how my hostpal look in target.

[rayray119]

so i;ve been thinking i; great offen not seeing below 7 when before meals(perherps sometimes because I start of at number)( I don't think my hospital seem just look at 3.9 to 10 at all times and don't seem to be bothered about weather that's before or after meals and I was just taking it and going to with their advice as they no what there doing I thought. but I know seem to question it because this advice does seem to go going agiast nice guidelines.

Blood glucose targets​

1.6.13Advise adults with type 1 diabetes to aim for:

• a fasting plasma glucose level of 5 to 7 mmol/litre on waking and
• a plasma glucose level of 4 to 7 mmol/litre before meals at other times of the day. [2015]

1.6.14Advise adults with type 1 diabetes who choose to test after meals to aim for a plasma glucose level of 5 to 9 mmol/litre at least 90 minutes after eating. (This timing may be different in pregnancy – for guidance on plasma glucose targets in pregnancy, see NICE's guideline on diabetes in pregnancy.) [2015]
1.6.15Agree bedtime target plasma glucose levels with each adult with type 1 diabetes. Take into account the timing of their last meal of the day and the related insulin dose, and ensure the target is consistent with the recommended fasting level on waking (see recommendation 1.6.13). [2015]

am I wrong to be starting question things my team are advising. (would being a above these sujested targets end up with more risks and is it okay).

 

[Bruce Stephens]

The two things aren't really conflicting. I think there's general acceptance that time in range is a useful measure (so spend as much time as possible between 3.9 and 10.0), but the NICE guidelines can't say that yet because still lots of people don't have a way to measure it.

So the best they can advise is readings before eating, on waking, etc. And those are also good targets if you want good time in range. (And if you have good time in range you're probably generally hitting those targets.)

 

[rebrascora]

The 3.9-10 are very much Libre Time in Range targets rather than finger prick targets because with finger pricks you have no way of knowing what your BG is doing the vast majority of the time.... only at those few moments when you test.... even if you tested 15 times a day, it is still just 15 seconds as compared to the 24 hours that Libre samples and plots your levels. And of course with Libre you are just looking to achieve 70% or more in target which just feels more achievable.

It may be that your team are happy for you to retain that wider Libre target because you are still relatively newly diagnosed and they don't want you to be doing corrections under 10 perhaps because you are still in the honeymoon phase and you have said yourself that you are often quite sensitive even to small corrections.

I think it is good that your team are not setting you the unrealistic 4-7 pre meal targets especially at this stage in your diabetes journey as it can be quite demoralizing when you fail to hit those targets, particularly if that happens frequently, whereas the 3.9-10 range 70% of the time is much more achievable, even if you are applying it to finger pricks rather than Libre results. It is a fine line to walk for DSNs between being potentially critical or demoralizing you by setting unrealistic targets and encouraging you to manage your diabetes well by setting slightly more relaxed targets which are achievable. Feeling good about how you are doing is better that feeling dejected that you aren't hitting set targets and it will encourage you to try harder whereas feeling like you are trying really hard and failing is very demotivating and may make you feel like you are just not going to bother because you are not getting rewarded for your effort with good results. Not sure if any of that makes sense to you but from my perspective the wider target range makes me feel much more motivated and positive than I did with those NICE targets you quoted, which I regularly failed to achieve.

 

[rayray119]

The two things aren't really conflicting. I think there's general acceptance that time in range is a useful measure (so spend as much time as possible between 3.9 and 10.0), but the NICE guidelines can't say that yet because still lots of people don't have a way to measure it.

So the best they can advise is readings before eating, on waking, etc. And those are also good targets if you want good time in range. (And if you have good time in range you're probably generally hitting those targets.)

i just figer pricks at the moment due to issues with the libre but even my readings they not bothering about what time of day is. they uploaded my letter last time and based time in target with that which was partly 60% over that month. 50% percent over two weeks but the weak before i had a nastey cough(so consultant said that wasn;t two bad) but i;m ill again now with a some sort stomach bug once i'm over it i'm going to do some

 

[rayray119]

The 3.9-10 are very much Libre Time in Range targets rather than finger prick targets because with finger pricks you have no way of knowing what your BG is doing the vast majority of the time.... only at those few moments when you test.... even if you tested 15 times a day, it is still just 15 seconds as compared to the 24 hours that Libre samples and plots your levels. And of course with Libre you are just looking to achieve 70% or more in target which just feels more achievable.

It may be that your team are happy for you to retain that wider Libre target because you are still relatively newly diagnosed and they don't want you to be doing corrections under 10 perhaps because you are still in the honeymoon phase and you have said yourself that you are often quite sensitive even to small corrections.

I think it is good that your team are not setting you the unrealistic 4-7 pre meal targets especially at this stage in your diabetes journey as it can be quite demoralizing when you fail to hit those targets, particularly if that happens frequently, whereas the 3.9-10 range 70% of the time is much more achievable, even if you are applying it to finger pricks rather than Libre results. It is a fine line to walk for DSNs between being potentially critical or demoralizing you by setting unrealistic targets and encouraging you to manage your diabetes well by setting slightly more relaxed targets which are achievable. Feeling good about how you are doing is better that feeling dejected that you aren't hitting set targets and it will encourage you to try harder whereas feeling like you are trying really hard and failing is very demotivating and may make you feel like you are just not going to bother because you are not getting rewarded for your effort with good results. Not sure if any of that makes sense to you but from my perspective the wider target range makes me feel much more motivated and positive than I did with those NICE targets you quoted, which I regularly failed to achieve.

the consudlent was looking for that of my meter as well. it said it was 3.9 to 10 but yes it probelly is good when I was dinogosed the target before meals was wrote in the hotial log book as between 4 and 7 before meals. i disnoasged in a diffenrt hostpail but yes i was getting those numbers so i am gernal happy if i wake up under 10. and i gues with a stoach bug hitting 11 and 12 isn't to bed. even if 12 it seem to going better in afternoon before going up.