Libre 2 eventually

Status
Not open for further replies.
helli said:
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.
Click to expand...
I use both the graph and the arrows to make a decision, not one or the other as the arrows and graph can switch quite rapidly.

If the graph (trend) is dropping and I have a downward arrow, then I would try and prevent a hypo by eating a couple of jelly babies etc (@Charl before I eat a meal). It's not easy btw. It's trial and error.
 
Any suggestions of something to eat when my readings drop to five ,if at work or out n about prefer something that I could snack on that's not gonna make my bloods go through the roof.Thanks
 
Charl said:
Any suggestions of something to eat when my readings drop to five ,if at work or out n about prefer something that I could snack on that's not gonna make my bloods go through the roof.
Click to expand...
Just not that much, I guess? So the usual 15g is probably a bit too much and you want something closer to 5-10g (though obviously it depends - if you're at 5 and the arrow's pointing directly down then maybe 15g is fine). So one or two jelly babies, or a small fruit (a tangerine, for example), or a small biscuit. Something like that?
 
A singe prune or dried apricot which are about 5g carbs works well for me or occasionally a dried fig which is nearer 8g carbs depending on the size.
 
Charl said:
What if my next meal is 3 to 4 hours away....
Click to expand...
If you mean that you are hungry and you want something more to eat than just a prune intended to top your BG levels up a bit, then you can have whatever you like and just bolus for it.
I thought the question was about topping your BG levels up a bit to prevent them dropping too low.
 
Charl said:
What if my next meal is 3 to 4 hours away....
Click to expand...
A certain amount of experimentation is required, I'm afraid. If you're still heading low then maybe your bolus earlier was a little too high for what you ate. As @rebrascora says, if you want to eat a little more, then by all means bolus for that; Novorapid isn't extraordinarily fast acting, so if you fancy a snack midmorning or midafternoon, probably adding a little for that in the bolus for the meal before will work fine so you don't necessarily have to inject specially for whatever it is. (Works for me, anyway.)
 
Sometimes I get a low reading in the afternoon whilst at work so usually need something to get by till I finish, sorry for all the questions, still learning.
 
Are you carb counting or are you on fixed doses at the moment as that could make a significant difference to advice?

A low reading that just needs a little top up of carbs like 5 or 10g which would be 1 or 2 prunes. If however you were hungry and wanted something more substantial then you would just inject for it the same as any other meal. The low BG doesn't mean you need to eat something substantial. I can happily tootle along in the 4s and 5s all day and not feel hungry or need to eat, but if my levels are dropping and I want to head off a hypo then I will have a small carb snack like a Jelly Baby or two or a prune or two. Being hungry is very different to low BG although you may get hungry if you are hypo, being hypo is not really about hunger, it is about having too much insulin in your system and needing some carbs to utilize it. (soak it up if you like)
You are not restricted to just 3 meals a day either. There is no limit to the number of meals or snacks you can have in a day, but obviously if you eat too much you will put on weight. If you are eating more than 10g carbs, then you will usually need to inject for whatever you are having, unless it is to bring you up out of a hypo. ie you would not inject insulin for your hypo treatment because that defeats the object of eating something because there is too much insulin in your system.

If my BG levels were at 5mmol;s, then 10g carbs would take me up to about 8mmols which is a little higher than I would like to be without any insulin to bring me back down again, so I would inject for any snack 10g carbs or above. That is just me. If you were hungry and didn't want to inject, you could have a low carb snack like a boiled egg or a crustless quiche or some cheese or a few nuts or a chicken drumstick or two etc. Those things would not need any insulin.
 
Do you understand what I am saying about the difference between topping your BG levels up (particularly if you have your alarm set at 5mmols and goes off) with 5g carbs like a single prune/apricot ..... and being hungry and wanting a more substantial snack, in which case you would calculate and inject for it?
 
rebrascora said:
Do you understand what I am saying about the difference between topping your BG levels up (particularly if you have your alarm set at 5mmols and goes off) with 5g carbs like a single prune/apricot ..... and being hungry and wanting a more substantial snack, in which case you would calculate and inject for it?
Click to expand...
Yes thanks, got a telephone appointment booked tomorrow with the dietician, will be putting some of these questions to her. Thanks
 
Charl said:
Sometimes I get a low reading in the afternoon whilst at work so usually need something to get by till I finish, sorry for all the questions, still learning.
Click to expand...
Which suggests what you're injecting for lunch is a little high, that's all. You could reduce the ratio slightly (so you inject less or eat slightly more), or (if you prefer) you could include an afternoon snack (so have a banana or a biscuit with your afternoon coffee or something).
 
rebrascora said:
"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.
Click to expand...
Regarding your alarm setting of 4.2,
am I correct in thinking that if your woken by your alarm you would take either 1 or 2 JBs then back to sleep,
for me it lasts about 90mins then my alarm is sounding again, if my alarm goes off at 5 should I be treating it as if it's nearly a hypo , sorry for all the questions but since I've had this libre I'm getting more confused with the readings and what to do....not straightforward this diabetes lark.‍ Thanks
 
If my low alarm goes off during the night at 4.2, the first thing I consider is whether it might be a compression low and I assess that based on the graph and how I was lying when the alarm went off. ie if I woke up lying on that arm and if there is a sudden dip or if my levels have gradually sloped downwards throughout the night whilst I have slept. If I am happy it is a genuine low, then I will consider the time of night. If it is 1am and my levels have drifted low already and especially if I had been active the day before, then I might eat 2 JBs, if it is 3am then I will usually just have 1JB because my levels will naturally rise towards the morning. I also take into consideration how much evening basal I took. I use Levemir and some nights if I have done lots of exercise or physical work during the previous day then I don't take any evening dose, so my levels are more likely to rise towards morning than if I had a small dose of Levemir which might be continuing to drop my levels, so I might need 2 JBs even though it is 3 or 4am. If you take a long acting basal insulin like Tresiba opr Toujeo and your levels are dropping at 3am or 4am then you may well need 2 JBs.
I adjust my evening Levemir dose regularly because my night time basal needs change a lot depending on what I have been up to the last few days. Levemir is flexible, so you can make changes day after day but the longer acting basals like Tresiba and Toujeo cannot be adjusted to frequently and you need to find the basal dose that holds you steady overnight and then use your bolus insulin during the day to make up the difference and go to bed with levels higher if you have been active.
So you really need to take quite a lot into consideration when you wake up to a low alarm before you decide what action to take. I find it amazing that my half asleep brain can take into account all that info and make a decision, I eat one or 2 JBs and I can be back to sleep within seconds. If it drops again an hour or so later, I wake up again and deal with it again.

The key to good diabetes management is understanding how your basal insulin works, optimizing the dose to keep your levels as steady as possible in the absence of food (and bolus insulin) in normal conditions and then learning when it needs tweaking. If you use a very long acting basal then you need to optimize your basal dose for during the night and then tweak your meal time insulin to cover any shortfall.
 
Charl said:
if my alarm goes off at 5 should I be treating it as if it's nearly a hypo
Click to expand...
As many others have said, different people's bodies react differently to different things, and there's a lot you can only learn by experiment.

That said: 5 is nowhere near a hypo; and I would never set my low-glucose alarm that high for overnight.

You want your basal to be set at a level where your BG will be stable overnight. If your basal dose is right, coasting along at 5 all night, or even 4, would great!

Daytime is different, especially if you're moving about a lot; your muscles will be 'consuming' the glucose in your blood. If I'm 5 in the daytime, I would definitely have a little top-up before going for a walk-- or even, for example, before doing any serious housecleaning! But only a little top-up; like Barbara, I'd have something with about 5g carbs and check in 15 minutes.

If your BG is ok, you're feeling hungry, but you don't want the bother of injecting more insulin to cover a snack-- snack on something with no carbs or hardly any carbs. I get through a lot of cheese and almonds! (Most cheeses have 0 carbs, and 25g of almonds only has 1.2g carbs.)

Overall-- yes, working out how to use the Libre in the way that works best for you can be quite confusing! But you've only had it for 3 weeks now; you will eventually work it out, with some trial and error. All best wishes!
 
Charl said:
Glad I don't pay, only got 12 days out of this one.
Click to expand...
It doesn’t matter whether you pay or the NHS pay, the process if a sensor doesn’t last the full 14 days is identical. Report it online or call Abbot to get the sensor replaced. The NHS should not be paying extra for individuals replacing sensors that have issues, Abbot replace these.
 
@Charl you seem to be coping really well and asking some great questions.

You mention that your levels often drop during the day and also mention your low alarm going off at night.
Do you find that your levels drop in the absence of food such as overnight? The reason I am asking is because I wondering if your basal dose may be a little high? The purpose of basal is to keep your levels stable in the absence of food. If they rise, it suggests your basal is too low and if they fall, i suggests your basal is too high.

Do you have half unit insulin pens? I am not sure how I would have coped without them as it makes that little tweak so much easier. You know - when decreasing the dose by a whole unit causes levels to rise but I know I will go hypo on the current dose.
These are often only available as reusable insulin pens but I much prefer them - they are much more robust, the cartridges take up less space in my fridge than the pens and there is less waste.

Keep asking questions. It is great that you can talk to your nurse but if you think of something before your next appointment, the forum is here for you.
 
Status
Not open for further replies.
Back
Top