal bolus?

 

[Leadinglights]

Sorry to butt in @mum2westiesGill, I know nothing about the technology you are using as Type 2 and not on insulin I don't need to but what comes over from some of your posts is you are not confident with what you are using to the extent that you doubt your judgement.
I believe somebody mentioned there was a training course available which may help you get to grips with the features which will allow easier management of your condition on a day to day basis and give you a bit more confidence to decide what is right for you and to interpret the information you get from your Libre.

 

[Bruce Stephens]

I believe somebody mentioned there was a training course available which may help you get to grips with the features which will allow easier management of your condition on a day to day basis and give you a bit more confidence to decide what is right for you and to interpret the information you get from your Libre.

Yes, there's DAFNE and a variety of local courses (broadly similar but I think), BERTIE online, and My Type 1 Diabetes.

And specifically for Libre there's a bunch of really good videos (which I learned a lot from). There's Abbott's Libre Academy and a collection of shorter videos from ABC Diabetes though it looks like they may have closed down (website doesn't support https). The ABC Diabetes videos are still available on YouTube (I gave the link earlier, or just search for "ABCDiab" and find their playlist on Flash Glucose Monitoring).

 

[rebrascora]

Hi @rebrascora I think waiting 20 minutes between injecting and eating is a bit too long for me to wait.

When you say stop finger pricking in a morning when I wake up - do you mean to do a libre scan when I wake up usually around 7am - 7:30am then around 9am sometimes a bit later do a finger pick before my breakfast so I can use my mysugr bolus advisor for my meal bolus?

Yes, that is what I mean. Save yourself at least 2 finger pricks a day by using the Libre to scan first thing when you wake up and at bedtime.... but do use it lots in between too to see what your BG is doing. Forget about the prebolusing for now as you clearly are not understanding what we are trying to explain and if it is causing you to hypo then there is more loss than potential gain.

Do do the online training and scan much more frequently but at least stop finger pricking on waking and before sleeping and just use the Libre instead as the main purpose of the Libre is to reduce the number of finger pricks required.

Do you have Libre on prescription or are you self funding? I am really surprised if they have prescribed it without you understanding how to use it and having completed some sort of training with it because at the moment it seems you are getting almost no benefit from using it.

 

[mum2westiesGill]

Libre scans today

 

[mum2westiesGill]

Finger pricks today

 

[PattiEvans]

Yes, there's DAFNE and a variety of local courses (broadly similar but I think), BERTIE online, and My Type 1 Diabetes.

And specifically for Libre there's a bunch of really good videos (which I learned a lot from). There's Abbott's Libre Academy and a collection of shorter videos from ABC Diabetes though it looks like they may have closed down (website doesn't support https). The ABC Diabetes videos are still available on YouTube (I gave the link earlier, or just search for "ABCDiab" and find their playlist on Flash Glucose Monitoring).

The Bertie online course is excellent. I would recommend it. When version 2 was in it's Beta phase myself and the mods on DSF were invited to evaluate and comment on it. It's certainly worth doing. @trophywench was one of the people who evaluated it too.

 

[pm133]

The next time I tested with a finger prick was at 9:34am - I between 9:02am & 9:34am I was doing a few things in the house ie making toast, putting pots in the dishwasher etc.

When you say monitor continuously how often do you mean & also do you mean by finger pricking?

Reading your responses, I am a bit worried that we are starting to drown you in good intentions here. The advice we are giving you might sound to us as though it's straightforwards but I'm getting a strong impression that we might be confusing you.

I think you are going to need to take a little time to play with the online material at your own pace and pursue things with your Diabetes Nurse to get you confident in what you are doing.
I have to re-iterate that I don't see any problems with your readings. They look perfectly fine to me and I hope you can find a way of relaxing a little over how things are going.

 

[mum2westiesGill]

Reading your responses, I am a bit worried that we are starting to drown you in good intentions here. The advice we are giving you might sound to us as though it's straightforwards but I'm getting a strong impression that we might be confusing you.

I think you are going to need to take a little time to play with the online material at your own pace and pursue things with your Diabetes Nurse to get you confident in what you are doing.
I have to re-iterate that I don't see any problems with your readings. They look perfectly fine to me and I hope you can find a way of relaxing a little over how things are going.

Hi @pm133 - thanks for your reply. Thanks you for reading my responses. Yes you're right saying it's confusing me - I'm not very technical .
I'm glad you think my readings are perfectly fine. Should I carry on posting my readings & if so finger prick readings or libre scan readings? Do you think I should carry on with my libre scans in between meals?

Good news
My dsn was really lovely yesterday. I sent her my last couple of weeks MySugr bgs and she said not to be too hard on myself. My glucose control is 7.1 & estimated HbA1c is 6.1%.
She said about injecting pre food - straight away is ok - 10 minutes is good but no longer than 15 minutes.

 

[pm133]

Hi @pm133 - thanks for your reply. Thanks you for reading my responses. Yes you're right saying it's confusing me - I'm not very technical .
I'm glad you think my readings are perfectly fine. Should I carry on posting my readings & if so finger prick readings or libre scan readings? Do you think I should carry on with my libre scans in between meals?

Good news
My dsn was really lovely yesterday. I sent her my last couple of weeks MySugr bgs and she said not to be too hard on myself. My glucose control is 7.1 & estimated HbA1c is 6.1%.
She said about injecting pre food - straight away is ok - 10 minutes is good but no longer than 15 minutes.

I'm glad you managed to talk to your DSN and that she has been more helpful and encouraging this time.

My advice would be to continue talking to her as she is best placed to help you. As I said earlier, I think my advice is confusing you and I'm really loathe to add to that confusion with further advice.

 

[mum2westiesGill]

So today is a new day 🙂

00:16am - 6.5 - finger prick - bedtime
7:26am - 4.2 - finger prick - waking
10:17am - 5.1 - finger prick - 3 units of humalog ready for breakfast
10:32am - 4.8 - finger prick - breakfast - 3.6 cp or 36g of carbs
10:32am - 4.7 - libre scan
10:49am - 3.7 - libre scan alarm - didn't do finger pick test because was still eating breakfast
10:47am - 11.9 - libre scan alarm
13:31pm - 8.6 - random libre scan

 

[Robin]

So today is a new day 🙂

00:16am - 6.5 - finger prick - bedtime
7:26am - 4.2 - finger prick - waking
10:17am - 5.1 - finger prick - 3 units of humalog ready for breakfast
10:32am - 4.8 - finger prick - breakfast - 3.6 cp or 36g of carbs
10:32am - 4.7 - libre scan
10:49am - 3.7 - libre scan alarm - didn't do finger pick test because was still eating breakfast
10:47am - 11.9 - libre scan alarm
13:31pm - 8.6 - random libre scan

Is 10.30am the first time you scan your Libre every day? Because it only stores the information for the previous 8 hours, so if you went to bed at half past midnight (and only if you scanned it then), and don’t scan til 10.30am, that’s 10 hours, and it will be missing the data between whenever you last scanned the evening before, and 2.30am (eight hours before your 10.30am scan). If you didn’t scan at bedtime, there’ll be a longer gap. This overnight info can be really useful in determining why you are sometimes hypo in the morning, and it would be good to swipe the Libre at the same time as doing your first waking test of the day. Then you’d get a complete 24 hour graph.

 

[mum2westiesGill]

Monday 24/5/2021
7:28am - 8.2 - waking
9:12am - 10.2 - breakfast
14:05pm - 4.5 - lunch

 

[helli]

So today is a new day 🙂

00:16am - 6.5 - finger prick - bedtime
7:26am - 4.2 - finger prick - waking
10:17am - 5.1 - finger prick - 3 units of humalog ready for breakfast
10:32am - 4.8 - finger prick - breakfast - 3.6 cp or 36g of carbs
10:32am - 4.7 - libre scan
10:49am - 3.7 - libre scan alarm - didn't do finger pick test because was still eating breakfast
10:47am - 11.9 - libre scan alarm
13:31pm - 8.6 - random libre scan

To minimise the time between scans, I would be replacing the waking finger prick with a scan and then, maybe, keep a finger prick before the breakfast bolus if I wanted a bit of confidence with the value.
I would also be doing a scan comparison every time I did a finger prick to build my Libre confidence.

The other thing to remember is that the Libre tells you what is happening between scans. The value "now" may be less interesting than the shape of the graph between the last scan - has it gone up and then back down again or down and back up again or ...? This is what will tell you whether you bolused too early or too late.

 

[mum2westiesGill]

To minimise the time between scans, I would be replacing the waking finger prick with a scan and then, maybe, keep a finger prick before the breakfast bolus if I wanted a bit of confidence with the value.
I would also be doing a scan comparison every time I did a finger prick to build my Libre confidence.

I like to do finger pricking
- on waking
- before meals
- before bed