Libre 2 eventually

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Charl said:
Well the alarm certainly works, was woken at 1.30 to a low blood sugar alarm.... 3.9 immediately took 4 x fast acting glucose chews,walked downstairs , finger pricked and I was 4.6, all in about 5 minutes, do the glucose chews work that quick or is my libre wrong regarding readings, do I treat as nearly a hypo, any advice appreciated.
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glucose chews tend to take, in my experience, more like 10 - 15 for blood testing, and a bit longer to show on libre. We were told to set alarms at 4.5 to start. I now alarm at 4.9 during the day (when i will have bolus insulin at work and do excercise so rates move faster) and 4.5 at night, when things move slower and i don't want to be woken. The dexcom lets you set up different day and night alarmd, but nothing stopping you changing your level before you go to bed.
if you catch a low at 4.5 then you have time to be more gradual with your treatment and avoid the rebound highs
 
Amity Island said:
Hi,

I set my low alarm at 5.5. This gives one a chance of preventing hypo's rather than dealing with them. If I get a 5.5 and a downward arrow I treat then. No point in having any unnecessary hypo's. That is just one of the amazing benefits of the libre 2.
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5.5 and a downward arrow, how do you treat it, I had another one last night 3.9 , finger prick showed 4.2, anyone know what the procedure is then, would rather be woken where I just have a snack to get me through the night, nothings easy.
 
Was it a vertical downward arrow or just sloping? I would probably just have 1 jelly baby for that situation assuming it was genuine and not a compression low where I had rolled over onto my Libre arm and that was causing the low. You can sometimes tell by the shape of the graph ie it shows a sudden dip if it is a compression low due to lying on it or if you wake up lying on that arm, whereas a genuine low will usually be a more gradual trend of levels reducing over a longer period.

One Jelly Baby will raise my levels by about 1mmol so if I was 5.5 it should push my levels up to about 6.5 which, even if levels are still genuinely dropping, it gives a good bit safely margin without pushing your levels up too high.
 
rebrascora said:
Was it a vertical downward arrow or just sloping? I would probably just have 1 jelly baby for that situation assuming it was genuine and not a compression low where I had rolled over onto my Libre arm and that was causing the low. You can sometimes tell by the shape of the graph ie it shows a sudden dip if it is a compression low due to lying on it or if you wake up lying on that arm, whereas a genuine low will usually be a more gradual trend of levels reducing over a longer period.

One Jelly Baby will raise my levels by about 1mmol so if I was 5.5 it should push my levels up to about 6.5 which, even if levels are still genuinely dropping, it gives a good bit safely margin without pushing your levels up too high.
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It was a changing slowly arrow.
 
"It was a changing slowly arrow."

In that case definitely just 1 jelly baby (5g carbs) or 2 dextrose tablets (about 6-7g carbs).... whichever you use, would be an appropriate response to that situation. If it was a vertical downward arrow, then I would consider 2 JBs or 3 Dextrose.


Personally I have my low alarm set lower, but I respond very quickly to carbs and I am more experienced using Libre so at 4.2 I can still turn a downward arrow around with a JB or two before I hit "the red" and I sleep best in the 4s and 5s, so for me, I prefer to "sail a bit closer to the wind" during the night for better, more sound sleep, so my low alarm is set at 4.2.
However I think 5.5 is a much safer option for you at the moment and gives you plenty of "wriggle room" to deal with it before you get close to hypo.
 
Charl said:
When it was fiffed last week the nurse set it at 3.9.....would they be happy if I changed it.
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I really don't understand why they would set it so low. It makes far more sense to set it above 4 so that you have time to prevent a hypo rather than be warned that it is happening.

Your insulin and technology are there to enable you to manage your diabetes effectively. You are the person who lives with your diabetes and providing you try not to do anything too dangerous then you decide how you manage it and what settings or doses you use. The important thing is that you can justify why you made whatever changes you did. Raising your low alarm above 4 makes absolute sense because you are using it to prevent hypos. Don't be frightened of what your nurse or consultant will say. They are there to SUPPORT you not criticize you and if they do criticize then they are bad at their job and not worth listening to anyway in my opinion. As long as any changes you make are logical and you can justify them, (even just as an experiment that perhaps might not work as well as you hoped it would) don't be frightened of adjusting things yourself..... as long as you keep one eye firmly on keeping yourself safe ..... and to me raising that low alarm is a step towards safety not away from it.
 
So if for example I set it at 5, what action should I be taking to keep my readings in the safe zone, tell me if you think I should be taking this up with my diabetic nurse. Thanks
 
Just as discussed above really, if you are not just about to eat a meal and your alarm goes off at 5.0, then have a single JB or dextrose just to bump your levels up a bit. If you find that the alarm setting at 5 means that you get a lot of alarms and start ignoring it (not safe) or finding it frustrating (stressful), then drop it a bit, maybe to 4.5. Gradually you will find what works best for you, with your lifestyle and your digestion and your insulins, but in order to do that you need to feel free to tweak thinks and see what works best. If you were thinking of lowering the alarm to 3.5, that would be less safe. If you raise it to 5.5 and then find you start to ignore it because it goes off all the time, then that defeats the point of having an alarm and means you may end up hypo because once it drops below the alarm, I don't think it continues to warn you. I can't see any other problem with raising it to 5. Your HbA1c might rise a little bit but that is less important than preventing hypos. Having more stable levels and less or no hypos is preferable to highs and lows that might give you a better HbA1c overall.
 
Charl said:
When it was fiffed last week the nurse set it at 3.9.....would they be happy if I changed it.
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Doesn’t matter what they think, it’s your diabetes
 
Charl said:
When it was fiffed last week the nurse set it at 3.9.....would they be happy if I changed it.
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This is the difference between the captains banging the drum (doctors and nurses) and the crew (diabetics).

Diabetes has to be self managed as it's a 24hr a day condition. It is common sense, that if someone has invented an amazing piece of technology that can prevent a hypo, that one would use it to it's full potential. The advice you are getting from the nurse is to allow a hypo when the device you are using can instead prevent them.

There is a reason so many come to this forum for advice, and you have found just one of those reasons.
 
If it's of any help to others, I was able to get glucojuice on my prescription a while ago and find it is the quickest at bringing up levels compared to anything else I tried. I only take a small amount and then something low glucose index to maintain levels (because glucojuice is high GI and will cause your blood glucose to drop again once it wears off).

Before the "sugar tax" came in and the watered down lucozade I already hated it as it was too slow and I always ended up drinking too much. They're quite small bottles too so it's easy to carry around
 
My diabetes management took a HUGE leap forward when i started taking control, not just doing what DSN told me to.
Obviously, til you know what you are doing, you should follow their advice.
But not the advice to set alerts at 3.9. That's bonkers
 
Charl said:
So if for example I set it at 5, what action should I be taking to keep my readings in the safe zone, tell me if you think I should be taking this up with my diabetic nurse. Thanks
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Thinking about this again. Are you sure they don't mean set the "time in range" from 3.9 to 10? not set the low alarm to 3.9? the nurse may have got this mixed up.
 
Well there's the first mistake, before evening meal,insulin etc, Readings were 6.3, later alarm went off at a reading of 4.9, had a small bowl of cereal thinking it would move my readings up, WRONG, half hour later it was down to 3 where I had to have JBs to get it back up, am I correct in thinking I should have done it the other way, JBs first then cereal.Screenshot_20230411_214204.jpg
 
Please remember that where to set the low alarm and how to treat depends upon how your body reacts.
@rebrascora writes about how many jelly babies she would take at 5.2.
I would take none or half a Lift tablet unless I had insulin on board
I also look for trends in the graph rather than the arrow as I find my lines can be wobbly. The arrow can point down for one reading and then up for the next. I find the arrows pretty pointless as they are based on so little data.

The advice above is a good starting point but test it on your body and decide whether it works for you. It is not gospel because we are all different.
 
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