Libre reading's difference

[Charl]

Finger prick test says 14.8 libre says 19.6 , it's been active just over 48hrs, I know 14.8 is high, hoping to bring that down after a brisk walk, will be going out for the day and night soon to watch football couple of drinks etc, usually set my alarm for 5.0 any suggestions as to what I should be now setting it to. Thanks

 

[Inka]

That’s a pretty normal difference for a high reading @Charl I always found my Libre was a similar amount out when I was high. Can you do a correction?

I always set my Libre Low alarm to 5.6 so that I had the best chance of catching lows before they happened. Depending on what you drink, you might need a few top-up carbs to offset the alcohol, eg crisps.

 

[rayray119]

you could aslo get that difference from 2 differert meters as there have an allowance of being withen 15% so if you could blood glugose was actually 17 your meter could show between 14.5 to 19.5

 

[everydayupsanddowns]

Hope it came down smoothly for you @Charl

How was the footie?

 

[Charl]

Football was ok ,as for the sensor, Readings were all over but decided to give it more time. Yesterday I was getting the old scan in ten minutes message's and then signal losses and yet more finger pricks, eventually at about 1.00am I silenced all alarms and removed the sensor this morning, once again will be contacting abbot regarding a replacement.

 

[helli]

I pay little attention to the readings from a Libre when over 10. It is just high.
As mentioned in the thread about CGM limitations, they are designed to be most accurate at "normal" levels and are known to be inaccurate when high (or low) regardless of the 15% accuracy of meters.

Take care doing exercise when that high - unless your body is used to those levels, it will put stress on your body which can raise your levels higher. I was advised it is better to use insulin to reduce your levels when they are above 10.

 

[SimonP]

This is taking things off topic, however.....I read quite a few posts saying to be careful about exercising when high.

Take care doing exercise when that high - unless your body is used to those levels, it will put stress on your body which can raise your levels higher. I was advised it is better to use insulin to reduce your levels when they are above 10.

As far as I understand the only issue with exercise while high is that it may increase your BG (any exercise may increase BG, depending on the intensity of the exercise) and if you're high you may also have ketones (which are not caused by being high, but are a side effect of too little insulin, which also makes you go high), you may therefore generate more ketones and potentially suffer from ketoacidosis.

I do feel this is perhaps blown out of all proportion though.

I have no qualms about exercising when high, though I tend to ensure I have at least a little bit of insulin on board if I'm properly high or heading upwards (like 15mmol/l+). A steady 10 mmol/l + exercise will probably drop me through the floor so no insulin required. I would certainly be more than happy to exercise with a blood glucose of >15mmol/l, though I would be wondering why I'm high, and would probably have some IoB (having mistimed my insulin) or be poorly. The former is troublesome as you risk going low very quickly as the insulin becomes very effective with exercise, the latter probably means I don't feel like exercise anyway.

In the "Exercise management in type 1 diabetes: a consensus statement" published in the Lancet (https://pubmed.ncbi.nlm.nih.gov/28126459/ or doi: 10.1016/S2213-8587(17)30014-1) they say that levels between 10.1 and 15mmol/l are fine, though that blood glucose may rise; for levels above 15 mmol/l they say that ketones should be monitored if the high blood sugar is not due to recent food. If ketones are normal then they say to continue to monitor; if ketones are slight elevated, only do short duration low intensity exercise; if ketones are high treat with insulin and don't exercise.

Here is the actual text:

Blood glucose concentrations before exercise commencement and recommended glucose management strategies
The carbohydrate intakes shown here aim to stabilise glycaemia at the start of exercise. Blood glucose at the start of exercise must also be viewed within a wider context. Factors to consider include directional trends in glucose and insulin concentrations, patient safety, and individual patient preferences based on experience. Carbohydrate intake will need to be higher if circulating insulin concentrations are high at the onset of exercise.
Starting glycaemia below target (<5 mmol/L; <90 mg/dL)

• •
  Ingest 10–20 g of glucose before starting exercise.
• •
  Delay exercise until blood glucose is more than 5 mmol/L (>90 mg/dL) and monitor closely for hypoglycaemia.

Starting glycaemia near target (5–6·9 mmol/L; 90–124 mg/dL)

• •
  Ingest 10 g of glucose before starting aerobic exercise.
• •
  Anaerobic exercise and high intensity interval training sessions can be started.

Starting glycaemia at target levels (7–10 mmol/L; 126–180 mg/dL)

• •
  Aerobic exercise can be started.
• •
  Anaerobic exercise and high intensity interval training sessions can be started, but glucose concentrations could rise.

Starting glycaemia slightly above target (10·1–15·0 mmol/L; 182–270 mg/dL)

• •
  Aerobic exercise can be started.
• •
  Anaerobic exercise can be started, but glucose concentrations could rise.

Starting glycaemia above target (>15 mmol/L; >270 mg/dL)

• •
  If the hyperglycaemia is unexplained (not associated with a recent meal), check blood ketones. If blood ketones are modestly elevated (up to 1·4 mmol/L), exercise should be restricted to a light intensity for only a brief duration (0 min) and a small corrective insulin dose might be needed before starting exercise. If blood ketones are elevated (≥1·5 mmol/L), exercise is contraindicated and glucose management should be initiated rapidly as per the advice of the health-care professional team.
• •
  Mild to moderate aerobic exercise can be started if blood ketones are low (<0·6 mmol/L) or the urine ketone dipstick is less than 2+ (or <4·0 mmol/L). Blood glucose concentrations should be monitored during exercise to help detect whether glucose concentrations increase further. Intense exercise should be initiated only with caution as it could promote further hyperglycaemia.

 

[rayray119]

This is taking things off topic, however.....I read quite a few posts saying to be careful about exercising when high.

As far as I understand the only issue with exercise while high is that it may increase your BG (any exercise may increase BG, depending on the intensity of the exercise) and if you're high you may also have ketones (which are not caused by being high, but are a side effect of too little insulin, which also makes you go high), you may therefore generate more ketones and potentially suffer from ketoacidosis.

I do feel this is perhaps blown out of all proportion though.

I have no qualms about exercising when high, though I tend to ensure I have at least a little bit of insulin on board if I'm properly high or heading upwards (like 15mmol/l+). A steady 10 mmol/l + exercise will probably drop me through the floor so no insulin required. I would certainly be more than happy to exercise with a blood glucose of >15mmol/l, though I would be wondering why I'm high, and would probably have some IoB (having mistimed my insulin) or be poorly. The former is troublesome as you risk going low very quickly as the insulin becomes very effective with exercise, the latter probably means I don't feel like exercise anyway.

In the "Exercise management in type 1 diabetes: a consensus statement" published in the Lancet (https://pubmed.ncbi.nlm.nih.gov/28126459/ or doi: 10.1016/S2213-8587(17)30014-1) they say that levels between 10.1 and 15mmol/l are fine, though that blood glucose may rise; for levels above 15 mmol/l they say that ketones should be monitored if the high blood sugar is not due to recent food. If ketones are normal then they say to continue to monitor; if ketones are slight elevated, only do short duration low intensity exercise; if ketones are high treat with insulin and don't exercise.

Here is the actual text:

Blood glucose concentrations before exercise commencement and recommended glucose management strategies
The carbohydrate intakes shown here aim to stabilise glycaemia at the start of exercise. Blood glucose at the start of exercise must also be viewed within a wider context. Factors to consider include directional trends in glucose and insulin concentrations, patient safety, and individual patient preferences based on experience. Carbohydrate intake will need to be higher if circulating insulin concentrations are high at the onset of exercise.
Starting glycaemia below target (<5 mmol/L; <90 mg/dL)

• •
  Ingest 10–20 g of glucose before starting exercise.
• •
  Delay exercise until blood glucose is more than 5 mmol/L (>90 mg/dL) and monitor closely for hypoglycaemia.

Starting glycaemia near target (5–6·9 mmol/L; 90–124 mg/dL)

• •
  Ingest 10 g of glucose before starting aerobic exercise.
• •
  Anaerobic exercise and high intensity interval training sessions can be started.

Starting glycaemia at target levels (7–10 mmol/L; 126–180 mg/dL)

• •
  Aerobic exercise can be started.
• •
  Anaerobic exercise and high intensity interval training sessions can be started, but glucose concentrations could rise.

Starting glycaemia slightly above target (10·1–15·0 mmol/L; 182–270 mg/dL)

• •
  Aerobic exercise can be started.
• •
  Anaerobic exercise can be started, but glucose concentrations could rise.

Starting glycaemia above target (>15 mmol/L; >270 mg/dL)

• •
  If the hyperglycaemia is unexplained (not associated with a recent meal), check blood ketones. If blood ketones are modestly elevated (up to 1·4 mmol/L), exercise should be restricted to a light intensity for only a brief duration (0 min) and a small corrective insulin dose might be needed before starting exercise. If blood ketones are elevated (≥1·5 mmol/L), exercise is contraindicated and glucose management should be initiated rapidly as per the advice of the health-care professional team.
• •
  Mild to moderate aerobic exercise can be started if blood ketones are low (<0·6 mmol/L) or the urine ketone dipstick is less than 2+ (or <4·0 mmol/L). Blood glucose concentrations should be monitored during exercise to help detect whether glucose concentrations increase further. Intense exercise should be initiated only with caution as it could promote further hyperglycaemia.

Maybe it would be worth starting another thread on that topic? 🙂

 

[SimonP]

Maybe it would be worth starting another thread on that topic? 🙂

Possibly, it was just that @helli happened to mention it so I felt I should say something. More than happy for the post to be (re)moved from the thread by a moderator.

 

[rayray119]

Possibly, it was just that @helli happened to mention it so I felt I should say something. More than happy for the post to be (re)moved from the thread by a moderator.

Sorry if it sounded like I was citizeing. I wasn't. 🙂.with regards to your post when I was n the DAFNE course it was advised not excise above 15 although I can't say I've always followed that.

 

[SimonP]

Sorry if it sounded like I was citizeing. I wasn't. 🙂.with regards to your post why I was n the DAFNE course it was advised not excise above 15 although I can't say I've always followed that.

No don't worry I think it is a reasonable suggestion.

I am interested to hear that DAFNE courses are telling people not to exercise at those blood sugar levels though, perhaps it would be worth popping it in its own thread to discuss further.

 

[SB2015]

This is taking things off topic, however.....I read quite a few posts saying to be careful about exercising when high.

As far as I understand the only issue with exercise while high is that it may increase your BG (any exercise may increase BG, depending on the intensity of the exercise) and if you're high you may also have ketones (which are not caused by being high, but are a side effect of too little insulin, which also makes you go high), you may therefore generate more ketones and potentially suffer from ketoacidosis.

I do feel this is perhaps blown out of all proportion though.

I have no qualms about exercising when high, though I tend to ensure I have at least a little bit of insulin on board if I'm properly high or heading upwards (like 15mmol/l+). A steady 10 mmol/l + exercise will probably drop me through the floor so no insulin required. I would certainly be more than happy to exercise with a blood glucose of >15mmol/l, though I would be wondering why I'm high, and would probably have some IoB (having mistimed my insulin) or be poorly. The former is troublesome as you risk going low very quickly as the insulin becomes very effective with exercise, the latter probably means I don't feel like exercise anyway.

In the "Exercise management in type 1 diabetes: a consensus statement" published in the Lancet (https://pubmed.ncbi.nlm.nih.gov/28126459/ or doi: 10.1016/S2213-8587(17)30014-1) they say that levels between 10.1 and 15mmol/l are fine, though that blood glucose may rise; for levels above 15 mmol/l they say that ketones should be monitored if the high blood sugar is not due to recent food. If ketones are normal then they say to continue to monitor; if ketones are slight elevated, only do short duration low intensity exercise; if ketones are high treat with insulin and don't exercise.

Here is the actual text:

Blood glucose concentrations before exercise commencement and recommended glucose management strategies
The carbohydrate intakes shown here aim to stabilise glycaemia at the start of exercise. Blood glucose at the start of exercise must also be viewed within a wider context. Factors to consider include directional trends in glucose and insulin concentrations, patient safety, and individual patient preferences based on experience. Carbohydrate intake will need to be higher if circulating insulin concentrations are high at the onset of exercise.
Starting glycaemia below target (<5 mmol/L; <90 mg/dL)

• •
  Ingest 10–20 g of glucose before starting exercise.
• •
  Delay exercise until blood glucose is more than 5 mmol/L (>90 mg/dL) and monitor closely for hypoglycaemia.

Starting glycaemia near target (5–6·9 mmol/L; 90–124 mg/dL)

• •
  Ingest 10 g of glucose before starting aerobic exercise.
• •
  Anaerobic exercise and high intensity interval training sessions can be started.

Starting glycaemia at target levels (7–10 mmol/L; 126–180 mg/dL)

• •
  Aerobic exercise can be started.
• •
  Anaerobic exercise and high intensity interval training sessions can be started, but glucose concentrations could rise.

Starting glycaemia slightly above target (10·1–15·0 mmol/L; 182–270 mg/dL)

• •
  Aerobic exercise can be started.
• •
  Anaerobic exercise can be started, but glucose concentrations could rise.

Starting glycaemia above target (>15 mmol/L; >270 mg/dL)

• •
  If the hyperglycaemia is unexplained (not associated with a recent meal), check blood ketones. If blood ketones are modestly elevated (up to 1·4 mmol/L), exercise should be restricted to a light intensity for only a brief duration (0 min) and a small corrective insulin dose might be needed before starting exercise. If blood ketones are elevated (≥1·5 mmol/L), exercise is contraindicated and glucose management should be initiated rapidly as per the advice of the health-care professional team.
• •
  Mild to moderate aerobic exercise can be started if blood ketones are low (<0·6 mmol/L) or the urine ketone dipstick is less than 2+ (or <4·0 mmol/L). Blood glucose concentrations should be monitored during exercise to help detect whether glucose concentrations increase further. Intense exercise should be initiated only with caution as it could promote further hyperglycaemia.

Hi Simon

I think this info will be missed by some and would be well worth putting in a new thread. A very useful reminder of checks before doing different types of exercise.

 

[SimonP]

Done: https://forum.diabetes.org.uk/board...a-consensus-statement-from-the-lancet.108996/

If a mod wants to clear out all of the messages from here please feel free to do so. Thanks!