How are you getting on @Busdriver60?

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Proud to be erratic

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Afternoon Paul @Busdriver60 and Angela @GraceAng. I was just wondering how you got on last night and now during today? I thought I'd ask now because I'm expecting to be busy tomorrow and local, but basically out of contact. Conversely I could be in London all day on grandson escort duty, but not busy and just waiting around all day. I won't know which until tomorrow morning!

So are you feeling a little less vulnerable than you were last night? Don't beat yourself up about asking last night; I felt dreadfully isolated for several weeks after my discharge from Hospital in early 2020 and the Covid lockdown had driven HCPs into their bunkers behind locked doors. I at least had a cousin of some 40 years as a T1 that I could speak to. It is normal to be worried about how your BG is going to behave.
 
Hello Roland @Proud to be erratic, I'm finally wear my sensor device on my left arm, it felt a bit strange at first, but now Ive got used to it. If I honest with you, I was having last minute doubts about it, I kept putting it off, which I shouldn't have done, but I did promise Angela, my wife I would cooperate. It was very interesting to see how the Libre app works on my phone. Linked to the device via Bluetooth, amazing! I've been a good boy now! ha ha!
 
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Afternoon Paul @Busdriver60 and Angela @GraceAng. I was just wondering how you got on last night and now during today? I thought I'd ask now because I'm expecting to be busy tomorrow and local, but basically out of contact. Conversely I could be in London all day on grandson escort duty, but not busy and just waiting around all day. I won't know which until tomorrow morning!

So are you feeling a little less vulnerable than you were last night? Don't beat yourself up about asking last night; I felt dreadfully isolated for several weeks after my discharge from Hospital in early 2020 and the Covid lockdown had driven HCPs into their bunkers behind locked doors. I at least had a cousin of some 40 years as a T1 that I could speak to. It is normal to be worried about how your BG is going to behave.
 
My new app has told me my BG has gone up 17.6! ooooops!!! What should I do now?
 
Thank you. I just need to get used to it, Im sure I will be ok.
 
Well done Paul for fitting your sensor and getting started. Now I need to be boring and introduce you to the potential limitations of CGMs. These were compiled by @helli when Libre 2 was more or less the only CGM available from GP's prescriptions.


I think you'll find the whole thread useful.

One change that has now occurred since I had Libre 2 the manufacturers have upgraded it to now be a truly continuous glucose monitor. Previously we had to bring our phones close to the sensor on our arm in order to get a reading. You should be getting a revised reading every 5 minutes automatically. That comes onto your LibreLink app on your phone; there is a Web based Libre site that you've probably been given a code for by whoever authorised Libre for you. That site is called LibreView and your sensor sends data to that site automatically through your wi-fi. But first you need to register on that site which is an independent registration from the registration process for the Libre tutorials. By the way have you been able to look at those tutorials?

If you do have challenges with keeping Libre working ask on the Forum. I have been changed to Dexcom G7 and today I'm a bit out of date on some of the "tricks and tips" with Libre.
 
If Libre is showing 17.6 and your finger prick reading is close to that sort of level as well then it's telling you the meal you ate earlier was pretty high in carbs. Because you only have a slow release basal insulin (your Toujeo) you can't in practice do all that much about your high. Just wait and it should go down of its own accord before your next meal.

However, one trick many of us do is quite deliberately get active; either around the house or go for a gentle walk. Aerobic (gentle) exercise helps lower your natural insulin resistance (we all have some of that, it's normal). More rigorous anaerobic exercise however, doesn't help in the short term. When your brain thinks you might be at risk in some way as a result of that anaerobic exercise your liver releases glucose from the store which worsens the high. It's a sort of "fight or flight" response that the glucose is trying to help you survive from. Another thing when you have a high BG status is to drink lots of water. That helps flush excess glucose out of your system; it is of course good to be as fully hydrated as you can, anyway.

Over the coming days and weeks you will start to see a solid "cause and effect" with your BG from your Libre graphs. How your BG responds to each meal; how your BG changes during the night while fasting and sleeping; what effect you get from simple aerobic exercise and from your adrenaline fuelled Karate. You might well find that you see BG changes while watching a comedy on TV or an emotional tear provoking movie. Most importantly your daily graphs will allow your GP or Hospital team to adjust your Toujeo and optimise the benefit of that for your 24 hr day. It is all a trial and learning experience. I still record on my CGM notes: what insulin I've taken and when; meals eaten carb content and from what food; activity and anything else that might have caused a significant BG change. I know not everyone does this diligently forever, but the data is so helpful to a DSN or Endocrinologist in these early days of managing your D.

Your graphs will look very spikey at this stage. The LibreLink app only displays in portrait form, not landscape so the graphs are very squeezed across the narrow phone screen.
 
Well done Paul for fitting your sensor and getting started. Now I need to be boring and introduce you to the potential limitations of CGMs. These were compiled by @helli when Libre 2 was more or less the only CGM available from GP's prescriptions.


I think you'll find the whole thread useful.

One change that has now occurred since I had Libre 2 the manufacturers have upgraded it to now be a truly continuous glucose monitor. Previously we had to bring our phones close to the sensor on our arm in order to get a reading. You should be getting a revised reading every 5 minutes automatically. That comes onto your LibreLink app on your phone; there is a Web based Libre site that you've probably been given a code for by whoever authorised Libre for you. That site is called LibreView and your sensor sends data to that site automatically through your wi-fi. But first you need to register on that site which is an independent registration from the registration process for the Libre tutorials. By the way have you been able to look at those tutorials?

If you do have challenges with keeping Libre working ask on the Forum. I have been changed to Dexcom G7 and today I'm a bit out of date on some of the "tricks and tips" with Libre.
 
Thank you, Roland, always glad to learn things from you. I'm very grateful indeed. I hope to learn something new today!
 
Thank you, Roland, always glad to learn things from you. I'm very grateful indeed. I hope to learn something new today!
Morning Paul,
When someone gets the diabetes diagnosis it is often “ overwhelming “ and most folk simply do not take everything on board and is another reason why people on here tend to offer additional advice,info and support when newly diagnosed people like yourself can more readily take it in a more timely manner.
I really must stop reading Roland’s posts as I will be accused of “idolising him” lol but I just find them so detailed and informative much better than my own less structured responses as I write probably much more from the heart than the head.
Now you are starting to using your Libre you will become more aware of its vagaries and how your body responds in terms of diet/ exercise and medication.
It willl warn you of the direction of travel and impending highs and lows but dint concern yourself at this point in time with specific readings but look at the trends.
You will soon gain confidence as you acquire knowledge about how to respond to these readings like I can almost guarantee the first time you head very low you will likely overreact by taking glucose tables/jelly babies etc and probably biscuits or whatever.Your reading will then reverse and seem volatile but you will learn from that and when you get a reoccurrence of the pattern you will more readily recognise it and your fine tuning will improve over time and quicker than what you think.
I know you will be keen to learn quickly but think like the bus driver you are “ getting to the destination is important but don’t forget to learn and hopefully enjoy the journey”.
 
Hi Wendal, it's lovely to hear from you. Thank you for that. There's so much to learn, in time I will know more about the new device what food to avoid and what I should be eating, to manage the condition. I don't think I can do without people like yourself on the forum. I am very grateful. Hopefully, I will do the same for new people on the forum in the near future.
Thank you again. Have a lovely weekend.
 
I wholly agree with @Wendal about taking notice of the trends rather than the precise numbers.

Firstly Paul, always in your mind ignore the figure after the decimal point and just treat the display as a whole number, rounded up or down. Neither the fp test meters nor the sensors can actually be that accurate and its just marketing that encourages manufacturers to embellish an answer with that extra digit.

Secondly both fps and sensor readings can just be variable because actual blood glucose can be variable. Osmotic pressure facilitates BG change and its unrealistic to imagine that one's BG is constantly the same all over our bodies at any one moment in time.

Thirdly that snapshot from each fp or every 5 minute sensor reading is just a momentary snapshot. However the trend (change up, down, or staying level) is generally consistent and reliable; and even if a first CGM reading suggests a direction change that has been inaccurately "interpreted" by the complex mathematics using computer managed "algorithms", that inaccuracy gets corrected by another algorithm 5 mins later. So waiting at least 5 mins for a confirmatory sensor reading of a trend is invariably good practice.

The outcome is that good practice = don't panic, don't rush. With a first alert at 5.6 of a falling BG, there is plenty of time to consider what response would be best. My unusual state of having absolutely no pancreas and so none of the inbuilt warnings from the different pancreatic hormones does make my D quite a lot more brittle than most people; but I still have time to think before reacting because I've been alerted in a timely manner.

Paul, I don't know if you saw this response from @everydayupsanddowns very recently about hypos. Note this is when the hypo is upon you, not after the timely alert that your BG is falling. But in case you didn't see this - I think it's definitely another bit of "learning" that both you and Angela should know and be comfortable with knowing:


Also, there is (rightly) a big emphasis on don't let yourself go hypo . Without wanting to undermine that advice, the early stages of going hypo are unpleasant. But they are also manageable and we don't immediately die from those modest early hypo symptoms (that of course depends on someone routinely having hypo warning symptoms, a few people don't). Knowledge dispels fear and knowing hypos are not pleasant makes us want to avoid them but also allows us to tell ourselves still don't panic. I'm not sure what medical advice you were given about hypos; I do know that when I did my formal DAFNE course 3 yrs after my diagnosis the DSN instructor opened the hypo training segment with words akin to "Hypos are inevitable and can be frequent .... ". I was uncomfortable with even that opening statement; I had CGM (Libre 2 then) for at least a year and since having Libre 2 my hypos were truly rare. I used the highest low alarm setting of 5.6 and those alerts kept me safe and away from going hypo. At most I only briefly nudged 4.0. Whereas before having Libre; I was regularly getting onto that hypo / hyper roller-coaster, with some very deep and frightening hypos.

I need to pause for now. But @Wendal your comments are most kind and most undeserved. I regularly write too much and if I had a lot more time I would readily rewrite most of my long rambles much more succinctly and consequently shorter and better.

Paul, how did you get on yesterday and today after that momentary wobble about the 17+ reading yesterday evening?
 
I just accepted it and relaxed as I knew it come down again. It's part of my education and learn from the experience.
 
I just accepted it and relaxed as I knew it come down again. It's part of my education and learn from the experience.
Glad it came down again. Also you now know that some modest activity after eating any meal can help and always stay hydrated. But of course the bigger lesson is that particular meal seems to be too carb heavy for your body at this stage in your D management.

However, if you cut back on the carbs too excessively you could push your BG not just closer to 5+ but even lower. Then your insulin would need to be gently reduced. All part of the trial and learning, cause and effect process for YOUR BG management; do make adjustments, but not dramatic adjustments. We are all different, what works for you may not work for others.
 
Yep just to back up Roland’s comments and as I have said before I am a fairly recently diagnosed so about 10 months now but I have not had a severe clinical hypo at all so far.
Yes I have gone into the Red on my Libre reading and I think my lowest was about 3.1.
I could feel my hypo awareness kicking in at an earlier stage so was aware even without needing to take a reading but my alert had been triggered as again like others I set it higher so mine is at 4.7 ( you have to find the level you are comfortable with and some will have lower/ higher).
However even thought I was in hypo territory I still felt in total control and my slight symptoms readily improved following my 15g of fast carbs regime.
So again different people will have varying levels of what they call a hypo or clinical hypo but for me it is about preventing an uncomfortable hypo that really affects you.
Am lucky in that I don’t get anxious in general and it is important to me that I can sleep without having a hypo fear as know it can be a real issue for many.
So at first I ran a little higher overnight but now am very comfortable with managing my levels and have my alert to warn me of any impending issues.
Some choose to run quite low overnight which personally I am not comfortable with but each to their own
 
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