Libre 2 Range

[HalfpipMarathon]

I have on occasion woke up to a bg reading of 9 & over. I know that's high but it could be Dawn Phenomenon. I went to bed @7.6 last night, I was awake early so scanned and it was 9.3. I then scanned before breakfast @6.27am it was 9.2 still too high for my liking so drank some water and waited but it went up to 9.5 which I don't understand. I'll admit I probably should have waited longer than 8 minutes but surely it shouldn't have gone up albeit not very much. So should I ignore this reading going forward?

Although higher than I would like, according to the Libre 2 range of 3.9-10.0, it is in range. Is the aforementioned range a bit generous compared to the recommended 4-7 before meals and no more than 8.5 after meals on Diabetes UK website?
Why is 10 the upper range?

As I said I am not happy about being that high in the morning although I am aware it could be DP if type 2 diabetics suffer from this. My concern is that having a high end range could lull some into thinking they are okay because they are in the range despite saying having consistent readings of 8.5 or 9+

 

[everydayupsanddowns]

Why is 10 the upper range?

I think that is to do with the International consensus recommendations for Time in Range , which is mostly aimed at T1s on insulin I think.

Personally I have mine set 4-9 for just the reasons you suggest. But if I want to see how I‘m doing against the recommendations I will switch the range to 4-10

 

[Leadinglights]

I would speculate that the Libre primarily is aimed at people who are on insulin with the giuidance they give as the body is going to be responding in a different way than in people who are dietary managed with or without oral meds as they are relient on their own insulin production which is not going to be the same as injected insulin.
Just a theory.

 

[Bruce Stephens]

Although higher than I would like, according to the Libre 2 range of 3.9-10.0, it is in range. Is the aforementioned range a bit generous compared to the recommended 4-7 before meals and no more than 8.5 after meals on Diabetes UK website?

That's not terribly practical for those of us with Type 1. Certainly more doable if we all had closed loops (I could imagine many more of us being able to get over, say 70% with a range 4-8.5).

I think they had evidence on the effect of keeping in 4-10 on the risk of complications, and also on other useful measures (like HbA1c, risk of hypos). So using that as the range (unless you're pregnant) seemed like a meaningful, practical guideline.

And it's not really that different to 4-7 before meals: if you want to keep under 10 after meals then being under 7 before helps a lot.

 

[DaveB]

I think the 8.5 upper limit is tight for some of us. I was up to 20 last night despite two correction doses! I had to take an early Basal as well to try to get it down.

 

[trophywench]

Aaah, @DaveB - when we get above middle teens -ish - most of us find we need a somewhat greater correction ratio than usual. Can't tell you 'How much more' though - cos as per usual, it all depends ! Myself I'd try + 20%.

 

[rebrascora]

I have on occasion woke up to a bg reading of 9 & over. I know that's high but it could be Dawn Phenomenon. I went to bed @7.6 last night, I was awake early so scanned and it was 9.3. I then scanned before breakfast @6.27am it was 9.2 still too high for my liking so drank some water and waited but it went up to 9.5 which I don't understand. I'll admit I probably should have waited longer than 8 minutes but surely it shouldn't have gone up albeit not very much. So should I ignore this reading going forward?

On a morning before food, your liver is churning out glucose to give you energy for the day (Dawn Phenomenon/Foot on the Floor Syndrome). As a diabetic, your body is not producing enough insulin or able to use it efficiently to remove that glucose and store it for later or supply your muscles with energy, so the glucose levels in your blood rise. Eating something usually switches the liver off from this function but drinking water almost certainly won't so the reason your levels continued to rise a bit is because your liver is still dumping glucose into your system.
Not sure what if any medication you are on but one of the functions of Metformin is to reduce the amount of glucose that the liver releases. Usually on a low carb diet, the liver gradually stops producing so much glucose and if you follow the Newcsatle very low calorie (800 cals) diet this is designed to shed weight from your liver and pancreas which not only helps the liver not to produce so much glucose but also enables the pancreas to recognize that it needs to produce more insulin to deal with that glucose and so balance your levels. The liver and pancreas need to be able to communicate well to balance your BG and keep it in range but when there is a lot of visceral fat in and around these two organs, they are not able to communicate properly and BG levels usually go high. If the pancreas has been under a strain for a while, then some insulin production capability will be lost and it may not be able to balance normal amounts of glucose from carbohydrates, which is where a low carb diet can help.

As others have said, the 3.9-10 range for Libre is designed for people using insulin and even then we are ideally looking to keep our premeal readings below 7 to allow for the effect of food, raising those levels before the insulin we inject brings them down again. If you are starting the day above 7 regularly then I would suggest that your diabetes management strategy needs tweaking. That may be adjusting your diet and/or increasing your activity levels or perhaps discussing increased medication options. Basically the 4-7 range for pre meal readings holds true in that that is what is ideal as that allows for a modest spike after food to remain mostly under 10 still or to go briefly above and then back down again.

Personally I am not sure that your current use of Libre is helping you and you may be getting confused regarding what you need to be aiming for as a Type 2 diabetic on diet and/or oral meds. Libre can be useful for dietary controlled diabetics as a short term measure to adjust diet and see how exercise benefits them but you have to understand how to make the most of that information and what it tells you and be quite focused for that period of use, whereas you seem to be looking at just scanning mostly just the basic every 8 hours to collect the data but not understanding how to interpret it.

Yes, your waking readings are higher than they should be, but diet controlled Type 2 diabetics need to work on reducing their meal time rises and if they can reduce those meal time spikes by reducing their carb intake, then the fasting levels will gradually come down over weeks and months. Sadly drinking a glass of water is not going to do that for you unless you are already dehydrated. Losing fat from your liver and pancreas and/or putting less glucose into your system and perhaps enabling your body to manage the glucose better through exercise and if necessary, medication are the things you need to work on.

Would you like to post a photo of a typical day's Libre graph so that we can perhaps give you some pointers of where it looks like your body is struggling?

 

[HalfpipMarathon]

I would speculate that the Libre primarily is aimed at people who are on insulin with the giuidance they give as the body is going to be responding in a different way than in people who are dietary managed with or without oral meds as they are relient on their own insulin production which is not going to be the same as injected insulin.
Just a theory.

On a morning before food, your liver is churning out glucose to give you energy for the day (Dawn Phenomenon/Foot on the Floor Syndrome). As a diabetic, your body is not producing enough insulin or able to use it efficiently to remove that glucose and store it for later or supply your muscles with energy, so the glucose levels in your blood rise. Eating something usually switches the liver off from this function but drinking water almost certainly won't so the reason your levels continued to rise a bit is because your liver is still dumping glucose into your system.
Not sure what if any medication you are on but one of the functions of Metformin is to reduce the amount of glucose that the liver releases. Usually on a low carb diet, the liver gradually stops producing so much glucose and if you follow the Newcsatle very low calorie (800 cals) diet this is designed to shed weight from your liver and pancreas which not only helps the liver not to produce so much glucose but also enables the pancreas to recognize that it needs to produce more insulin to deal with that glucose and so balance your levels. The liver and pancreas need to be able to communicate well to balance your BG and keep it in range but when there is a lot of visceral fat in and around these two organs, they are not able to communicate properly and BG levels usually go high. If the pancreas has been under a strain for a while, then some insulin production capability will be lost and it may not be able to balance normal amounts of glucose from carbohydrates, which is where a low carb diet can help.

As others have said, the 3.9-10 range for Libre is designed for people using insulin and even then we are ideally looking to keep our premeal readings below 7 to allow for the effect of food, raising those levels before the insulin we inject brings them down again. If you are starting the day above 7 regularly then I would suggest that your diabetes management strategy needs tweaking. That may be adjusting your diet and/or increasing your activity levels or perhaps discussing increased medication options. Basically the 4-7 range for pre meal readings holds true in that that is what is ideal as that allows for a modest spike after food to remain mostly under 10 still or to go briefly above and then back down again.

Personally I am not sure that your current use of Libre is helping you and you may be getting confused regarding what you need to be aiming for as a Type 2 diabetic on diet and/or oral meds. Libre can be useful for dietary controlled diabetics as a short term measure to adjust diet and see how exercise benefits them but you have to understand how to make the most of that information and what it tells you and be quite focused for that period of use, whereas you seem to be looking at just scanning mostly just the basic every 8 hours to collect the data but not understanding how to interpret it.

Yes, your waking readings are higher than they should be, but diet controlled Type 2 diabetics need to work on reducing their meal time rises and if they can reduce those meal time spikes by reducing their carb intake, then the fasting levels will gradually come down over weeks and months. Sadly drinking a glass of water is not going to do that for you unless you are already dehydrated. Losing fat from your liver and pancreas and/or putting less glucose into your system and perhaps enabling your body to manage the glucose better through exercise and if necessary, medication are the things you need to work on.

Would you like to post a photo of a typical day's Libre graph so that we can perhaps give you some pointers of where it looks like your body is struggling?

Thank you for your reply.

Regards drinking water not helping bring my blood glucose level down I would disagree for example yesterday I had a double digit reading (10.3) @9.22pm , drank some water and then tested exactly 1hr later it had dropped to 7.7 (I woke up to 6.8 this morning) doesn't always work but nothing else I can do at that time of night.

I don't regularly wake up to readings of 8 or higher it depends on what my reading was before going to bed but having a lower reading before bed doesn't mean I will have a an okay reading in the morning.

Please find attached yesterday"s Libre graph. This is not typical though and might be influenced by the conflict within me as to whether I should remove the sensor before the 14 days are up or see it through and not bother with another one.

I have said in previous posts that I use the Time in Range feature as a guide to see how I am doing. By scanning and keeping an eye on TIR I can make dietary changes . Doing this I have reduced my HbA1c but I know I have a lot more to do.

My Dr said that if you don't scan how do you know what your blood sugars are doing. She said that If you scanned and got a reading of 15 say you wouldn't then go and eat a cake. My Dr is happy with my progress and is has no issues with me using the Libre in that she hasn't said I don't need it.