Diabetes, and CGMs (Freestyle), non-diabetic using one!

I have been diabetic for a few years. My mum was too, since she had me, and we suspect this is what did my grandfather in (undiagnosed) to be honest. It is often hereditary.

I have often felt almost like some sort of fraud. I have insulin, as just taking tablets was not working, but the process is to review my HbA1c, maybe once a year, which is a test that sort of gives an average blood glucose over some months, which is not that good a "picture". But (having lost some weight) I am on a low daily dose of insulin now. That has advantages (one jab) and disadvantages (cannot adapt to changing circumstances easily). I have tablets too. It is "mild" compared to many people.

However, when I started losing weight, I also decided to buy, with my own money, at a cost of some £100+ a month, a continuous glucose monitor (CGM). It sticks on my arm and logs interstitial glucose levels and keeps a history. It has its quirks, like only 8 hours of data (and some times I try and sleep more than that!) so has to be scanned at least that often for a full picture. It is also maybe half an hour behind blood sugar levels, so I can feel hypo when it shows higher as it has not caught up.

However, I have found it hugely useful with managing my diabetes and diet. It is really good for making me aware of the wrong things to eat (basically sugar) and what I can eat in moderation and get away with in, and how much I can eat of something without getting away with it. This is mostly feedback of history rather than "am I really hypo now" which a blood test can do.

Sadly they are not cheap, but I feel they should be used more. They are normally only prescribed for people with severe diabetes, but I can see they should be really useful, even for people just trying to control it with diet. It is a shame they are not cheaper and prescribed more.

Recently I was able to see what a "normal person" is like on one of these. That said, it was rather odd. A friend of mine (who will, no doubt, read this blog) was diagnosed with gestational diabetes. So I gave her a CGM (and another as she knocked the first one off on a car door, FFS). She did not want to do the requested 8+ finger pricks a day, so my treat.

The thing is, having used the CGM, no way is she remotely diabetic. This is one day (with her permission)... Yes, charge that battery FFS!

Subsequent days I have seen are lower than that. She does not spike over 7 even when eating stuff she knows she should not.

For me this was really interesting as I did not know what a "normal", non-diabetic person looked like on a CGM, and now I do. It puts my graph to shame, and I am well controlled (apparently).

Like I say, I almost felt like a fraud, until I saw that, and I know I am nothing like that good. My diabetes is mild, under good control, but very real. I don't feel like a fraud any more, and even wonder if I need fast acting insulin doses when I eat as I can peak at 10 mmol/l, and occasionally more.

Interesting stuff.

P.S. As requested, here is one of mine, on a really good day... Most days I am peaking higher.

My first Borg implant

Actually, just a Freestyle Libre glucose sensor!

As you will know I am diabetic, but I am reasonably lucky at this point that whilst I don't make enough insulin, I only have to have one long term injection a day. This is, in some ways, a mixed blessing, but I would rather not have an injection with every meal.

When I have a good routine I don't have to check my glucose levels, but I am losing weight (lost 19kg so far) and this is causing a bit of fun and games. I have been lowering my carbohydrate intake and my insulin but I do need to keep things in balance. On top of all of that, exercising is helping and means I am lowering my insulin even more to avoid hypos (low blood sugar) all the time. I was managing to have high glucose and low glucose, both of which are a problem. I was getting fed up pricking my finger to be honest.

So I got a Freestyle Libre glucose monitor. It monitors interstitial glucose levels so apparently has a lag of 10-15 minutes compared to blood sugar glucose, but it is monitoring all the time, and allows me to see how my glucose levels change during the day. It is easy to just scan from my phone by holding it to my arm. It has a memory of 8 hours (I am surprised not longer) so you need to scan at most every 8 hours to not have a gap in the readings, but that is not really an issue.

I am not really the typical user for these. They are also not cheap (over £60 for a sensor that lasts 14 days). Normally these would be used by people that need insulin with every meal. In my case I am trying to make sure my insulin levels are right for a daily dose, but also trying to work out when, and how much, exercise works well to keep my glucose levels in check. Also working out if, and when, and how much Gliclazide I need to take. Having this near instant feedback from the sensor, and the graphs, is ideal. Hopefully I will not need to keep using them as I get in to a more sensible routine.

Basically, at this point, I need to go for a walk after each meal. Doing that, and taking a tablet with my main meal, should keep my glucose sensible all day. But it is a learning exercise for me, and I have only been using this for a few days. I managed to have a level of 12 mmol/l for 9 hours after having a pizza and not going for a walk, but at least I know without having to prick my finger.

I thought it would be uncomfortable to be honest, but not had any trouble sleeping on it. I did catch my arm on a door frame at one point, but otherwise it seems pretty easy to cope with. It is waterproof. I am not sure how easy it will be to get off at the end of the 14 days, I'll see.

Losing weight is good, but definitely causing changes, not just with diabetes. I have actually had to stop taking blood pressure tablets! You do have to be careful changing things like this (and I would suggest asking your doctor/nurse). I reduced dosage slowly and monitored blood pressure carefully - but basically I was getting dizzy when I stood up. Blood pressure of 100 over 60 is a tad low. I now have sensible blood pressure with no medication, which is a side effect I did not expect!

I also did not realise that there seems to be a big market for stickers people put on the sensor! Crazy.