My Libre2 is always at least 3 up to 6 mmol/L lower than finger prick

[Jasmin2000]

Do these hypos show up on your graph afterwards or does te graph not dip into the red. This is typical of the algorithm over extrapolating the downward trend and then changing the graph line wen it gets more data and realises levels have gone back up. If you can prevent the rapid drops then you should see much less of this. The way to do this would probabl;y be to work on your prebolus timing so that the insulin and carbs are arriving in the blood stream at about the same time rather than the carbs releasing glucose into the blood stream and sending your levels high and then the insulin kicking in and dropping you fast. If you can get the timing better, you don't go up as high or come down as fast.

Just as an example.... I used to prebolus the usual 20 mins with NovoRapid for breakfast when I was first diagnosed. If I was starting in range, my levels would shoot up to 15 every morning and then come hurtling back down to about 5 a couple of hours later. It didn't feel very p[leasant and it wasn't doing me any good. I was finger pricking at the time as I didn't have Libre but I did lots of testing and established that I needed 75 mins prebolus time at breakfast with NR to get a relatively small hillock instead of a church spire in BG levels. As a result I changed to Fiasp which is a bit quicker but I still needed 45 mins most morning prebolus time before eating my breakfast (usually yoghurt and berries and seeds) Other times of the day I need less and these lengthy timings for breakfast are extreme and most people would hypo in that time, so you have to start with the timing you currently use and increase it by a few mins each day until you find the balance point for you. Once you can stop the peaks, you can slow down the drops and it becomes more stable. It also helps me that I follow a low carb way of eating so the few carbs I eat don't spike me too high and the glucose release from the protein slows down any drop, essentially buffering my levels as protein releases over about 6 hours, rather than the usual approx. 90 mins carbs release glucose.

Dexcom One IS available on the NHS and a direct alternative to Libre 2 so speak to your DSN if you decide to try something else, but I understand that the hardware and software set up will make you reluctant to do so and your body might not be any more compatible with Dexcom although usually people find one or the other works better for them.

The Libre hypos are in the red and are fixed on the sensor graph and aren't "corrected" by the algorithm - I've had those too. The Libre hypo goes on for half an hour and finger pricks only dip to 4.5 during that time and are mostly back up to 6.

It's not so much a prebolus issue as an exercise issue. The drop in BG vs. carb timing is essential and the post-exercise muscle replenishment is to blame. It took a while to get finger pricks to 5-6 before during and after the exercise and it's still tricky, but Libre is not having it and says there's a parallel universe where you're at 3

I'll have a word with my GP about Dexcom - thanks for that.

 

[helli]

yea its a possibility however the NHS do not do Dexcom or any of the others, libre3's just about maybe i think.

This is not the case in England where Dexcom One is available under the same guidelines as Libre 2.
Dexcom 6 and 7 and Libre 3 require different hoops to be jumped through but are available on the NHS if you satisfy the NICE criteria.
It is a good idea from @rebrascora to try the Dexcom One if you are finding the Libre 2 does not suit you. You need to discuss this with your DSN.

 

[jackdinn]

its going down fast now, arrow was pointing straight down, was at 7.4 but going down very fast.
I'v had to take some Lift glucose just to try and stop it as i know where it heading. but on the other hand the Caresens says don't worry.
Anyhow it might shoot up in a min (or 20) and i said i would get a shot when it was a better value. This is prob the best im going to get today, i really don't know. This is my life ^^

 

[rebrascora]

its going down fast now, arrow was pointing straight down, was at 7.4 but going down very fast.
I'v had to take some Lift glucose just to try and stop it as i know where it heading. but on the other hand the Caresens says don't worry.
Anyhow it might shoot up in a min (or 20) and i said i would get a shot when it was a better value. This is prob the best im going to get today, i really don't know. This is my life ^^
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To me you are perhaps being too reactive to your Libre, especially when you know it reads low compared to a finger prick. A downward sloping or even vertically downward arrow at 7.7 is nothing to be concerned about assuming there is active bolus insulin in your system. When did you inject and eat before these readings?

Your graph for today shows you almost totally above range so far, so it looks like you are not at any great risk of hypo at this stage unless your meal time ratio is badly wrong or you have overcorrected. or you have been doing some exercise with active bolus insulin on board, so knowing when you injected fast acting insulin prior to these readings is important and what you ate and whether you exercised and what that exercise was all need to be taken into consideration before you think about having glucose at this stage.

I can be 4.5 with a vertical downward arrow and a couple of well chewed Jelly Babies (glucose absorbs quickest through the cells in the mouth and they are closer to the brain than the stomach, so chewing well will work quicker than a couple of chews and swallowing) will bring me back up. Libre will continue to show my levels dropping well into the red before it catches on that levels are actually rising again but once it catches on, usually half an hour later, it will often show the graph as not even dipping into the red at all or sometimes only very slightly for a very brief, very minor hypo.... and bearing in mind that Libre only reads 1mmols lower than my Caresens, I think you are probably overreacting to a 7.7 with a slanting downward arrow, especially when it has changed from a vertical downward arrow, which tells you that the drop in BG is slowing down.

 

[jackdinn]

To me you are perhaps being too reactive to your Libre

Of course you are correct, i tell myself the same all the time but when i just had food and insulin and it starts going down like that iv only had bad experiences of the libre going as low as 2.2 very quickly, happened just a couple of days ago. I am terrified of getting really ill and being unable to do anything about it, that would be that. so i do watch it all day, every waking moment and make 100% sure that does not happen. Now it looks more and more like most of the time the libre are not even anywhere near correct so its all been academic.

Quite frankly i don't have a clue what I'm doing anyhow, they just said here's your insulin's, take them x times a day etc and good luck. Iv never even seen a dietitian or a specialist or anyone apart from a blood draw now and again. All i know is to keep me from another 2 week hospital experience or worse I have to keep the BG in the green, that's about the extent of my knowledge. They will see the libre logs that are auto sent to them and think im ok but that's looking like a complete lie.

 

[rebrascora]

I have learned more from this forum than from any other source including my consultant, who I have a 10 mins phone appointment once every 9-12 months. They don't monitor your Libre results and only look at them during an appointment or if you contact them because you are having difficulties. They still do an HbA1c blood test so if that doesn't tally with your Libre results then they should be able to see that, especially if you tell them Libre is reading much lower than your Caresens meter. In reality you should be reporting these sensors to Abbott and getting replacements but as I have said, you body chemistry is likely not suited to the Libre algorithm so replacement sensors would likely be just the same.
Either....
You test each new sensor in the first couple of days when your levels are nice and stable and in range to see how much below your finger prick reading each particular sensor is and factor that into your in range readings, so if it is 3mmols out then a 7 is likely a 10 and a 4 is likely a 7, but any readings which are above or below range and require action, should be double checked with a finger prick before treating or calculating a correction, unless you feel obviously hypo, in which case you treat and check afterwards....
Or...
You ask to try a Dexcom One to see if you can get better compatibility with your BG meter and
therefore gain more confidence in the device and the readings it gives you.

I know that your DKA will have been traumatic and you will want to avoid that again at all costs but now that you are taking insulin regularly that is extremely unlikely, unless you become ill.
Yes, hypos can be scary and particularly if you live on your own, but they are manageable and unless you have injected significantly more insulin than you should, they are generally relatively easily fixed with 2-3 jelly babies or 4-5 Lift/glucose tablets or a small carton of fruit juice. The important thing is that you test with a finger prick before you treat (unless you feel obviously hypo) and if below 4 you have 15g fast acting carbs and then test again with a finger prick in 15 mins. Do not rely on Libre in this situation or even look at it because it will show you dropping lower when you are almost certainly not and seeing those numbers dropping will make you panic. If 15 mins later, your finger prick indicates that your levels have still not come up abaove 4, then you have another 15g of fast acting carbs and wait another 15 mins. Those carbs are acting to stop the drop and bring you up, so try to relax and wait and perhaps phone a friend or relative if you are on your own and let them know what the situation is and where you are and that you are dealing with it, at least until you get confident of dealing with them. I used to phone my sister even though she was 30 miles away and she would keep me talking until I tested 15 mins later and levels were back up. Sometimes you feel worse after they come back up because the adrenaline rush kicks in and makes you feel sick and sweaty, but as long as your meter says you are back up above 4, trust it, not Libre.

In some respects I do wonder if starting on Libre right from diagnosis makes people a little too reliant on it. I keep thinking about my uncle who had Type 1 most of his adult life and never even had a BG meter until he was in his 70s. He was found a few times unconscious either with a hypo or DKA and needed a trip to hospital, but he still lived well into his 80s and was still going out and cycling alone at 80, so he was still in pretty impressive health at that age despite those occasional bad hypos and DKAs.
We have so much technology to keep us safe now but I wonder sometimes if it makes us more anxious. I managed fine before Libre and whilst I hypoed quite regularly, sometimes as often as once a day, I managed to treat them myself. Then I got Libre, although it didn't have alarms originally and I had to self fund it at first. Sometimes I would get frustrated with it "spying on me" and I would take a break from it but that first night without it, I would feel horribly vulnerable... far more so that I did before I got Libre, so I do think it can make us more heavily reliant on it than we need to be or is perhaps good for us. I really resented that going without it made me feel vulnerable and made me more determined to stick it out until I had at least overcome the vulnerability before I went back to using it again, because it is almost like we become a slave to it and that is not healthy and I kind of see your situation as akin to that. You have it, so you are constantly monitoring it and making decisions and taking action when you often don't need to and it is feeding your anxiety instead of allaying it.

 

[jackdinn]

Nicely written, Quit frankly i wouldn't even know where to start without a minute interval CGM, that's how bad i am. I've never ever had a hypo after 2 years as T1, I make god darn sure of that, so that's got a hold on me psychologically, but i also do know its a real danger its not all in the mind.

Well the glucose chew i had when i started plummeting had the effect i was hoping for, it arrested the rapid fall and now it floating along at about 8.8 which i normally would be happy with but now i don't even want to know what the caresens says because it's not like i can start using it, i never have used it except on occasion. I had to put new batteries and adjust the time it was so long since i last used it. When i think of the number of times iv had the libre in the red and then think how would I even have known without it just makes me shudder.

Anyhow, thx for all the support people, I just wanted to know why all my tags were always so far off and if i was doing something wrong or were misunderstanding. Does not look like it. Finger prick is saying 13.2 ATM and Libre 8.6

I might go through tag's one after another until one is close, then contact Abbott and get them all replaced, but i would forever be in contact with them and thats not a lot of fun either, and im sure they would soon have a problem with that.

Ok, thx again. 🙂

 

[trophywench]

Jack - it's my belief from what you've told us that because your Caresens meter was out of us for so very long it needed new batteries - that it may well NOT be accurate any more. An easy way of checking is to nip into whatever pharmacists shop you use and ask them if they can check your blood glucose - many of them do this with no prob as long as they're not rushed off their feet so they take you into a side room, sit you down and will do it, so have your own meter ready and use an extra drop of the same fingerprick - and then compare the results from their meter and yours.

 

[jackdinn]

Jack - it's my belief from what you've told us that because your Caresens meter was out of us for so very long it needed new batteries - that it may well NOT be accurate any more. An easy way of checking is to nip into whatever pharmacists shop you use and ask them if they can check your blood glucose - many of them do this with no prob as long as they're not rushed off their feet so they take you into a side room, sit you down and will do it, so have your own meter ready and use an extra drop of the same fingerprick - and then compare the results from their meter and yours.

HI, thx, Yea a good idea, i was also looking at the control solutions for the Caresens to test it with. I could just buy another GM, would be here tomorrow (o well maybe not its late and Saturday ^^) but yea. A good few option open to me.

 

[rebrascora]

Can I just say that they are sensors not "tags"..... You make us sound like we are criminals wearing tags!

As regards hypos, my first few were pretty scary but after that, once I got confident dealing with them I am mostly fine and can just pop a jelly baby or two in my mouth and keep mucking out my stables or whatever. I used to worry a lot about nocturnal hypos (before I got Libre) and "What if I didn't wake up??" Then one week about 9 months after diagnosis I hypoed nearly every night, despite reducing my Levemir until the last couple of nights I was having no evening basal and still hypoing. I had started to get back into exercise and it turns out my overnight levels are very susceptible to exercise that I have done during the day. That week of nocturnal hypos and many since then, have also given me confidence that my body will wake me up and I can deal with them and now, I wake up, eat a jelly baby or two and can be back to sleep within a couple of minutes. I don't panic or feel ill, I just deal with it and straight back to sleep. Yes they are dangerous if you don't treat them properly but being terrified of them and spending every waking moment watching your Libre is not healthy for your mental health and will be impacting on your quality of life. If my uncle can live to 88 without even a BG meter to check his levels once or twice a day and not have the modern insulins we have now, then surely we can manage to survive and thrive without knowing what our levels are every 5 mins.

 

[jackdinn]

every 5 mins.

Every 1 minute, get it right 😛 (30 secs if i had my way).

Tags , hmm iv always referred to any device that is attached to usually a person but could be an animal, that measures, monitors, tracks, transmits etc. and its got half the letters ! Ha

I was wondering about what symptoms hypo's have to begin with, iv shown other diabetics my libreview stats and they said iv definitely had many, but they said well if you never felt them or even knew then you might be one of the few that don't get symptoms (had a name, cant remember) but now i suspect thats not the case at all.

Yea, i say to myself there are kids who live all their lives with this. I try to reduce its magnitude but in the end it's not going to make any difference. I already suffered from very bad physiological health so this is just perfect.

I'm an engineer by trade and I'm used to being able to logically and rationally pin things down but this i just cant get my head around. The exact same meal with the exact same novarapid will balance for weeks and then one day it just goes crazy and i end up reducing all pre-meal insulin by more than a half or else it just crashes directly after the usual food & insulin. It can last like that for a week or more, slowly requiring more and more until its kinda back to where it was before. This is another reason why i have become so weary of it.

 

[helli]

I'm an engineer by trade and I'm used to being able to logically and rationally pin things down but this i just cant get my head around. The exact same meal with the exact same novarapid will balance for weeks and then one day it just goes crazy and i end up reducing all pre-meal insulin by more than a half or else it just crashes directly after the usual food & insulin. It can last like that for a week or more, slowly requiring more and more until its kinda back to where it was before. This is another reason why i have become so weary of it.

I too am an engineer and appreciate that it took time to get my head around what appeared to be inconsistencies. However, once I realised my BG is affected by far more than just what I eat and how much insulin I take. As I referenced earlier, there are 42 different things which can affect our BG including alcohol, exercise, illness, medication, weather, time of day and more. I no longer expect the same BG reaction to the same food.
Expecting the same thing all the time, expecting Libre to be accurate all the time, expecting to never experience a hypo will all make you weary. And checking your BG 100 times a day will lead to diabetes burnout.
Have you asked for mental health support? It may help.

 

[jackdinn]

I realised my BG is affected by far more than just what I eat and how much insulin I take

Indeed, i realize that there will be many many variables, i of course pondered what was going on, what could have changed. It was odd though, because it lasted for over a week and i cant see anything that would do that and its happened a few times now as well.
Problem is i would have to spend some real mental processing effort to get some kind of grip on this and iv got a terrible personality trait whereby i find it nearly impossible to study or learn anything that i am not completely fascinated by, and this looks like a complex one too.

Have you asked for mental health support? It may help.

I already do, but thx for asking 🙂

 

[gillrogers]

I have a Caresens and Libre always reads lower than it but generally no more than 1-2 mmols. If it is more than 2 mmols then I woud report it to Abbott customer services and they will usually replace it. Being out by more than 3 is absolutely unacceptable. However I make a point of doing my double checks when my levels have been stable and mid range for at least half an hour and very rarely is Libre more than 1mmol lower. I do wonder if Caresens test strips read high as I bought some Freestyle Optium test strips to use in my Libre reader and they always read very slightly lower by one or two tenth of a mmol, than the Libre sensor, which was quite a surprise. I still go by my Caresens as that is my "official" BG meter and my hypo awareness is pretty well tuned into it and I feel hypos between 4.3 and 3.8 (finger prick). If it is wrong and Libre is right then I am sometimes not feeling hypos until 2.8 which I very much doubt.

Anyway, my main reason for commenting on your thread was that some people find that Libre doesn't suit their body chemistry and Dexcom aligns better for them, so if this is a consistent problem then ask to try a Dexcom One instead. As far as I a concerned, Libre works brilliantly for me and 1mmol out is not a problem, but if it is consistently 3 or more out for you then you really need to try something else.

, interesting Barbera, I’m using a caresens too and find it’s higher than the libre by about the same so reckon you’re right that it’s a Caresens thing but they do read blood where as the sensor reads the intersatial fluid so it will be different anyways to some degree.

 

[PhoebeC]

@jackdinn as @rebrascora said I have had more support and advice from this forum than any other source. However I would say from my personal experience if you can get yourself access to a good diabetic support nurse and their team then you will have more support, and they can be useful.

Are you under a hospital team?
When we moved here I asked my gp if I could be under the hospital, nurse at the surgery gave me the wrong very incorrect advice that would have made me very ill, so with them it depends who you speak to what knowledge they have of diabetes but my hospital team is great. That gave me access to a dietitian too who was supportive but didn’t really tell me anything I didn’t already know.

As an example when I had my recent op the pre op team kept telling me different things about my libre and pump, I asked you lot and you gave me answer I thought was right, and a few options and I ran this past my DSN and she agreed. And then doing what I thought was best actually was the best thing on the day and I was in control and confidently told the surgeon, anaesthetist and the nurses what I would be doing with my devices and how they could take action if needed.

You are not on your own and support is out there even if it’s just us, we are pretty useful!