Hello

[Fiona#42]

I've been lurking on the forum for a while, but joined as I have some questions. I'm finding it difficult to get advice on issues that don't seem to fit in with what is asked at my diabetice check up, which was on 3/6/25. HbA1c was 6.8,which I thought was too high, nurse said it was OK. As i had had a couple of hypos (I use insulin) she offered me a Freestyle Libre, which I got las week. Here lies the problem. I wasn't given much advice about it, and currently my sugars are all over the place: when I'm at work I'm on my feet all the time, on Saturday I had to have emergency carbs as I kept going below 4. Yesterday and today I have been at home, and I can see that my current level (3 hours after breakfast, small glass orange juice, 1slice granary toast with peanut butter, no snacking) is 12.2. I knew it went up during the night, but surely my pre-breakfast insulin (12 units Humalog, 34 units Humulin 1) should bring it down?
Until i got the Freestyle i was quite confidently

 

[Fiona#42]

Adjusting my insulin, but now I'm not. I have been using insulin since 1994, with no issues. This is probably the wrong place to vent, sorry.

 

[rebrascora]

Hi and welcome.

Sorry to hear you are finding the additional information from Libre a bit overwhelming. How frequently were you testing before you got it. The chances are that your levels were going up and down like this before but you just didn't see it and it was mostly back where it should be by the next meal when you tested, so you didn't see the peaks and perhaps troughs inbetween. Added to that Libre has a tendency to over exaggerate the highs and the lows and often it will say that you are hypo when your levels were dropping sharply but then started to rise once you ate a few carbs, but the Libre shows you continuing to drop for up to half an hour when in reality they have been rising for most of that time. Most nurses have no understanding of this delay but the advice should be to finger prick to check any hypos Libre reports unless you feel obviously hypo and then to finger prick again 15 mins after taking your hypo treatment to check for recovery. A finger prick will almost always show you are recovering at that 15 min point if you have used fast acting carbs, where Libre will show you continuing to drop. If you rely on Libre it can cause you to over treat hypos and also to panic that your hypo treatment isn't working, so please do not rely on it at these times and revert to finger pricks. Usually the Libre graph will be redrawn afterwards and show that you didn't actually drop into the red (below 4) or only very briefly whereas the readings it gave showed you were well below 4 for a long time. I have had it show me as low as 2.9 when I didn't actually drop below 4 but I had had quite a steep drop down to 4 and the algorithm the Libre uses, extrapolates that fast drop until it gets more data to say that levels are coming back up, but interstitial fluid lags behind blood so it takes that extra 15 mins to catch on that you have recovered.

Once you learn when you can rely on the data and when it is being a bit of a drama queen, it is a great bit of kit, but it is a learning process and you can't always take what it tells you at face value all the time. When your levels are relatively stable and in range I find it is very reliable, but if levels are rising or falling fast it becomes less reliable other than telling you that you are rising or falling fast.
I have a graded response to it now so if it shows me as 4.3 with a sloping downward arrow, 1 jelly baby will normally level me out and bring me up to about 5. If it says I am 4.3 with a vertical downward arrow, then I eat 2 jelly babies and that will usually stop the drop and bring me back up, despite what Libre says about me continuing to drop. You just learn what works for you. It is also helpful to set your low alarm a bit above 4. I have mine set at 4.5 but others have it set higher.

 

[helli]

My advice is
- check Libre highs and lows with a finger prick
- treat real (finger prick confirmed) lows
- for now, do not treat highs until your next meal unless they are very high (this varies from person to person) but keep and eye on the graph
- if you find your BG comes down by the next meal (remember "fast acting" insulin keeps working for 4 to 5 hours), your insulin dose was correct but you need to pre-bolus earlier - the peak of the glucose digestion was earlier than the peak of the insulin activity. Next morning, trying injecting 5 minutes earlier
- if your BG does not come down by your next meal, your insulin dose was too low and needs to be increased but I recommend increasing it by a small amount
- I would also recommend a basal test to see if your basal dose is correct and adjust if needed. Remember, our basal needs can vary. For example, on days when you are rushing around at work, you may need less than on days when you are at home. Again, I recommend small changes.

As @rebrscora mentioned, Libre is great. Once you get used to it.

 

[Bruce Stephens]

Again, I recommend small changes.

Advice we were given when we were prescribed the first Libre (as people with Type 1) was that the best time to respond to the Libre readings was the next day (and that only dead people have flat graphs). You can get in a mess if you try and react too soon. Obviously they didn't expect us to do that long term (or at all) but it's worth considering trying it for a few days, because as most of us find there's a risk of being overwhelmed by a desire to act to fix problems in a way that's ultimately not going to be productive.

 

[Fiona#42]

Thank you both for your very helpful replies. I have been finger prick testing and the Freesyle sensor seems to read low, but I will carry on with it and see how I get on.

 

[Fiona#42]

Advice we were given when we were prescribed the first Libre (as people with Type 1) was that the best time to respond to the Libre readings was the next day (and that only dead people have flat graphs). You can get in a mess if you try and react too soon. Obviously they didn't expect us to do that long term (or at all) but it's worth considering trying it for a few days, because as most of us find there's a risk of being overwhelmed by a desire to act to fix problems in a way that's ultimately not going to be productive.

 

[Fiona#42]

Thank you, that makes sense. I wasn't given any advice, the sensor was put on for me, and that was it. It's obviously a steep learning curve.

 

[p4ul]

This is probably the wrong place to vent, sorry.

It's absolutely the right place to vent. Welcome!

 

[Aish]

Adjusting my insulin, but now I'm not. I have been using insulin since 1994, with no issues. This is probably the wrong place to vent, sorry.

Hello @Fiona#42, Welcome to the forum. I am happy to read that you’ve gotten some answers to your questions. Please feel free to vent or ask any concerns on this forum as you wish, we have lots of supportive and experienced members who are willing to help.
Best wishes.