Query about monitoring sugar...

[Dave Harbud]

I use the Libre 2 to monitor my blood sugar and pay for HBA1C tests to supplement my annual NHS ones (my GP appears sceptical on non-NHS tests).
Since my diagnosis as T2, I have lost 50lb (5:2 diet) and my HBA1C is currently 39. My GP reckons that if I can control my blood glucose then I should be able to come off the metformin. I interpret 4 to 9 as acceptable range.
I adjusted my diet to cut down on carbs. Notably white bread seems to produce spikes (highest was 14). A single slice of rye bread seems fine. Eggs, meat, greens seem to have little effect on me.
When I cut my metformin down to zero (from 4), I was getting more spikes in the 10 to 12 range, I have moved back to 2 tablets at day.
My question is what is the best course
a) lose more weight (current BMI 26.7)?
b) keep taking the metformin?
c) find more interesting ways to live on eggs and green salad?
d) make sure I go for a walk after each meal?
Also, if my HBA1C and blood glucose are in range, then am I ok or should I be trying to reduce both further (without hypos, of course)?

 

[harbottle]

All of the above?

If stopping Metformin causes BG to rise, it may be a good idea to keep taking it. A full dose can make a fairly moderate change to fasting and post-meal glucose.

Green salad can be made nice with a dressing made from olive oil, red wine vinegar, mustard, salt and pepper...
Or a dressing made from yoghurt and red wine vinegar and lemon juice.
Or turned into a spicy omelette.

I go for a lunchtime walk around 40 minutes after eating.

Be warned: when I used libre sensors I found they were way out. I'd see readings of 11 after eating oats and when did a finger prick test it would be in the 7s. Sometimes the high readings would vanish from the graph once it had worked out that the rise wasn't as high as it predicted.

Well done on the weight loss and the hba1c reduction!

 

[Landrover Jason]

I've used Libra 2 for about 2 years, I find that sometimes it does give different readings from a finger prick test even allowing for the delay with CGM systems.
The way to look at CGM is trend and pattern its really useful for capturing trends over time. The estimated HbA1c is never that far off so you get a good direction of travel.

Keep going with the weight loss and activity, looks like you've done really well with managing that....... its tough, but don't starve yourself totally of carbs, eat them earlier in the day and exercise after.
Keep going it takes time and if metformin along with diet and exercise doesn't get your HbA1c down there are other options.

 

[helli]

@Landrover Jason are you aware that the LibreLInk app takes the delay into consideration so you do not have to?
It does this by extrapolating the current trend. This can result in a few oddities if the trend changes direction (e.g when treating a hypo)
- Libre may reported lower for longer than actualy happens
- Libre may report a low (or high) that then "disappear" when reality catches up with the prediction

As for the estimated HBA1C, mine was off by over 20%. I think i is a useful metric to track but do not consider it an indication of my "real" HBA1C.

 

[Landrover Jason]

That's why I said its good for trend patterns and direction