• Please Remember: Members are only permitted to share their own experiences. Members are not qualified to give medical advice. Additionally, everyone manages their health differently. Please be respectful of other people's opinions about their own diabetes management.
  • We seem to be having technical difficulties with new user accounts. If you are trying to register please check your Spam or Junk folder for your confirmation email. If you still haven't received a confirmation email, please reach out to our support inbox: support.forum@diabetes.org.uk

Help to work out ratios

rebrascora said:
Is it 5.4 and level or 5.4 and sloping downwards. Personally I am very happy to bimble along in the low 5s or even in the mid 4s, but I know that my basal insulin dose is right, so I am not at risk of dropping lower. If your Tresiba dose is too high as some of us suspect, then it may be dropping you. It may also be that a slow 30 min walk for you is sufficient exercise to drop your levels whereas for me it would have almost no effect and I would need a 45 min fast power walk to show any real downward trend.
I would say it is probably safest to have a couple of grapes (about 5g carbs) now before lunch, which should raise your levels by about 1.5 mmols if Tresiba is holding you steady or keep you steady if Tresiba is pushing you lower. Log the grapes in the Libre app as this is all info which will help you to see if you are having to eat to keep level and therefore tell you if Tresiba dose is too much.
Click to expand...
Hi. It was saying steady. Fear of going low kicked in so had the grapes. We will see what happens
 
Lovely people who have been so helpful
How do I test my background. I do kind of know but I feel you will.be able to.give me best way to do.it
 
I wonder if you are relying too heavily on Libre which has quite a delay on it when levels are changing direction. So when your levels were dropping after the walk and then you ate the grapes, Libre will usually show your levels continuing to drop for another half an hour before it twigs that you have actually eaten something to bring them back up. It is to do with the algorithm which it uses to try to convert the interstitial fluid readings it takes to blood glucose readings which are about 15 mins ahead of interstitial fluid. Basically, it extrapolates your previous few interstitial readings to predict what your actual BG is. This is fine when levels are dropping or rising in a nice straight line but if levels are dropping and you eat some carbs to make them go back up, the Libre is still predicting them to be dropping until eventually that glucose gets to your interstitial fluid and it realises you are coming up. It is the main reason why you should not rely on Libre when you are hypo, because it will show your levels continuing to drop 15 mins after treating the hypo when a finger prick will almost always show you are recovering. Seeing that your levels are continuing to drop will cause panic and make you eat even more carbs and end up over treating hypos.
It also works the opposite way with peaks, where levels are rising due to the release of glucose from food but then starts to drop as the insulin brings them down. Libre will continue to predict them rising for about half an hour longer and going higher than they actually do which is why a finger prick should be done before calculating a correction.
You often find when you look at your graph later that it doesn't show you going as low or as high as when you did a scan or looked at the reading and if you did a scan the event is left hanging below or above the graph line which doesn't actually go through it but gets smoothed out. Basically you have to accept that Libre can be a bit of a drama queen at the extremes or peaks and troughs and it shouldn't be relied on at these times.
 
rebrascora said:
I wonder if you are relying too heavily on Libre which has quite a delay on it when levels are changing direction. So when your levels were dropping after the walk and then you ate the grapes, Libre will usually show your levels continuing to drop for another half an hour before it twigs that you have actually eaten something to bring them back up. It is to do with the algorithm which it uses to try to convert the interstitial fluid readings it takes to blood glucose readings which are about 15 mins ahead of interstitial fluid. Basically, it extrapolates your previous few interstitial readings to predict what your actual BG is. This is fine when levels are dropping or rising in a nice straight line but if levels are dropping and you eat some carbs to make them go back up, the Libre is still predicting them to be dropping until eventually that glucose gets to your interstitial fluid and it realises you are coming up. It is the main reason why you should not rely on Libre when you are hypo, because it will show your levels continuing to drop 15 mins after treating the hypo when a finger prick will almost always show you are recovering. Seeing that your levels are continuing to drop will cause panic and make you eat even more carbs and end up over treating hypos.
It also works the opposite way with peaks, where levels are rising due to the release of glucose from food but then starts to drop as the insulin brings them down. Libre will continue to predict them rising for about half an hour longer and going higher than they actually do which is why a finger prick should be done before calculating a correction.
You often find when you look at your graph later that it doesn't show you going as low or as high as when you did a scan or looked at the reading and if you did a scan the event is left hanging below or above the graph line which doesn't actually go through it but gets smoothed out. Basically you have to accept that Libre can be a bit of a drama queen at the extremes or peaks and troughs and it shouldn't be relied on at
Click to expand...
I really shouldn't be looking it as much as I am. I do get very obsessed x
 
I look at my Libre loads as it gives me such a lot of background info and I find it quite fascinating. That said, I have a reader rather than the phone app and I scan an average of 34 times a day pretty well every day since I got it nearly 5 years ago, but I am pretty chilled about the info it gives me and I know that even if it alarms at 4.3 with a vertical downward arrow, I can turn it around with 2 well chewed jelly babies before I hit the red or occasionally from just slipping into the red a little. I have ultimate confidence in my little hypo heroes (jelly babies) to fix the problem and bring me back up, so I ignore the Libre after that because I know I have sorted it and a finger prick will show that I am recovered in 15 mins.
 
rebrascora said:
I look at my Libre loads as it gives me such a lot of background info and I find it quite fascinating. That said, I have a reader rather than the phone app and I scan an average of 34 times a day pretty well every day since I got it nearly 5 years ago, but I am pretty chilled about the info it gives me and I know that even if it alarms at 4.3 with a vertical downward arrow, I can turn it around with 2 well chewed jelly babies before I hit the red or occasionally from just slipping into the red a little. I have ultimate confidence in my little hypo heroes (jelly babies) to fix the problem and bring me back up, so I ignore the Libre after that because I know I have sorted it and a finger prick will show that I am recovered in 15 mins.
Click to expand...
Yes grapes and jelly babies i know work for.me x
 
Ali11782 said:
I had 40g of grapes
Click to expand...
I use 15% for grapes, so 40 gm wt would be 6 gms carbs. A mini nudge against a low. Personally I would target being at 7 rather than 5mmol/L. In Range is from 4 to 10, 7is midway and leaves plenty of time to catch a rapid drop or to intercept a high. Trying to stay in the high 4s and 5s is risking matters when you don't yet have great control. NB: none of us can really control our D and I like the notion of (improved) management. We can't control it because there are far too many factors outside of our direct control
 
Ali11782 said:
Lovely people who have been so helpful
How do I test my background. I do kind of know but I feel you will.be able to.give me best way to do.it
Click to expand...
NB Grapes are way lower in carbs than JBs, c.15% to 85%. So 1 small grape can be less than 1/2 a carb and even one big grape only 1+ carbs. I JB invariably 4 to 5 gms carbs, depending on who has made them, as well as much faster response.

Testing your background basal is traditionally done by spitting a 24 hr day into 3 segments of 8 hrs or 4 of 6 hrs. Then fasting on successive days before and during each period (wirh no bolus insulin) and seeing how your body behaves during each fasting period. You should eat normally for the rest of each 24hr session. That gives you a reasonable insight into how your basal is managing your natural inner glucose releases.

However, this doesn't work so well for Tresiba AND since Tresiba doesn't respond quickly to changes it's an academic exercise (and faff) to do the traditional basal test process. Unless you are a night shift worker or have really unusual sleeping patterns.

With Tresiba you just check your waking graph is broadly the same as your going to bed point. Its very hepful to look at a 24 hr display and see the overall trend in context to a full day. Then discount or make due allowance for any correction dose at bedtime or any overnight long fasting with unusual difference in normal behaviour . If several night in succession are showing a similar trend you then have enough info to make a basal decision. Same at start and finish means your basal is about right. Regular overnight falling means basal too high, regular overnight rising means basal too little. Ignore DP effects, they need managing with bolus, since DP doesn't hit anyone every night at the same level.

I am probably repeating what I said in post #10. Tresiba needs a very different mindset!

Have you come across Gary Scheiner's book "Think Like a Pancreas". Early on he tells his readers that Diabetes is Complicated, Confusing and Contradictory. This is so true. Whatever the rules are Diabetes doesn't know them or follow them much of the time.
 
Lucyr said:
You shouldn’t be using cgm to inform you whether something you’ve just eaten to boost bg has worked or not. You need to use fingerpricks for that.
Click to expand...
I think it's a matter of context whether to use CGM or finger pricking, @Lucyr. Since @Ali11782 was looking at a steady level arrow on her CGM and was not checking a possible hypo but hoping to establish if the grapes were providing a nudge up after a gentle walk - I think CGM is a very satisfactory way of monitoring what response she might be getting at that time.

As it happens some 7 mins later she did tell us that the grapes had worked (from her CGM, without finger pricking). All in all it was an excellent outcome for Alison to regain confidence in her BG management techniques and with minimal stress for her in making the fresh start she'd earlier talked about.
 
Proud to be erratic said:
As it happens some 7 mins later she did tell us that the grapes had worked (from her CGM, without finger pricking).
Click to expand...
It wasn’t minimal stress as she had the grapes at 11:30 then at 12:11 panicked that they weren’t working. 7 minutes after that she said they were.

If she’d fingerpricked instead of panicking they weren’t working she’d have seen the bg in 5s not 4s.
 
You must log in or register to reply here.
Back
Top