Confused about my Libre2 readings overnight

[Kittyrose]

Hi - Type 2 diabetic here. I obtained a Libre 2 sensor on their free trial and started it yesterday at lunchtime. It was reading pretty high at around 16 all day (which I expected). Overnight I see it dropped into the normal range round about midnight but by 1am it was climbing again - up to about 14 at 3am and back into normal range about 4:30. But then it lost contact for about 30 mins and by 5am it was at 12, rose to 18 at 6:30, and is currently at 13 at 9am. (Unsure why it lost contact as my phone was on my bedside table next to me.)

I have had nothing to eat since my evening meal last night and only water to drink. I don't understand why the reading should go so high in the night? I know it is only my first day of using Libre, so is it likely to 'settle down' over the next few days? I'm trying to decide whether to self fund this sensor in the hope that it might help me to moderate my diet if I can see the levels on a real time basis. Thank you.

 

[rebrascora]

It sounds more like your levels are consistently in the teens and perhaps the dips into the normal range were what we call "compression lows" where you lie on the sensor in your sleep and that causes a false low, then when you roll off it, the sensor reading returns to where it was before. f you can post a screen shot of your overnight graph I might be able to confirm that as there tends to be a sort of pattern to compression lows that you can sometimes recognise once you are used to them.

As regards the loss of signal, I think it is more to do with your phone than the sensor. Some phones have a weaker Bluetooth than others, particularly if you have other Bluetooth devices paired with it. You can regain the info in the gap by scanning with your phone.

 

[Jasmin2000]

The spike at 3-8 am sounds like the Dawn Phenomenon (liver dump) and there are many sites describing the effects,

Dawn Phenomenon: What It Means for People with Diabetes

The dawn phenomenon is when your blood sugar rises in the morning. This can be an issue for people with diabetes.

www.healthline.com

The Dawn Phenomenon: Causes & How to Fix It

The dawn phenomenon, known as the "dawn effect," is a term used to describe early-morning elevated blood glucose levels between 3-8am.

www.virtahealth.com

Check whether these symptoms are similar to yours before taking any action and consult with your GP first.

Other sites propose how to deal with it,

The dawn phenomenon: What can you do?

Take steps to prevent this early-morning increase in blood sugar.

www.mayoclinic.org

Dawn phenomenon: How to control high morning blood sugars

The dawn phenomenon is a natural rise in blood sugar that happens before a person wakes up. Why does it happen, what is the impact, and how can a person treat or prevent it? Find out more.

www.medicalnewstoday.com

 

[Kittyrose]

thank you. I will try to screenshot the daily graph as it is not showing on the other graph - has gone off to the left!.

It sounds more like your levels are consistently in the teens and perhaps the dips into the normal range were what we call "compression lows" where you lie on the sensor in your sleep and that causes a false low, then when you roll off it, the sensor reading returns to where it was before. f you can post a screen shot of your overnight graph I might be able to confirm that as there tends to be a sort of pattern to compression lows that you can sometimes recognise once you are used to them.

As regards the loss of signal, I think it is more to do with your phone than the sensor. Some phones have a weaker Bluetooth than others, particularly if you have other Bluetooth devices paired with it. You can regain the info in the gap by scanning with your phone.

Thanks- I’ll try to post a screenshot.

 

[Kittyrose]

The spike at 3-8 am sounds like the Dawn Phenomenon (liver dump) and there are many sites describing the effects,

Dawn Phenomenon: What It Means for People with Diabetes

The dawn phenomenon is when your blood sugar rises in the morning. This can be an issue for people with diabetes.

www.healthline.com

The Dawn Phenomenon: Causes & How to Fix It

The dawn phenomenon, known as the "dawn effect," is a term used to describe early-morning elevated blood glucose levels between 3-8am.

www.virtahealth.com

Check whether these symptoms are similar to yours before taking any action and consult with your GP first.

Other sites propose how to deal with it,

The dawn phenomenon: What can you do?

Take steps to prevent this early-morning increase in blood sugar.

www.mayoclinic.org

Dawn phenomenon: How to control high morning blood sugars

The dawn phenomenon is a natural rise in blood sugar that happens before a person wakes up. Why does it happen, what is the impact, and how can a person treat or prevent it? Find out more.

www.medicalnewstoday.com

I will have a look at those - thank you. It does sound as though it might be the reason

 

[Kittyrose]

thank you. I will try to screenshot the daily graph as it is not showing on the other graph - has gone off to the left!.

Thanks- I’ll try to post a screenshot.

Sorry for the double reply - I had started to answer on my laptop and then needed to switch to my phone to get the sreenshot. Didnt realise it would post both!

 

[rebrascora]

thank you. I will try to screenshot the daily graph as it is not showing on the other graph - has gone off to the left!.

Thanks- I’ll try to post a screenshot.

Those sharp dips and then rises through the night are almost certainly compression lows where you lie on the arm wih the sensor but the overall trend is upwards which suggests Dawn Phenomenon as well.

What medication are you taking for your diabetes? I know from reading one of your previous posts a year or so ago, your nurse was "threatening" insulin, but you were reluctant and trying low carb. Have you now started on insulin or are you still trying to manage with oral Type 2 meds and diet? These very high levels a year later suggest that you probably need to consider insulin if you haven't started it yet and if you have started it, that you need an increased dose, so either way, you need to have a serious discussion with your nurse or GP.

 

[Kittyrose]

Those sharp dips and then rises through the night are almost certainly compression lows where you lie on the arm wih the sensor but the overall trend is upwards which suggests Dawn Phenomenon as well.

What medication are you taking for your diabetes? I know from reading one of your previous posts a year or so ago, your nurse was "threatening" insulin, but you were reluctant and trying low carb. Have you now started on insulin or are you still trying to manage with oral Type 2 meds and diet? These very high levels a year later suggest that you probably need to consider insulin if you haven't started it yet and if you have started it, that you need an increased dose, so either way, you need to have a serious discussion with your nurse or GP.

Yes saw the nurse on Friday and she still wants me to take insulin (last 4 HbA1cs were all around 80) but I dont want to. I want a GLP1 (which isn't available) so she has prescribed Rybelsus, but I'm not to take it until she has checked with my eye consultant. At the moment I'm still taking metformin, dapagliflozin and sitagliptin at maximum dose. And I havent managed to change my diet, which is why I thought it might help to see the levels in real time. Thank you for taking an interest and -wow- for remembering me from a year ago!

 

[Leadinglights]

Yes saw the nurse on Friday and she still wants me to take insulin (last 4 HbA1cs were all around 80) but I dont want to. I want a GLP1 (which isn't available) so she has prescribed Rybelsus, but I'm not to take it until she has checked with my eye consultant. At the moment I'm still taking metformin, dapagliflozin and sitagliptin at maximum dose. And I havent managed to change my diet, which is why I thought it might help to see the levels in real time. Thank you for taking an interest and -wow- for remembering me from a year ago.

If you haven't made any changes to your diet that would likely explain why you have high glucose levels despite all those medications.
Your diet is doing you no favours and even some small changes would help you turn things around before you strt to get some of those unpleasant consequences of long tern high blood glucose.

 

[harbottle]

The guidelines issued by NICE indicate switching a drug to a GLP1 inhibitor (Rybelsus) if hba1c isn't coming down with triple therapy, but this is based on a number of criteria such as weight and ethnicity and whether or not insulin would be difficult for the patient. You are getting to the point where the only real option for the healthcare professionals is to recommend insulin to get levels under control.