Fears and Findings from Freestyle Libre2

[ColinUK]

I had posted these in the General Messages part as bits of my everyday posts and chat but it was pointed out that they might be useful spun off into their own thread.

So here's that thread. This is initially going to be cut and pasted copy from the general chat/7 days waking average thread and it may stay that way but it ought to become a thread specifically about my thoughts on using Libre2 sensors.

A bit of background. I'm T2. My BG is reasonably under control although I'm not that strict with my diet so my HbA1c rises and falls.

I've tried the Newcastle Diet and will likely keep the shakes incorporated into my kitchen cabinet contents as I find them useful. I exercise lightly as I'm recovering from an injury and I battle mental ill-health ranging from complex PTSD through to depression and anxiety.

Regarding my diabetes specifically, I wanted to see exactly what various foods were doing to my BG levels but couldn't face doing a gazillion finger pricks and logging them manually so I coughed up and self fund my Libre2.

In order to make it into a continuous glucose monitor (CGM) it's linked to an app called Shuggah (available in both iOS and Android) which scans the sensor every minute.

This is my journey with the sensor. Forgive me if I include phrases or comments that don't appear to make any sense here, but that's because I've copied and pasted this from another thread without editing too much.

 

[ColinUK]

April 26, 2023

I’ve got the Libre sample still sitting in the box.

There’s a clear reluctance to stick it on my arm and see more accurately what my BG is doing.

I suspect it’s because at heart I know I’m nowhere near as mindful or wise about food choices as I once was and I am apprehensive about having that highlighted by the CGM.

I know that’s an illogical position to take as there’s part of me that wants to go low carb 24/7 and drop the excess weight I’m carrying, lower my HbA1C again and improve my health. There’s also part of me that really can’t be bothered and it’s important to acknowledge that’s there.

I’m vacillating between beating myself up for not knowing better and being compassionate and saying that with everything else that’s going on (police stuff - they should be in contact this week about definite dates for interviewing him; estate stuff - trying to find auctioneers who turn up would be a start; suing electricians who falsified EICR reports a year ago and claimed to do work which was either done but sub par or just not done at all; and all the usual stuff going on) I’m doing the best I can.

Anyway I didn’t test today. I’ll chase the gp for an annual diabetes check up appointment and will ponder the ramifications of sticking the sensor on my arm.

 

[ColinUK]

Later on April 26th I attached the sensor to my arm. This was still using the LibreLink app and meant I needed to scan the sensor so it wasn't yet a full CGM but was rather on demand.

This is the next post which references it:

April 27th

Having a bit of tech in my arm has meant that I’m checking BG much more frequently than I otherwise ever would. And it’s interesting.

Psychologically there’s almost a gamification thing going on where I want to make sure I’m in the green. I’ll keep an eye on that thinking as it may feed right into restrictive eating tendencies I’ve had before but at the moment I’m loving being able to just tap my phone to the sensor and see what’s what. Yes a CGM would be even better but this is good in its own right.

And 6.5 this morning.

 

[ColinUK]

27th April 2023

Just installed and connected Shuggah.
It’s so good to be able to see instant figures on my Apple Watch with just one press.

I’ve not set any high or low alarms as what I want is to track food choices vs BG and I’m not using insulin so don’t have to worry about that.

The UI for shuggah is overly complicated compared to LibreApp but as I’m not expecting to have to look at it that often it shouldn’t be an issue.

Thank you for the recommendation!

 

[ColinUK]

27th April (again)

Guess when I had a tuna melt and a bit of cheesecake…

I’m just amazed that the level fell so quickly. And the angle of ascent and descent look interesting.
I’m wondering what could be thrown into the mix to slow the rise. Not that tuna melts and cheesecake are advisable but it’d be interesting to know how to mitigate the BG spike in case I ever have that meal again. (In case?!)

 

[ColinUK]

April 28th

6.2 this morning. No idea what it was overnight as Shuggah shows a lovely big gap for overnight. Not sure why so does anyone have a clue?

 

[ColinUK]

29th April

Been awake since 4am ish and it’s been bouncing around a little bit since then. I think my brain is wondering if I’m going to get up at some point.

100% in the green yesterday (although once was by a whisker) and I’m loving the extraordinarily detailed picture it’s giving me of what’s going on. I’ll be carrying on with different foods today I think as it’s good to know how I handle them. Same with exercise. I want to know how quickly I can bring things down if they veer a little high.

 

[ColinUK]

29th April 6pm (and I'd been commenting earlier in the day about finding traces of mice in the kitchen)

I can’t block access for the mice unfortunately. They’re getting in through gaps in the wall behind the kitchen cabinets.
They building is actually almost 250 years old so older than I thought, and it’s got holes in it. All I can do is put down traps and keep dry goods in plastic boxes so the blighters can’t find anything fun to eat. Hopefully they’ll bugger off next door soon enough.

Meanwhile… I’m finding the CGM fascinating. Take a look at this for today for example:

Breakfast was just after 10 but I’ve not eaten anything since. The spike at 2pm was entirely down to stress.

 

[ColinUK]

Monday May 1st

Bonjour. 5.2

In a move to further understand wtf my body can cope with I had ice cream last night. Full fat. Full sweet. Ice cream. And deliberately quite a hefty portion of it. Not an absurd portion but just a generous one.

I was 6.1 at 20:23 and here’s the chart for the two hours after eating:

So there’s an obvious spike but the recovery is equally obvious. Or so you’d think if using a finger prick and testing two hours post. That wouldn’t show what happened next whereas the Libre does.

I went to bed at roughly 11pm and was asleep by midnight.

I’m finding these double spikes are a recurring feature for me and they suggest that two hours post finger pricks don’t show me the true picture.

Here’s the day in full:

It didn’t impact TIR and as the rest of the day was pretty flat I’m wondering if it’s that rest that slowed the pancreas to get things under control so fast initially. But it’s that second spike I think might be more important. That it’s there isn’t a surprise but I’d expect it to be less than the initial one as the pendulum swing of the body correcting levels kicks into action. But it isn’t. It’s almost the exact same profile as the first.

I’m not doing this to excuse or permit a return to old eating habits but rather to understand what’s happening inside me so I can make better choices.

To that end I’m curious to know if anyone else sees similar double spikes and also what folks think about them and the results above.

Thanks all.

 

[ColinUK]

My question received this answer from a knowledgeable forum user:

As regards your twin peaks, I believe there are 2 phases of insulin response, an initial release of stored insulin when food hits the stomach and then a follow up as the beta cells get to work. That second phase I believe is more controlled by communication between liver and pancreas and is often slower and less efficient due to visceral fat hampering that communication for how much is required and it is often that second phase which is impacted in Type 2s. Can't explain why the peaks are so uniform in profile, but it is quite impressive. I imagine the fat in the ice cream is also a factor in slowing the release down which is why the second peak is after the 2 hour mark.

 

[ColinUK]

Monday May 1st (still)

Q. Does the Libre2 sensor box come with an applicator each time or do I have to hold to the one I’ve got?

And when it dies how do I remove it or will it just fall off by itself?

Yes I’ve decided to carry on with it for at least another month so I can learn more.

 

[ColinUK]

Answer received:

Yes , it comes with a new applicator every time.
Sometimes the sensor is ready to fall off and comes off easily, other times it’s fastened on like a limpet and I have to pick at the edges for ages until I can find a loose bit, then once you’ve got purchase, the whole thing peels off. Some people use baby oil or something like that which acts as a solvent on the glue, which helps get it unstuck.

 

[ColinUK]

Tuesday May 2nd

5.3 - Another unicorn day.
(I will spin off the findings and thoughts about the CGM into another thread when I’ve got time but) look at this for yesterday:

Yoghurt with some berries and sprinkle of paleo co almond and pecan granola for breakfast. No lunch. Made a chicken salad baguette for supper as I wanted to test the response to the bread.

Pre: 5.2
1hr: 7.3
2hr: 6.1

The post 9pm spike was the handful of almonds I had whilst watching telly.

 

[JamietDE6]

Hi this looks fascinating. I have a Libre 2 but only use the Libre software on my smartphone. If I switch to this are there any downsides? I currently share my data with the DSN so assume this would be lost?

 

[ColinUK]

Here's a question on Tuesday from another forum participant:

You seem to be getting much better waking readings recently, since using Libre. Do you think that is a conscious effort or down to scanning as soon as you wake up rather than spending a couple of minutes fiddling with test strips, meter and lancing device?

 

[ColinUK]

Hi this looks fascinating. I have a Libre 2 but only use the Libre software on my smartphone. If I switch to this are there any downsides? I currently share my data with the DSN so assume this would be lost?

I don't know if there's a way to share from Shuggah directly.

 

[ColinUK]

Here's a question on Tuesday from another forum participant:

You seem to be getting much better waking readings recently, since using Libre. Do you think that is a conscious effort or down to scanning as soon as you wake up rather than spending a couple of minutes fiddling with test strips, meter and lancing device?

My answer to the above question:

It’s two fold I think.
1 - it’s connected to Shuggah so I’m not having to scan anything
2 - I’m treating it as a learning exercise

So many times I thought I was running high so would get miserable and eat crap. But I didn’t test when I thought I was high but just felt that I was. Now I can see what’s actually going on I’m more inclined to make wiser choices. That said I’m repeating the ice cream test today and I’m chucking but crisps and bread at it just to see how fast levels recover without exercise.

I have bought another two sensors so that means I’ll be monitoring closely through until at least the first week of June.
That covers a couple of planned meals out, some inevitable unplanned, a break away where I’m really not in control of the food and mum and dad’s 60th anniversary bash.

It’s all really useful as a learning tool. And ok it’s £98 for two sensors but even if I do that a few times a year it still helps and saves on finger pricking.

 

[ColinUK]

Wednesday 3rd May 2023

Another unicorn, even with the repeated ice cream experiment. And a HS.

Went out for breakfast with the lady I met at the Spain and Hispanics exhibition at the RA a few weeks ago. She’s 78/9, and old time actress, slightly deaf and terribly, terribly English. As well as being outspoken, charming and slightly eccentric!
She took me to breakfast as I was taking her to an Aida rehearsal at Covent Garden.

Interestingly she’s just been told by her private GP that she’s pre diabetic and she’s been told to have “yogurt and fruit for breakfast, what you’d put in a sandwich for lunch and whatever you want for supper”.

Breakfast for both of us was the most lacklustre scrambled egg and smoked salmon. I added half an avocado on the side of my order and had one half slice of wholemeal toast. BG didn’t really budge at all as you can see.

Nothing to eat before the experiment later in the day. Deliberately I pushed things with the Devil’s Trifecta of crisps, bread and ice cream.

Although I did stray into the yellow it was for just two minutes before levels returned to the green. I double checked those levels with finger pricks and they matched exactly so Libre has registered that as still being 100% TIR for the day.

I am not thinking this gives me license to dine like this every day, on the contrary it’s giving me added incentive to get my HbA1c down and to not fret about the odd indulgence as my body can cope.

If I ate carb heavy at every meal though I’d expect to see the base line creep higher and to scare the unicorns into stampeding and I’d lose them.

 

[ColinUK]

May 3rd - around 12:50

My unicorns have fled!

Ok breakfast which didn’t move things at all, then about 10am started to feel hot and it rocketed to 10.2 and stayed there long enough to take me out of range for a couple of minutes. C’est la vie.



I found it interesting that I went from perfectly ok to over 10 and then down to 3.6 when I scoffed almonds and milk in an attempt to get the levels to rise. I'm not on insulin or T1 so don't have a ready supply of jelly babies or similar to hand and had to just use what I had.

 

[ColinUK]

May 4th 2023

6.6 this morning and an absolutely dead unicorn.

Felt off pretty much all day. Like I was coming down with some bug. Hot from about 10:30 then cold from midday.