Hello
@Tom37,
I'm far from an expert in D management, so others may correct or adjust my observations.
Hi , Libre readings seem to be higher that finger prick by several units lately, glucose high in general
How much higher? I regularly have Libre sensors that give me 2 or even 3 mmol/L higher than actual - and under steady state, ie with a decent period of a horizontal arrow. My body doesn't seem to be in tune with Libre. This is a nuisance, in that I'm constantly having to mentally adjust and generates a misleading picture on LibreLink on my phone. But I work with it, because I use the trend (ie the arrows) to watch what is going on and no longer get obsessed with the numerical Libre reading.
Also, for me, when I'm in the 4s and 5s my Libre readings are closer to actual, perhaps only 1 mmol/L above. But when I'm above 10 the Libre differential is a lot greater. However, the broad guidance to all Libre users is test by FP whenever you are out of range (4-10), high or low; and your post sounds as though you are already doing that.
and libre estimating ac1 at 9.9%
the Libre estimate of your HbA1c has limited validity. Although it is (presumably) using every single reading the sensor is generating, each minute and extrapolating from that - the HbA1c from your blood test is looking at residual glucose in your blood, looking back over approximately 3 months. So, in my layman's mind, the HbA1c is reflecting how your body is actually managing glucose over a reasonable time span. Now, you can have a theoretical debate whether the HbA1c is more or less appropriate than an algorithm in a CGM taking an average over a certain period of time - but such debate is irrelevant in terms of the guidance we are given for our D management which is against the backdrop of HbA1c results and those are our benchmarks. So I view Libre averages as a possible guide but not the medical reference point.
any advice on reducing this number quickly
My advice would be not quickly, just steadily. Rapid changes can bring other difficulties. You are in a marathon and slow and steady is best.
or if I should consider this dangerously high?
I would not consider that dangerous, just a level that needs reducing.
Perhaps more relevant, is does being constantly a bit high affect how you physically feel? Other than the psychological response of thinking its bad! Some people, as well as recognising by their body's response that they are hypo - experience feeling 'off' in different ways when hyper, even at 9 or 10. I don't seem to have that recognition, until I get above 20; happily for me that is now rare - but it wasn't in my first 9 months!
Can you be showing signs of dka even with a relatively low keytone reading?
I simply don't know about this.
Struggling with controlling levels when out of usual daily work routine and putting off travel due to this!
Yes, I struggled with 'control' pretty much for 12 months. BUT, control is the wrong word. I think any longstanding T1 will not claim to have their D under control, but rather managed acceptably. This might sound like semantics, however there are so many factors that can affect your BG it is my understanding that all of us unexpectedly have something periodically come along and play havoc with one's BG. Then it's a matter of seeing if one can identify why (so try to prevent a recurrence) and responding regardless of why.
I only deferred travel in my first 12 months, because the deep hypos were a significant obstruction; also, as bad fortune would have it, I had significant gastro and urology problems after my surgery which affected my confidence about being away from home - a couple of times with good reason! But if high I went out walking, a lot, or in my car if I had something to do. The hypos hindered me, but not the hypers.
What is it that's making you put off travel - unless you are 'roller-coasting' between high and low? I experienced that a lot, until I had Libre, after 12 months, and then used the trend arrows to anticipate 'what next'.
What insulin are you using? Multiple daily injections (MDI) of basal and bolus, or just fixed doses of a mixed insulin?
Are you carb counting?
Have you done a DAFNE course or had any structured training in D management?
Have you been told, or read about the limitations of Libre?
Sorry for the list of questions but a little more info will allow response to be more directed to your difficulties.
