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annabel53

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Type 2
Hi, I was diagnosed Type 2, 17 years ago. Have progressed through various medications and am now carb counting and injecting basal and bolus insulin. Also taking Metformin and Empagliflozin (have lost 1 stone since starting this). Have recently started self-funding Freestyle Libre ... are there any other Type 2’s here using it?
 
annabel53 said:
Hi, I was diagnosed Type 2, 17 years ago. Have progressed through various medications and am now carb counting and injecting basal and bolus insulin. Also taking Metformin and Empagliflozin (have lost 1 stone since starting this). Have recently started self-funding Freestyle Libre ... are there any other Type 2’s here using it?
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Hi Annabel53 and welcome!

I was diagnosed with T2 in June and have been on a rapid and fascinating learning journey. Having tried and failed to lose weight for most of my adult life I knew there was something wrong when I started dropping a lot of lbs without trying. That's what led to my diagnosis. Since starting Metformin and Gliclazide the weight stopped coming off but my blood glucose (BG) started coming down. I immediately cut out refined sugar and flour and upped my activity level. I have always walked quite a lot, and cycled, and I just add another 10-20 minutes where I can. I then read about the Keto diet and decided to give it a go. It is working really well for me. I've lost another half a stone, but purposefully this time, and my BGs remain good. I also have more energy and can walk at a faster pace for longer. I went for a walk this evening and thought I'd been out for 20-30mins but turned out it had been an hour - I think it's just the faster pace kicking in. I don't feel the effort quite so much so the timescape changes. There's a long way to go - I need to lose another 8 stones - but for the first time in my adult life I feel I am making progress.

I have been prescribed a BG monitor and it has been wonderfully helpful. I think information is key and rather than having to wait for my next HbAc1 test I am learning every day and every mealtime what works. I would thoroughly recommend it. I'm surprised, given the meds you are on, you haven't been prescribed one too?
 
I started using it in January this year but have no DSN support. My surgery nurse has no experience of it so I am ‘flying blind’. I have joined some user groups on Facebook and have watched the Abbot videos. I find the graph of what happens to my blood glucose very interesting ... I seem to peak 3 hours after eating then drop quite quickly back to ‘normal’ after 5 hours. I am trying to stay between 4 and 10 mmol (trying being the operative word) . The arrows to indicate which way the glucose level is going is very useful.
 
Largesse1! said:
Hi Annabel53 and welcome!

I was diagnosed with T2 in June and have been on a rapid and fascinating learning journey. Having tried and failed to lose weight for most of my adult life I knew there was something wrong when I started dropping a lot of lbs without trying. That's what led to my diagnosis. Since starting Metformin and Gliclazide the weight stopped coming off but my blood glucose (BG) started coming down. I immediately cut out refined sugar and flour and upped my activity level. I have always walked quite a lot, and cycled, and I just add another 10-20 minutes where I can. I then read about the Keto diet and decided to give it a go. It is working really well for me. I've lost another half a stone, but purposefully this time, and my BGs remain good. I also have more energy and can walk at a faster pace for longer. I went for a walk this evening and thought I'd been out for 20-30mins but turned out it had been an hour - I think it's just the faster pace kicking in. I don't feel the effort quite so much so the timescape changes. There's a long way to go - I need to lose another 8 stones - but for the first time in my adult life I feel I am making progress.

I have been prescribed a BG monitor and it has been wonderfully helpful. I think information is key and rather than having to wait for my next HbAc1 test I am learning every day and every mealtime what works. I would thoroughly recommend it. I'm surprised, given the meds you are on, you haven't been prescribed one too?
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I have a blood glucose monitor from the doctor but the Freestyle Libre is the 14 day monitor that you wear on your upper arm and scan to get a reading (no finger pricking needed) ... unfortunately not available on prescription for Type 2’s
 
It is quite incredible when you can see what is happening in the gaps between when you might normally have used a finger stick test, if you’d only been testing before/after meals you might not see that 3 hour peak and 5 hour normal reading. Also very good for seeing what happens overnight.
It’s a shame your nurse has no experience but hopefully they will be able to interpret any graphs you show them to ensure your insulin doses are as they should be for optimal numbers.
 
LucyDUK said:
It is quite incredible when you can see what is happening in the gaps between when you might normally have used a finger stick test, if you’d only been testing before/after meals you might not see that 3 hour peak and 5 hour normal reading. Also very good for seeing what happens overnight.
It’s a shame your nurse has no experience but hopefully they will be able to interpret any graphs you show them to ensure your insulin doses are as they should be for optimal numbers.
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Hopefully ... I was hoping for a June HBA1C test to see how things were going but I assume Covid-19 has interfered with that. Libre
is estimating 45 mmol but it would be nice to know whether the lab test agreed with it
 
Hi Annabel and welcome from me too.
I am Type 1 and currently self funding the Libre although I hope to get it on prescription soon.
Do you use the Time in Target function on it?
When do you inject your bolus insulin? Ie when you eat or before you eat and if the latter, how long before you eat.
Experimenting with bringing forward the timing of the bolus injection may help to reduce your BG spike.... for instance, for me, I need to inject my breakfast bolus (NovoRapid) about an hour before I eat breakfast and about 20 mins for lunch and dinner. That is extreme and some people would hypo injecting that far in advance but there are other members of the forum who follow a similar timing regime. The Libre should enable you to find the best timing for you but do it carefully by increasing in 5 min increments and choose days when you have plenty of time to monitor it, not on days when you are rushing out to work or for an appointment etc.
Peaking 3 hours after eating suggests that you may have a slow digestive system or it may reflect the food you are eating... high fat or protein meals slow the peak down. I follow a low carb way of eating and things like eggs usually take 2-3 hours to hit my system so I tend to bolus after eating for those. Of course, if you are a proper Type 2 then you will likely be insulin resistant so it may take longer for the insulin to work.
Having said all that, if your Libre is predicting an HbA1c of 45 you are likely to be somewhere in that region which is pretty good, so I wouldn't worry too much. Do you get many hypos as that would be the only concern, which is why Time in Range/Target tends to be a more useful measure.
 
Hi ... am usually over 90% in target (which I realise is very good) but think that type 1 and type 2 seem to react quite differently from what I have seen in the Libre users posts on Facebook. I try to bolus about 15 minutes before food and have found that I need 1 extra unit in the mornings (possibly because I favour sourdough & peanut butter). Try to limit meals to max of 60 g CHO so I don’t have to use too much insulin. Since taking Empagliflozin I have been able to halve my insulin so ratio of 1:10 now and 22 units basal. I have noticed that when I go for a long walk (or cycle) my readings climb quite steeply but fall again quite rapidly ... it is all very confusing
 
I have been using it for about a year.
Some exercise does raise levels before falling. Also the effects of exercise can also last into the following day too.
The HBA1C predication for me is not been close, my last one in February was 53, but the predication was 48.
 
I am finding in this current heat that exercise which would normally lower my BG is raising it initially and then bringing it down later which is making it a bit difficult to predict. the effects.

90% TIR (Time in Range) is brilliant!

60g carbs per meal is still pretty high. Have you tried going lower?

Needing more bolus insulin on a morning is common and is probably more to do with counteracting Dawn Phenomenon than the carbs you eat.

Sounds like you are doing great!

@grovesy Personally I don't see a significant difference between 48 and 53 as there will be levels of error involved in both the lab HbA1c results and the Libre... I would be happy with either of those, but then as a Type 1 I suppose it is a bit trickier for us to get it lower without going too low too often, so my expectation of achievement is probably lower.
 
Sorry, I do not believe there is any level of error in a lab BG or HbA1c result, whereas if a person does not exactly match whatever algorithm is in the Libre's 'brain', then of course there will be an error level. Does the Libre match the fingerprick results in the first place - obviously you have to do the fingerprick 10 -15 minutes after scanning the Libre to assess that; then does the difference between the Libre predicted and the actual HbA1c match the difference between the first two things? (the same percentage)
 
rebrascora said:
I am finding in this current heat that exercise which would normally lower my BG is raising it initially and then bringing it down later which is making it a bit difficult to predict. the effects.

90% TIR (Time in Range) is brilliant!

60g carbs per meal is still pretty high. Have you tried going lower?

Needing more bolus insulin on a morning is common and is probably more to do with counteracting Dawn Phenomenon than the carbs you eat.

Sounds like you are doing great!

@grovesy Personally I don't see a significant difference between 48 and 53 as there will be levels of error involved in both the lab HbA1c results and the Libre... I would be happy with either of those, but then as a Type 1 I suppose it is a bit trickier for us to get it lower without going too low too often, so my expectation of achievement is probably lower.
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I find if I go much lower than 60g CHO per meal I need to eat/snack at around 9.00 pm to keep my overnight levels in the safe range ... I think I have to decrease my basal insulin and am in the process of dropping it to see what happens ...
 
rebrascora said:
I am finding in this current heat that exercise which would normally lower my BG is raising it initially and then bringing it down later which is making it a bit difficult to predict. the effects.

90% TIR (Time in Range) is brilliant!

60g carbs per meal is still pretty high. Have you tried going lower?

Needing more bolus insulin on a morning is common and is probably more to do with counteracting Dawn Phenomenon than the carbs you eat.

Sounds like you are doing great!

@grovesy Personally I don't see a significant difference between 48 and 53 as there will be levels of error involved in both the lab HbA1c results and the Libre... I would be happy with either of those, but then as a Type 1 I suppose it is a bit trickier for us to get it lower without going too low too often, so my expectation of achievement is probably lower.
Click to expand...
Sorry I disagree the Diabetic nurse was trying to use the 53 to add to my meds.
 
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