Hi

[type1est1999]

Hi everyone,

Hope you are all ok.

I was diagnosed with type 1 diabetes aged 13 and am almost 37 now.

I've had a sensor for around 18 months possibly longer and my current HBa1C is 52 on my sensor but my recent bloods showed 57

I have good days and bad days as I'm sure you all do and can safely say no two days are ever the same!

Any tips for a quick and easy carb free breakfast are much appreciated. I used to have two Weetabix with 3 units and was fine but now I spike, not sure if they have changed the Weetabix or my ratio has changed but I've stopped having them. Was on overnight oats for a bit and now on Belvita but losing the will a little with the spikes from dawn phenomenon plus breakfast but don't really want to always fast.

Also, how are people who have the freestyle libre 2 with the recent continuous glucose monitoring as opposed to previous flash monitoring finding it? Whilst I like the continuous readings I'm slightly miffed my time in range daily percentage has disappeared and I still need to scan to store readings in my logbook (unless there's something I'm not doing!).
.
Anyway hope everyone is ok and hoping to learn lots on here.

 

[Lucyr]

I still need to scan to store readings in my logbook

No you don’t. Just add a note or a carb value or whatever you’re storing it for. No need to scan.

 

[TheClockworkDodo]

Hi @type1est1999 and welcome to the forum 🙂

Do you pre-bolus for your breakfast at all? If not, you might find that helps. I get DP and I find I have to inject my bolus about half an hour before I eat breakfast if I want to avoid a huge spike after eating. I know some people here have to inject even further ahead of eating breakfast. If you haven't tried this, I wouldn't start with half an hour in case that's too much for you - I'd start with ten minutes and see if it helps, and then maybe try 20 minutes if it does, and keep going until you find what works for you and doesn't make you hypo before you start eating.

 

[rebrascora]

Another vote for prebolusing further in advance than you currently do. I need 45mins prebolus time for me at breakfast to prevent spikes and that is for creamy Greek yoghurt ,berries and seeds and using Fiasp which is supposed to be fast. Most importantly, I need to inject my breakfast bolus before I get out of bed because once my feet hit the floor my levels start rising and then my insulin has to work harder to play catch up.

 

[Inka]

Welcome @type1est1999 🙂 For me, breakfast needs the longest pre-bolus time - approx 30 mins with Humalog. For other meals 10 mins is fine. So, I’d try carefully advancing your bolus time 5 mins at a time. You could also look at your breakfast ratio. My ratios change quite frequently. Finally, have you done a basal check recently?

I suspect it’s a mix of the wrong ratio and bolusing slightly too late.

 

[helli]

Welcome @type1est1999
I second (or would that be "third") the suggestion to prebolus earlier for breakfast, especially if you find your levels return to normal.
You mention that you don't always want to fast. In my experience fasting extends the DP - my liver continues to think I am starving it so will continue to release glucose ... until I eat.

Regarding the LIbre, I no longer use it (I have a CGM which talks to my pump) but I understand the TIR has not disappeared: it has moved the form the home page to one of the menus.

 

[TheClockworkDodo]

I thought of something else, which is that the speed of the insulin you inject will depend on where (on your body) you inject it - if I inject in my leg or buttocks my Novorapid takes up to half an hour to really get going and then lasts 5-6 hours in my system, but if I inject in my abdomen it gets going more or less immediately and is out of my system in 3 hours. I've had to stop using my abdomen for anything other than correction doses (or if I want a cake mid-afternoon). So it might be worth experimenting with where you do your before-breakfast injection to see if somewhere else works more quickly for you. Abdomen is usually the quickest place. It wouldn't work for me for breakfast because my bgl would suddenly spike after 3 hours instead of dropping, but different people have different reaction speeds.

 

[Lucyr]

I understand the TIR has not disappeared: it has moved the form the home page to one of the menus.

24hr time in range is no longer available.

7/14/30 day time in range hasn’t moved, it remains in the same menu as previously

 

[Tdm]

Also, you may need a different ratio for breakfast to the rest of the day. I do, also different ratios workdays to weekends

 

[everydayupsanddowns]

Welcome to the forum @type1est1999

Sorry to hear breakfast has been giving you the runaround recently. So frustrating when you have things working well, and then things drift and you have to go round fixing basals / ratios / correction factors again. 🙄

I’m another who has to give my breakfast dose a bit of a head start. 10, 20, or 30 minutes depending on which way the wind is blowing or whether the moon is in Jupiter… and woe betide me if I use the ‘wrong’ one 😱

Hope you find the special secret settings that are needed this week.

I’ve tweaked your user profile, so that it reads T1 rather than ‘neonatal diabetes‘ which seemed to have been selected in error 🙂

 

[T1Nick]

Hi everyone,

Hope you are all ok.

I was diagnosed with type 1 diabetes aged 13 and am almost 37 now.

I've had a sensor for around 18 months possibly longer and my current HBa1C is 52 on my sensor but my recent bloods showed 57

I have good days and bad days as I'm sure you all do and can safely say no two days are ever the same!

Any tips for a quick and easy carb free breakfast are much appreciated. I used to have two Weetabix with 3 units and was fine but now I spike, not sure if they have changed the Weetabix or my ratio has changed but I've stopped having them. Was on overnight oats for a bit and now on Belvita but losing the will a little with the spikes from dawn phenomenon plus breakfast but don't really want to always fast.

Also, how are people who have the freestyle libre 2 with the recent continuous glucose monitoring as opposed to previous flash monitoring finding it? Whilst I like the continuous readings I'm slightly miffed my time in range daily percentage has disappeared and I still need to scan to store readings in my logbook (unless there's something I'm not doing!).
.
Anyway hope everyone is ok and hoping to learn lots on here.

Regarding the breakfast challenge - as you've seen, you certainly aren't alone. For me the pre-bolus time is never the same (depends on my BG level when I wake up, whether I have exercised much the day before, how big the DP has impacted that day + a load of other unfathomable factors) so what I do is take my insulin and then keep a close eye on the Libre readings and only choose to eat once the levels start to drop (hopefully easier with CGM rather than FGM). This way I know that the insulin is starting to take effect and therefore it is time to eat. Sometimes I have had to wait over an hour for this and some days it is as little as 10 minutes - so impossible to predict. This approach does work for me - current TIR is 93% for the past 14 days. Hope this helps!

 

[rebrascora]

Regarding the breakfast challenge - as you've seen, you certainly aren't alone. For me the pre-bolus time is never the same (depends on my BG level when I wake up, whether I have exercised much the day before, how big the DP has impacted that day + a load of other unfathomable factors) so what I do is take my insulin and then keep a close eye on the Libre readings and only choose to eat once the levels start to drop (hopefully easier with CGM rather than FGM). This way I know that the insulin is starting to take effect and therefore it is time to eat. Sometimes I have had to wait over an hour for this and some days it is as little as 10 minutes - so impossible to predict. This approach does work for me - current TIR is 93% for the past 14 days. Hope this helps!

Yes, this is what I have founf too. If my levels are above 10 I can be waiting well over an hour whereas if they are in the 4s, for me that is usually still at least 30 mins as I have a strong Foot on the Floor response.
Like you, I inject and then keep a close eye on my Libre and usually eat when my levels get down to mid 5s or if I am below that, the arrow indicates that it is kicking in. This works really well for me but I do need to keep my eye on the ball and the longer you wait, the easier it is to get distracted.

 

[T1Nick]

Nice to compare notes Rebrascora! TBH I also wait until my levels are in the mid-5's before eating but wasn't sure if that should be recommended because, as you say, you really do need to keep your eye on the ball as, if you get it wrong, a nasty Hypo can occur (especially given all CGM's are some 10 minutes behind in their levels). I have only got it badly wrong once - and don't intend to do so again! My justification is I'd rather have a short time at ~3.5 to 3.8 on occasion than most days spiking to 13 or 14 which is how it used to be before I started this approach. My TIR shows it really works for me and is sustainable.

 

[rebrascora]

@T1Nick Yes, you have to find what works for you as an individual and I have a fast digestive system so mid 5s or even mid 4s are Ok for me with my Greek yoghurt and berries breakfast. If I take my eye off the ball and it gets below mid 4s with a sloping or downward arrow, then I eat a single jelly baby, chew it really well so that it absorbs through my mouth as much as possible and then follow it with my breakfast which I make up ready to eat as soon as my levels get to where I want them.

II am also on 93%TIR with just 1% below at the moment so doing pretty well. And I too find it quicker and easier (and pleasanter) dealing with a mild hypo than being high for hours.

I should mention that the algorithm on the Libre does it's best to counteract the lag between interstitial fluid and blood, so assuming that your levels are not changing direction, there is generally no time lag as the Libre result is extrapolated from previous readings to predict what the current Blood Glucose level will be now from that interstitial reading. I think when Libre first came out, you had to accept the 10-15 min lag but with the algorithm, the Libre reading should now more or less equate to your current BG providing that levels are not changing course.... ie after a hypo treatment etc.

 

[T1Nick]

@rebrascora : More very useful stuff thanks! I hadn't kept up with the algorithm improvements on the Libre so that is good to know and I will bear it in mind.
I appreciate this is probably starting another topic but I do find that the current Libre sensors are much more likely to give me a "Sensor unavailable - try again in 10 minutes" response than the older ones did. Given the methodology we both have adopted about tracking our levels before breakfast to find the best time to eat, I do find this message highly frustrating and unhelpful. Do you have any insight on this - or any tricks to get around it? Occasionally I have resorted to multiple finger prick tests to establish my situation but this feels such a backwards step and isn't really sustainable.

 

[nonethewiser]

Yes, this is what I have founf too. If my levels are above 10 I can be waiting well over an hour whereas if they are in the 4s, for me that is usually still at least 30 mins as I have a strong Foot on the Floor response.
Like you, I inject and then keep a close eye on my Libre and usually eat when my levels get down to mid 5s or if I am below that, the arrow indicates that it is kicking in. This works really well for me but I do need to keep my eye on the ball and the longer you wait, the easier it is to get distracted.

Just shows how different we all are @rebrascora , if I were to wait over an hour you'd find me on the floor.

 

[nonethewiser]

@rebrascora : More very useful stuff thanks! I hadn't kept up with the algorithm improvements on the Libre so that is good to know and I will bear it in mind.
I appreciate this is probably starting another topic but I do find that the current Libre sensors are much more likely to give me a "Sensor unavailable - try again in 10 minutes" response than the older ones did. Given the methodology we both have adopted about tracking our levels before breakfast to find the best time to eat, I do find this message highly frustrating and unhelpful. Do you have any insight on this - or any tricks to get around it? Occasionally I have resorted to multiple finger prick tests to establish my situation but this feels such a backwards step and isn't really sustainable.

Was getting fair few of those messages plus signal loss alarms before changing to Dexcom G6, don't know why as had very few issues before & been using device since it was introduced here in UK.

 

[rebrascora]

@rebrascora : More very useful stuff thanks! I hadn't kept up with the algorithm improvements on the Libre so that is good to know and I will bear it in mind.
I appreciate this is probably starting another topic but I do find that the current Libre sensors are much more likely to give me a "Sensor unavailable - try again in 10 minutes" response than the older ones did. Given the methodology we both have adopted about tracking our levels before breakfast to find the best time to eat, I do find this message highly frustrating and unhelpful. Do you have any insight on this - or any tricks to get around it? Occasionally I have resorted to multiple finger prick tests to establish my situation but this feels such a backwards step and isn't really sustainable.

It may be because I follow a low carb way of eating and so my levels rarely change fast which I believe can prompt that issue, but I also use the reader rather than LibreLink and I think the reader seems to be much more reliable and dependable in lots of respects. Of course I don't have full CGM on the reader, but I find I actually manage better with Flash. I scan about 30 times a day and have done for the last 3 years with Libre and that seems to give me the right amount of info to understand my body and make all my decisions off Libre. I recently used the LibreLink on an iphone because I lost my reader (I was gutted!!) and absolutely hated it, even though the full CGM update worked straight away for me and it was a bit of a novelty seeing my readings tick up or down on screen in real time, I didn't actually find it useful and it just used battery life. Much, much happier going back to the reader which provides me with everything I need and is so quick and simple to scan and just needs charging once a week. I found there was a huge delay on LibreLink between scanning and getting a reading a lot of the time, so I would try to scan again because \i thought it hadn't worked. My levels went haywire whilst I was using it but they have settled nicely back in the 90s now I am back to the reader. Part of that was no doubt due to irritation and frustration at the app and my mind not being familiar with it particularly when woken from sleep by it or when hypo. With the reader, I don't have to think and I can calculate and inject a correction from it whilst half asleep with no light on and be back to sleep in minutes if not less.... or the same to treat a hypo with JBs. With the phone I just couldn't do it on autopilot and it was often too much mental effort to wake up fully and deal with it, so I would just ignore it and go back to sleep and then wake up again when I was actually hypo hypo or levels so high it woke me up. I would not believe someone else if they had said such a small change would make a big difference like that but it really did for me and I absolutely hated LibreLink.... although it didn't help that I also hated the iphone that I needed to change to to get Librelink because my Motorola was not compatible.
Maybe it is just because I am an old fart and I just hate change and mobile phones in particular but getting that try again in 10 mins message even just a few times did my head in, especially when I really needed to know where I was.

 

[T1Nick]

Hah - I love it - a couple of old f**rts together I think! I too use the reader in preference although keep the phone App working in case I forget the reader (I like to have a back-up). Unfortunately for me the "sensor unavailable" message is just as common whichever system I use. I'm reasonably low carb (no meals more than 50g) but perhaps not as low as you. I also play a lot of tennis and getting the "sensor unavailable" message on court is really annoying because levels can change rapidly with the exercise so it's extra important not to have to wait for the reading to come back online.
I agree with you completely regarding using the reader overnight and have the same way of using it. Being on a pump, having a bit extra insulin if needed or even stopping my basal if the numbers are going down slowly is so easy to do. The only way we differ is that my Motorola mobile is fine with LibreLink (phone operates Android 10) when I need it.
I also had the chance to try Libre 3 - which has no reader available of course. This didn't work for me because the phone went out of range when I was playing tennis (I can't carry a phone and play) and the CGM didn't re-connect quickly enough when we changed ends on court. I'm hoping the latest software for Libre 2 will enable me to have CGM for most of the time but then still have the ability to "swipe" the sensor when the CGM is off line. I will be changing my sensor tomorrow for the first time since the App update, so will find out soon!