Mike's Excellent Glucose Monitor Adventure

[amwassil]

Possibly, I’ll check it out. I already did a very quick and superficial inquiry on coupons for the sensors and it looks like only with a prescription. But I will investigate further. Thanks.

[amwassil]

Tentative start date is Tuesday, Mar 3. I’m off work that day so I’ll be able to apply the sensor in the morning before my keto coffee and take my first reading at 8 hours. That timeframe will cover both my keto coffee and my mid-day primary meal. This is interesting:

CGM Experiment: What I learned as a non-diabetic from wearing a continuous...

[KetoSnaps]

After you’ve started the sensor with the reader, there is a 60-minute waiting time before you can read a result for the first time.

I always apply my sensors 24 hours before I start them. That way I get much, much more accurate readings right from the off (in my experience the readings take a while to settle down, perhaps due to the mild skin and tissue trauma of having the probe fired in with the spring-loaded introducer needle, and I’ve found waiting a day really does make the readings more comparable to the readings on my blood glucose meter.

So if my sensor is due to expire on a Saturday morning, I apply (but don’t start!) my next one on the Friday morning. As soon as the old sensor expires I start the new one, and then wait 60 minutes for it to initialise.

I’m giggling at the 8-hour thing! I scan every few minutes. But then I’m a straight-line-obsessed T1D with perfectionist issues. Careful you don’t go over the 8-hour period between scans - you’ll have gaps in your graph.

Have fun!

[amwassil]

@KetoSnaps May I conclude you’re using the FreeStyle Libre? So I can stick the sensor on and it does nothing until activated by the reader? No loss of battery charge? Maybe I’ll stick it on the night before going to bed then get up for few minutes earlier than normal to activate the sensor. The first few days I’ll probably read the device multiple times. I am a gadget guy! Thanks.

[KetoSnaps]

Yes, Freestyle Libre.

The sensor only starts when you scan it for the first time - then the 60-min countdown begins. After that you can scan it again for your first reading.

Absolutely I would stick it in the night before - that way your body’s reaction to being stuck with the probe won’t risk skewing any data.

If you want to keep track of actual number values as you go through your day, you do need to scan frequently. The reader is only able to go back 8 hours, so if you leave it longer than that you’ll get a gap. But it does store all the data it collects for a full 90 days. The Logbook screen will show you every number from whenever you scan, and these numbers are also recorded when you download the reader. I need these numbers in order to make dosing decisions.

The graph line is great, don’t get me wrong, but as a diabetic I need to know what the actual number value is.

Excuse the ironing board background - I’m off sick from work but feeling better enough for catching up on chores.

I love the Libre, but one day I’d love a CGM rather than ‘just’ a flash monitor! Okay, I could pimp the Libre with a retrofitted transmitter, but that’s only compatible with Android at the moment, which doesn’t fit with me. I’d love one that automatically transmits to a reader minute by minute, rather than having to harvest the data myself. That would be very handy while driving, or while at work, where my safety is important and it would be good to be able to glance at a screen in real time!

[amwassil]

Thanks again. I don’t have any metabolic issues that I’m aware of. I’m mostly interested, at least initially, in the trend. 3+ years into keto and pretty much 99% of the time in ketosis, I expect to see low glucose and not much up/down. If I don’t see that initially, I’ll try to figure out why not. If I do, then I intend to test the effect of various activities and foods on glucose levels. For example:

Is Keeping Blood Sugar Below 100 Unrealistic?

This article describes the factors that determine how much glucose rises in response to 1 gram of carbs. Yes, one measly gram. There’s nothing in this article about keto, so it’s about carb eaters and may or may not apply 100%. But I’m sure it’s relevant.

Treating Hypos: One-Size Does NOT Fit All! | diaTribe

[KetoCancerMom]

Yeah, should start applying my sensor a day in advance. Its annoying how "off " it can get. Also, I seem to run into a problem the last few days before the sensor expires. My BG (fingerstick) usually reads 15-20 points higher than the scan.

[Stephen_Judd]

I’ve also experienced the off-readings at beginning and end of cycle and also between sensors. Luckily, I am mainly interested in the relative changes due to food and exercise, and don’t obsess over the specific numbers…

@amwassil - The elevation in blood glucose from intense exercise is easily noticeable. It can also stay relatively elevated for quite a while afterwards, especially if I remain fasted.

[KetoSnaps]

Yeah, should start applying my sensor a day in advance. Its annoying how "off " it can get.

When I first started using the system I found readings for the first day or so to be so out of the park (usually high) that my calculations - and therefore my wellbeing - were seriously compromised. I soon discovered that other users were applying them ahead of time, so I’ve been doing that habitually for the last four years.

A couple of months ago I had a sensor fail entirely, so I applied a replacement and started it immediately. It read ‘LO’ for the next 10+ hours (fortunately I was monitoring on my BG meter at the same time - and showing readings in range -, so I wasn’t in any diabetic danger. Annoying, though).

The only actual downside of applying my next sensor 24 hours in advance is that in wearing a sensor on each arm I feel I must look rather like a crash-test dummy for that period…!

[KetoCancerMom]

Right now my sensor is being annoying. It’s having trouble getting reading. Says to check back in 7hrs . I’ve been told that it’s from White cells sticking to the filament

[amwassil]

2020/03/02 9:45 pm Attached the sensor. I have to admit when I saw that pin my first thought was “this is going to hurt”. It’s looks about 1/4 inch long. But it went in with no pain, although I did feel it.

[amwassil]

I activated the sensor a little after 7am. I’m posting this here as a reference. Almost everyone is talking in terms of mg/dL while my FreeStyle uses mmol/L. I need to have a reference to understand what others are talking about to compare my results. I’ll post my first morning’s results later. I first have to figure out just how to upload the raw data to LibreView to get the graph, then how to get the graph into here.

[amwassil]

Gluconeogenesis at work. I’ve eaten 5 grams of carbs in the last 18 hours and 1.35 grams in the last 12 hours, which was my keto coffee this morning between 11a-12p. That appears to have raised my glucose from 5.5 to 6.3.

[KetoSnaps]

Here in UK we measure in mmol/l too - I remember when I first came across BG numbers in mainland Europe and US I was staggered, assuming they were on the same scale, and thinking ‘how on earth is 100 normal, when surely if mine were 100 I’d be dead?!’

[amwassil]

2020/03/03 16:30 19:00 20:00 PST Updates

I changed the ‘target’ limits to 3.5 x 6.5 mmol/L.

Meals:
11:00 - 12:00 Keto coffee
13:00 - 14:00 Main meal

BrAce: 16.5 ppm
Lumen: 5 (my first 5!)

Interesting. I’m in ketosis, have a 5.6 mmol/L glucose, heading for 5.4. And I blow a 5 on the Lumen! I wonder if the Lumen is better correlated with glucose rather than ketones? Hmmmmmm.

19:30 - 20:00 Secondary meal

[amwassil]

2020/03/03 23:00 PST Update

22:30 - 22:45 Before bed bone broth nightcap

Day’s Meal Summary

Glucose Plot for day 1:

These numbers are higher than I expected. Mostly still within the ‘normal’ range, although the 6.6 and the two 6.3s are borderline. I expected I’d be in the mid-upper 4s. Well, the ups/downs from eating are fairly gentle and that’s good. Maybe both @KetoSnaps and @KetoCancerMom are correct and the first day readings are high and will come down. So we’ll see what happens over the next few days. I’m working tomorrow from 7am to 3pm, then I’m off both Thursday and Friday. It’s been an interesting day.

Grating the cacao butter for my bone broth nightcap:

The payoff:

[KetoSnaps]

I think any first-day anomalies are down to site issues (damage to tissue) rather than the sensor itself - so I’d assume given that it had had a few hours to settle down overnight before you started it, what you’re seeing is the way it is - although if you’ve got blood testing strips it might be worth doing a fingerprick test for comparison. Having said that, my last reader (I’m on my second) did habitually read a little high. I don’t seem to have much variation from sensor to sensor themselves, though, which initially surprised me as I gather others do notice differences.

Two things I would mention both about the graph line and the numbers:

1. I would be head over heels with delight at numbers such as these
   (Disclaimer: I have type 1 diabetes and therefore my body has access only to exogenous insulin - so my criteria for my own blood glucose satisfaction might of course not be the same as someone with functioning beta cells!)
   (Disclaimer 2: I actually have no idea what numbers even would be desirable in a non-diabetic! So maybe take my opinion with a pinch of salt.)

2. The consistency looks really good, with not much variation in the numbers.
   It is my understanding that a smooth line is more desirable than peaks and troughs.
   The thing that has transformed my own graph line since slashing my carb intake is that it’s much, much smoother and flatter - which of course is why I’m doing it!

[amwassil]

I’m not ‘unhappy’ with yesterday’s numbers. Just curious as to how I have normal glucose while in ketosis. I thought I’d be ‘low normal’. So maybe just another incorrect assumption disproved by data. I’ve been taking readings during the night whenever I awakened from sleep. The low point was 3.7 mmol/L which was bracketed about an hour apart by preceding and succeeding 4.3s. I’m 4.6 (05:30) now.

I’ll take reading periodically at work, upload the data when I get home mid-afternoon and post the graphs later.

[amwassil]

2020/03/04 Updates. Posting the 3 meals I’ve completed so far today and the glucose chart to 18:00. Wife and I are leaving for the rec centre in an hour, so I’ll post the remaining meal and glucose chart for the full day after we get home again later.

Note: I’ve decided to upload the meal details/summaries and the glucose plots to another server. I link to them for anyone who’s interested rather than including them in my reports here. That will encourage this topic to remain mostly an exchange of comments and ideas rather than a data dump. Hopefully.

05:30 - 06:00 Keto coffee
10:30 - 11:30 Secondary meal at work (included a 473 ml Sugar Free Red Bull)
17:30 - 18:00 Main meal
23:30 - 23:45 Nightcap
Day’s Meal Summary

Glucose Plot for day 2

[KetoSnaps]

I’m not ‘unhappy’ with yesterday’s numbers. Just curious as to how I have normal glucose while in ketosis. I thought I’d be ‘low normal’.

No, I shouldn’t think you were unhappy - as I say, I’d be delighted with them! It’s great to have the means to see how great they are.

I’m reassured by your post that it’s possible for the body to have normal glucose when in ketosis (and in your circumstances of being without any metabolic disorder), because it shows (and I’m assuming based on your data that this might be the case for others) that the body isn’t having a blood glucose-related problem from being in ketosis.

Body’s working well, right?