Hello... What is normal, and eye related questions?

[patrlck]

Recently (Christmas) diagnosed as a type 1, am in early-mid 50's, male, with a complex medical history which includes some obscure (genetically diagnosed) chanelopathy stuff. Am using an Abbot Labs monitor, together with long and rapid insulin pens.

I have a couple of questions I'm hoping someone might be able to help with:

- What does normal actually look like? I am averaging 70-75% of the time "in range" according to the abbots app. Is that OK, middling or bad?

- I know eyesight is affected by diabetes. I have an astigmatism in one eye/one eye is long sighted/one eye is short sighted. I've recently started noticing what I can only describe as 'bad pixels' in one eye - small dots that swim about, a bit like a speck of dust. Is that likely to be diabetes related? Or am I just a hypochondriac? Either way, they are really annoying!!

- Lastly, I've read that I should 'wait for things to settle down', esp wrt opticians/glasses etc. What is the typical criteria for this, as I'd really like to get some glasses but I can't afford to throw money away...

Many thanks for any insights (ho ho),

Patrick

 

[Bruce Stephens]

- What does normal actually look like? I am averaging 70-75% of the time "in range" according to the abbots app. Is that OK, middling or bad?

That's fine. You should also look at the proportion below 3.9, and you want that to be <5%. The guidelines are formally given here:

Clinical Targets for Continuous Glucose Monitoring Data Interpretation: Recommendations From the International Consensus on Time in Range

Improvements in sensor accuracy, greater convenience and ease of use, and expanding reimbursement have led to growing adoption of continuous glucose monito

diabetesjournals.org

Informally,

https://twitter.com/x/status/1657658167688306688

 

[Leadinglights]

Re the eyes, it sounds like what are called floaters, which a lot of people get. Usually they are a minor annoyance and the brain adapts to ignore them but worth getting checked out by your optician as occasionally they can affect the retina.
I thought I had spiders on my face when it happened to me a few years ago, panicked and rushed to the optician and he explained what they were, they did settle down and I am occasionally aware of something floating there.

 

[Peely66]

That's fine. You should also look at the proportion below 3.9, and you want that to be <5%. The guidelines are formally given here:

Clinical Targets for Continuous Glucose Monitoring Data Interpretation: Recommendations From the International Consensus on Time in Range

Improvements in sensor accuracy, greater convenience and ease of use, and expanding reimbursement have led to growing adoption of continuous glucose monito

diabetesjournals.org

Informally,

https://twitter.com/x/status/1657658167688306688

I love that from Partha Kar...struggling to keep at 60% and above these days (although today was good)and constantly down on myself about it but I'm "nailing it".

 

[patrlck]

thank you all, that's all very assuring and much appreciated!

 

[Bruce Stephens]

together with long and rapid insulin pens.

If you're currently using disposable pens (especially if the insulins are something like Levemir and Novorapid, so from Novo Nordisk), it's worth asking about reusable ones. There's less waste (the cartridges are much smaller than the pens) and the pens have fancy features (they remember the doses you've taken and so on).

 

[patrlck]

If you're currently using disposable pens (especially if the insulins are something like Levemir and Novorapid, so from Novo Nordisk), it's worth asking about reusable ones. There's less waste (the cartridges are much smaller than the pens) and the pens have fancy features (they remember the doses you've taken and so on).

Thanks for the reply! Yes, I have the fancy Nova(?) pens with nfc logging. The diabetes nursing team review the data logged in the app via video appointment - they are frankly fantastic - if overworked (next appt is in 8 weeks time, hence the questions here). I am a bit horrified by the plastic waste associated with the CGM, which doesn't appear to have any recycling info. Surely one could reuse the applicator multiple times? Hey ho.

 

[Bruce Stephens]

Surely one could reuse the applicator multiple times?

I think one of them has a reusable applicator. Yes, it's the GlucoMen Day. Unfortunately that one is no longer available for prescription (Partha Kar didn't seem confident about why but suggested it was probably the manufacturer who'd decided not to continue).

 

[everydayupsanddowns]

The Figure 1 in the paper that @Bruce Stephens linked is really helpful.

There was a summary thread about it here too:

Time In Range - useful for Libre / CGM wearers

I've been meaning to post this for ages, but kept forgetting! At the ADA this year the international consensus paper on TIR (time in range) was published by a panel of experts with a huge amount of knowledge and expertise in supporting people to use continuous data to help manage their...

forum.diabetes.org.uk

Abbott / Libre were more focussed on getting the applicator to work reliably and repeatably (by relatively untrained users), than in reusability of the inserters I think @patrlck . T1s are a fairly small market I suppose?

Some sources seem to suggest that eyes will begin to settle ‘in a few weeks’. I think this can vary depending on the starting point… rapidity of change… and perhaps the length of time that levels have been above range - so I think it would be hard to get a definitive answer. Asking your optician as suggested by @Leadinglights is a wise thought.

 

[EmmaL76]

Hey, I have the dots also, sometimes they look like squiggles. I mostly see them when light conditions are changing, like going out in the bright sunshine. I also get them when my bg is moving fast. I had my screening the other week and my routine eye test also. There is nothing wrong with my eyes diabetes related, I wear glasses for distance but that’s it. So the squiggles and I just go about our day lol. I do have dry eye syndrome which may or may not be a contributing factor. My vision disturbances were much worse after my diagnosis when i brought my levels down, but that was more of a blurring. That settled. Hope yours get better soon, seems you have a few bits and bobs going on. Sending you best wishes