Tag: insulin

Life after Libre – updated

I’ve been using Libre for around five months now and it is great. Convenience and frequency of testing and the insight into rising or falling sugars is a big step forward.  When Abbott had problems with distribution at the end of the year I didn’t imagine how much I had formed new routines around the scanning and how different it would feel without the sensor.

Back to finger-pricking then, and that of itself is a pain. Testing is much more involved than a casual swipe of the iPhone under and armpit but one gets used to that. Fewer tests a day and the static nature of each result leaven me less informed. The most telling difference of me is the awareness of control – the time in target statistic has become my go-to measure, and without the Libre’s continuous record it can’t be assessed.

Single point tests are ok at the time, but I found myself wanting to test again in 30 minutes to see where I was heading. The single most useful insight the Libre gave was into overnight profiles.  This helped me to know what was going on whilst sleeping, adjust evening sugar levels to get the best balance and avoid waking up with low sugars which had become a regular experience. It even prompted discussion with the specialists to change my basal insulin type for a slightly longer lasting alternative. The effects have been good so far and I feel better balanced and controlled, which would have been really tough on the intermittent finger-prick tests.

It’s only a week, but I miss the Libre already and hope that Abbot get their act together soon. It is a really useful part of my new regime.

Update – a few months after this post was originally published, there was a change of eligibility criteria in my area and after a long process of demonstrating high levels of finger-prick testing I was admitted to the prescribed programme. Since then I have been a continuous user and can’t imaging life without the better insight and awareness that the Libre system provides. 

More posts will follow as I reflect on how it goes and how it evolves.

Sweet times in America?

Travelling as a type 1 diabetic can throw a few extra variables into the mix. My last trip to the US really took me by surprise and will reset my plans for future visits.

Time zone shifts are tricky anyway, but with more frequent finger prick tests it is possible to manage more or less on an hour-by-hour basis. A previous trip during a trial of the Freestyle Libre was a revelation, but I’m not on the qualifying list yet so its back to the stabbing process.

The difference I found in America was the inaccuracy of my lifetime of carb counting. I made my standard estimates for a slice of bread, a bowl of fruit and yogurt, a burger with fries, a bottle of Sam Adams, and found my BG readings constantly high.

I typically take 40 to 50 units of Humalog a day and that covers 160 to 200 grams of carbs at an average BG of around 7 mmol/l. On my week in America I averaged 80 units a day. By my standard carb counting this was covering around 150 grams of carbs and yet my average BG was more than 13mmol/l. Something was out and it can only be the sugar content of what I was eating.

Throughout the week I was careful – no donuts, avoid the coffee creamer, moderate portions etc. It’s really tough to load the insulin doses when a lifetime of caution to minimise hypos has drummed in the opposite behaviours. 

I found that once the BG readings got high, it was very tough to get them back down. The two-hour effect time of Humalog led me to a strange world of scheduled testing and re-dosing, even through the night.

The only answer, I think, is experience. I may be doing more business in the States, so will need to travel there more often. Over time I will calibrate the body systems and the management processes and hope to find a better balance on future visits.

Which brings me back to the Libre – business travel doesn’t make finger pricking easy or convenient, and so the more constant monitoring offered by the Libre would be welcome. If only to hit rising sugars earlier and prevent rather than recover from high readings.