Effectively managing hypos

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friendlydiabetic

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Type 2
I bought a FreeStyle Libre this week and have been using it several times a day. I compared it with my blood glucose monitor readings and found it to be off by between 1-2.6 mmol/L each time which is a lot more than I expected. The sensor is on my arm as recommended.

I was hoping to pair this with a MiaoMiao transmitter in order to detect hypos but the sensor is already giving me false low readings (sensor says 4.1 but blood glucose is actually 5.6).

I was hoping to use a CGM to manage hypos but I'm now having second thoughts. What strategies/tools do you use to manage hypos (I can't always feel when my blood sugars are low)?
I'm afraid of sleeping sometimes.
 
Each monitoring device will have a margin of error. And without a lab value to cross-check there isn’t any way to work out which value from either different strips in the same meter, or different fingerstick monitors, or different monitoring technologies (Libre vs strip) is closest to the actual value.

Generally keeping hydrated helps sensors, as does bearing in mind ‘sensor lag’ where there’s a difference and BG is rising or falling.

Libre has a new algorithm (updates for phones and readers) to improve performance, especially during the first 24 hours.

Some find they still find Libre useful for trends even if they don’t feel the spot values work so well for them, others find they never really get on with Libre, and still others find the differences they see between technologies are relatively consistent, and so can mentally adjust the numbers to make sense of them.
 
The only thing I would add is that eating a very low carb diet can significantly reduces the risk of hypos, because you are using less or no bolus insulin.
 
As @everydayupanddowns says you might just as well say "the monitor is constantly reading high", and the only thing that is certain is that they are different.

As a type 11 I assume that you are on insulin or some other medication that does give hypos, otherwise hypos would never be a problem.

I understand that the miao miao, in combination with associated receiver and software, can be set to alarm at a user defined level, so that the actual reading given from the libre would not be important. It appears to be a very good option.

You should remember that the libre reading is always a few minutes behind your actual BG level.
 
friendlydiabetic said:
I bought a FreeStyle Libre this week and have been using it several times a day.
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Did you purchase it from abbott or buy it somewhere on line, if the latter then you might need to update the software, in the system info it should read 2.4.8

Since getting a new reader and downloading the latest app on phone I'm seeing more reliable readings.
 
friendlydiabetic said:
I was hoping to use a CGM to manage hypos but I'm now having second thoughts. What strategies/tools do you use to manage hypos (I can't always feel when my blood sugars are low)?
Click to expand...

As others note, our regular BG meters don't give accurate readings either. (In normal ranges, they're supposed to be +-15% for some large percentage of the time, IIRC.) I note that 4.1+15% is (by coincidence) really close to 5.6-15%. So take both with a pinch of salt.

If the Libre is consistently a bit lower, you could just mentally adjust for that. (Keep in mind the next sensor is likely to be different.)

Even if you don't use it for day to day management, you might find trend information useful: after a few days the software can show various graphs which may reveal patterns that suggest things you might try.
 
friendlydiabetic said:
I bought a FreeStyle Libre this week and have been using it several times a day. I compared it with my blood glucose monitor readings and found it to be off by between 1-2.6 mmol/L each time which is a lot more than I expected. The sensor is on my arm as recommended.

I was hoping to pair this with a MiaoMiao transmitter in order to detect hypos but the sensor is already giving me false low readings (sensor says 4.1 but blood glucose is actually 5.6).

I was hoping to use a CGM to manage hypos but I'm now having second thoughts. What strategies/tools do you use to manage hypos (I can't always feel when my blood sugars are low)?
I'm afraid of sleeping sometimes.
Click to expand...
I was surprised when I started with the Libre just how much my hydration impacted on the accuracy. It makes sense as the Libre is measuring the glucose in the interstitial fluid, rather than in blood. I still find that that it generally reads a bit lower when I am low, and higher when I am high, but I take that, along with the direction of arrows when making any decisions.

I am more interested in the overall peaks and troughs, rather than individual readings in the log, in order to consider where I might need to change diet/ratios/basal insulin. If I do get a low reading I will do a blood test to confirm before treating it.

The time lag that @everydayupsanddowns mentions is also worth bearing in mind. My Libre is telling me what was going on about 15 minutes ago, so I take account of that in decisions that I make.
 
Bruce Stephens said:
If the Libre is consistently a bit lower, you could just mentally adjust for that. (Keep in mind the next sensor is likely to be different.)
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That is a great point mate, like getting a different absorption rate in each part of the body with insulin. The things you have to account for.
 
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