random libre and hypo question

[rayray119]

i know people arn't going to be abble to awser this but its a thought that ocured to to me, if below 4 is techailly a hypo then why is the libre taget autotity set at 3.9 to 10.

 

[Robin]

I think with non-diabetic people their blood glucose can quite naturally go down to 3.5. Because blood glucose meters and other monitoring devices aren’t 100%accurate, I think 4.0 was adopted as a good standard for people to aim to stay above, allowing for meter inaccuracies. So 4 is a bit of an artificial target anyway.

 

[rebrascora]

I don't believe there is actually a standard definition of what level is considered a hypo. We generally take it as below 4 but the way I understood it from my DAFNE course it is actually 3.5 as non diabetic people can drop below 4 and damage doesn't occur in that 3.5-4 range. The issue is that as insulin users we need to keep our hypo awareness as sharp as possible because obviously a surplus of insulin can take us much lower, so keeping our levels higher than 4 helps to preserve that awareness. Non diabetic people don't need that awareness because their levels won't drop dangerously low.
The 3.9-10 range for Libre is a bit odd though I agree, especially as Libre usually reads slightly lower than a finger prick at low levels for many of us anyway.

 

[rayray119]

I don't believe there is actually a standard definition of what level is considered a hypo. We generally take it as below 4 but the way I understood it from my DAFNE course it is actually 3.5 as non diabetic people can drop below 4 and damage doesn't occur in that 3.5-4 range. The issue is that as insulin users we need to keep our hypo awareness as sharp as possible because obviously a surplus of insulin can take us much lower, so keeping our levels higher than 4 helps to preserve that awareness. Non diabetic people don't need that awareness because their levels won't drop dangerously low.
The 3.9-10 range for Libre is a bit odd though I agree, especially as Libre usually reads slightly lower than a finger prick at low levels for many of us anyway.

I was told to treat anthing below 4 as a hypo and the sheats of information the hospital gave me said so. However i ofen teat low 4s the same now anyway just because i feel like its kind of heanding towards the edge

 

[helli]

The minimum level alarm is configurable. I set it at 4.5 to allow me to increase my levels before I reach hypo levels.
Likewise, I have changed my upper alarm level to 9.5 so I can treat it before i get to double figures.

 

[rayray119]

The minimum level alarm is configurable. I set it at 4.5 to allow me to increase my levels before I reach hypo levels.
Likewise, I have changed my upper alarm level to 9.5 so I can treat it before i get to double figures.

I mean if i finger pick and it was somthing like 4.2 i will eat a couple of jelly babies anyway sometimes to feead of a hypo. So sometimes that seems like the right thing to do sometimes not.

 

[rayray119]

Likewise, I have changed my upper alarm level to 9.5 so I can treat it before i get to double figures.

Ive also been told by team not to correct anything below 10 and also not to do iy withen 4 hours of having insulin.

 

[rebrascora]

Ive also been told by team not to correct anything below 10 and also not to do iy withen 4 hours of having insulin.

Yes, that would be good advice when you are newly diagnosed partly because your own insulin can sometimes kick in on top of any you inject and that could cause you to hypo. Once your body settles down and your BG levels are more predictable, you may become confident enough to correct before you get to 10 and perhaps correct before the next meal. It depends how finely you want to manage your levels. It is also worth noting that @helli is using a pump, so she can make small corrections relatively easily as compared to a whole unit or half unit injected correction with a pen.

 

[rayray119]

Yes, that would be good advice when you are newly diagnosed partly because your own insulin can sometimes kick in on top of any you inject and that could cause you to hypo. Once your body settles down and your BG levels are more predictable, you may become confident enough to correct before you get to 10 and perhaps correct before the next meal. It depends how finely you want to manage your levels. It is also worth noting that @helli is using a pump, so she can make small corrections relatively easily as compared to a whole unit or half unit injected correction with a pen.

i was told it was because insullin is active in your system for 4 hours so if you correct before that its stacking loads up. i wasn't saying she shouldnt i was just saying thats what i was told

 

[rebrascora]

And that is good advice but it is just guidance and as you get more experienced there may be times when you want to ignore that guidance to gain better control. I am not advocating it but I regularly stack insulin without a problem because I know how my body responds to the insulin and I can watch my Libre to see how it is working. If you think about it, splitting a dose is a bit like stacking insulin or if you decide to have a dessert after your main meal and inject some more insulin for that. You just have to remember it may be still in your system when you come to your next meal.

 

[rayray119]

And that is good advice but it is just guidance and as you get more experienced there may be times when you want to ignore that guidance to gain better control. I am not advocating it but I regularly stack insulin without a problem because I know how my body responds to the insulin and I can watch my Libre to see how it is working. If you think about it, splitting a dose is a bit like stacking insulin or if you decide to have a dessert after your main meal and inject some more insulin for that. You just have to remember it may be still in your system when you come to your next meal.

yeah i mean they were partlly taking about in between snacks so if i'm higher when eating something buts it withen 4 hours of having insullin the do the normal amount but dont have add a connection.

 

[Lily123]

i was told it was because insullin is active in your system for 4 hours so if you correct before that its stacking loads up. i wasn't saying she shouldnt i was just saying thats what i was told

Everyone will have different time in which the body processes insulin

 

[Sally71]

yeah i mean they were partlly taking about in between snacks so if i'm higher when eating something buts it withen 4 hours of having insullin the do the normal amount but dont have add a connection.

Yes if you eat again less than 4 hours after your last meal, you have to take insulin for the food or you will just go higher and higher, BUT if you have done a correction dose for a high blood sugar less than 4 hours ago, then that will still be working so it’s best not to do another one or you risk having too much and going low. Insulin from any previous food will also still be working but that will get used up by the food so shouldn’t be a problem.

 

[rayray119]

Yes if you eat again less than 4 hours after your last meal, you have to take insulin for the food or you will just go higher and higher, BUT if you have done a correction dose for a high blood sugar less than 4 hours ago, then that will still be working so it’s best not to do another one or you risk having too much and going low. Insulin from any previous food will also still be working but that will get used up by the food so shouldn’t be a problem.

i didn't mean i wouldnt take insullin for food unless my blood surger was droping and i was trying to stop it.

 

[helli]

Sorry, my last comment derailed the conversation and my key points may not have been clear so I will repeat them
- you can change the alarm points on the Libre- the recommendation is to set the alarm points at values which give you a chance to correct before they become a problem. So set the low alert above 4.

 

[rebrascora]

@helli I think the confusion may be around the fact that @rayray119 is talking about the "range" setting of 3.9-10 for the "time in range" feature rather than the alarm levels.

 

[mikeyB]

I don’t even look at the Libre sensor reading during hypos. It’s so unpredictable because of physiological changes. I just use the reader with Optium strips to follow my BG.

You can set the range on the Libre to whatever you want. I’ve set my reader to 4.5 to 13.

 

[rayray119]

I don’t even look at the Libre sensor reading during hypos. It’s so unpredictable because of physiological changes. I just use the reader with Optium strips to follow my BG.

You can set the range on the Libre to whatever you want. I’ve set my reader to 4.5 to 13.

yeah yeah i just meant as staendred.