# Can I set up my libre without a nurse?



## StephanieMLW (Oct 7, 2022)

Hi all,

I was diagnosed with Type 1 almost a month ago now. It's been a busy month! I was really excited to receive my Libre 2 at the start of this week, however when I visited my GP practise for my pneumonia vaccine, I was told by the nurse there that I'd have to make an appointment with a nurse at my local diabetes centre to set it up. I have been trying to get hold of them to make an appointment all week, but to no avail. 

Have other people had the same experience? Or have you set up your libres by yourself? I'm keen to be on a CGM asap, especially as I don't have much hypo awareness and I have various work trips in the next few weeks where I will be travelling alone. 

Any advice much appreciated - thank you


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## steveo (Oct 7, 2022)

StephanieMLW said:


> Hi all,
> 
> I was diagnosed with Type 1 almost a month ago now. It's been a busy month! I was really excited to receive my Libre 2 at the start of this week, however when I visited my GP practise for my pneumonia vaccine, I was told by the nurse there that I'd have to make an appointment with a nurse at my local diabetes centre to set it up. I have been trying to get hold of them to make an appointment all week, but to no avail.
> 
> ...


Hi Stephanie 
When I first started using the libre I had to be shown how to use it by a rep at the hospital. To be honest it's really easy to do especially as there's loads of videos online but I still think it's a requirement you have to do. If you don't get much hypo awareness then you should get a cgm. I would mention this to your dsn the next time.  Good luck  

To


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## helli (Oct 7, 2022)

Given how many people self fund Libre, you should be able to set it up yourself. 
However, some areas won't prescribe it until you have had the training.
I also had to sign a form to confirm that I would scan at least 3 times a day, report failures to Abbott, etc.


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## nonethewiser (Oct 7, 2022)

Didn't have any training, so easy to set up a child could do it, you learn as you go along like all things in life.


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## Bruce Stephens (Oct 7, 2022)

StephanieMLW said:


> Have other people had the same experience? Or have you set up your libres by yourself? I'm keen to be on a CGM asap, especially as I don't have much hypo awareness and I have various work trips in the next few weeks where I will be travelling alone.


Like many others I self funded for a year or so, so set it up myself. There's an advantage in having someone do the first application (or watch you as you do it) and so on, but it's not that hard.


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## Robin (Oct 7, 2022)

I set mine up by myself when I was self funding. However, when I had it prescribed, I had to attend an online webinar, and during the course of that, they gave out the hospital's code to put into Libre view, which I had to agree to do so that the hospital could access the results. That may be why they want some input.


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## Matchless (Oct 7, 2022)

StephanieMLW said:


> Hi all,
> 
> I was diagnosed with Type 1 almost a month ago now. It's been a busy month! I was really excited to receive my Libre 2 at the start of this week, however when I visited my GP practise for my pneumonia vaccine, I was told by the nurse there that I'd have to make an appointment with a nurse at my local diabetes centre to set it up. I have been trying to get hold of them to make an appointment all week, but to no avail.
> 
> ...


Hi stephannie like others i self funded for a year and bought them online and got on with it without any help but the FSL site i was about 69 then when they was first available am now 75 so if i can get it going any one can,good luck.


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## Bruce Stephens (Oct 7, 2022)

Robin said:


> However, when I had it prescribed, I had to attend an online webinar, and during the course of that, they gave out the hospital's code to put into Libre view, which I had to agree to do so that the hospital could access the results.


But that shouldn't be _required _any more. And if that's what they want, it can be done later. (It's not trivial to find the right place to enter the code and so on, but all that can be done later just as easily.)


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## Robin (Oct 7, 2022)

Bruce Stephens said:


> But that shouldn't be _required _any more. And if that's what they want, it can be done later. (It's not trivial to find the right place to enter the code and so on, but all that can be done later just as easily.)


Oh I agree, but from the point of view of the clinics, it’s easier if you can collar people at the time, and it also means they are sure people are going to be using properly, what after all is quite an expensive piece of kit. But I’m all for someone who is engaged and competent setting up their own.


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## Proud to be erratic (Oct 8, 2022)

Hi Stephanie, welcome to the forum.


StephanieMLW said:


> Hi all,


I was prescribed Libre 2 in Feb 2, 12 months after my surgery, when Covid isolation was preventing any face to face contact. Abbott have about 9 video seminars, freely available to anyone and one NHS condition was that I watched these.  I did; no-one could prove I had watched but I truthfully declared I'd watched them. My Libre 2 came in the post and I've been wearing one ever since.


StephanieMLW said:


> I was diagnosed with Type 1 almost a month ago now. It's been a busy month! I was really excited to receive my Libre 2 at the start of this week, however when I visited my GP practise for my pneumonia vaccine, I was told by the nurse there that I'd have to make an appointment with a nurse at my local diabetes centre to set it up. I have been trying to get hold of them to make an appointment all week, but to no avail.


I think your GP surgery nurse is misinformed. The reality is that, despite a great improvement in availability of sensors for T1s since the change in the NICE Guidelines earlier this year, most GP surgeries don't look after T1s. They routinely care for T2s, some 90% of the D population, but T1s are looked after by their specialist hospital team (Endocrinologists and Diabetes Specialist Nurses [DSNs]). At our small surgery, during a face to face, our Practice Nurse had never seen a sensor before and thought there were 3 other patients on their books with Libre.  She was happy to spend a few minutes hearing about its benefits. So politely but robustly challenge this. Rules do change, but fitting Libre 2 is easy and doesn't need face to face training for most people.

The quandary is that you need your GP to write the repeat prescriptions. So, you don't need anyone's permission to wear the medical equipment you've been sent, but you do need your GP Surgery to add Libre 2 to your prescriptions for needles, insulin, test strips etc. The training is easily available on line.


Amity Island said:


> The benefit of you having being newly diagnosed (as opposed to someone who was diagnosed some time ago and used to using finger pricks etc) is you won't have to adjust your managment in any way.


I think this advice could be slightly misleading. Libre 2 is an excellent aid and improver of your D management, but it does have its limitations, which (not surprisingly) Abbott don't make much emphasis about!

When Libre isn't working, and it happens, you need the traditional D management technique of finger prick testing to keep you safe. At this early stage you need a bit more testing to help you see results in relation to your normal daily living: not just what you are eating and how your body manages that food, but what any exercise and activity does for you and your BG; stress has major effects on BG - be that stress from difficulties, medical or hormonal issues or even just watching a frightening or sad TV programme!

Libre provides a significant improvement in your visibility of your BG without the faff of finger pricking, but Libre is looking at your interstitial BG not your actual BG and lags actual BG by up to 15 minutes. Abbott claim this was reduced from 15 mins to c. 2.5 mins, but the claim is not quite fair; they use an algorithm to adjust the sensor reading and that bit of technical maths (science) does not (can not) take account of how your body is behaving.

Just one example: you get so low you go hypo. Your body might tell you this, but your Libre might not have caught up and be showing you as a little above the hypo threshold. You treat the hypo, say 15gms of a fast glucose such as Dextrose or Jelly Babies and recovery is underway - but Libre is now telling you that you are actually hypo. Tendency is to then over react and take more glucose, with a rebound that can become a hyper. This scenario is real enough and manageable, but needs an element of self-control along with understanding of what the technology is doing.


Amity Island said:


> With the older style of management, you only had to check your glucose reading before meals if you wanted to, you rarely got to see what was happening to blood sugars between meals. In times gone by, it was perfectly acceptable (by the medical profession) to have huge spikes between meals. Now, with the libre, after a few weeks of using it, you will soon be able to manage your doses, your timing of doses (how far upfront you need to take your insulin to avoid spikes) and see what foods have what effects.


I certainly agree with all of that.


Amity Island said:


> It really is a great piece of technology which sees an end to relentless finger pricking and allows you to do things (activities) many of us didn't dare to do. There hasn't been a better time to be diagnosed (not that there is ever a good time lol).


But just be aware that not everyone has a perfect, albeit delayed, correlation between Libre and actual BG. Even without manufacturing tolerances of some 15% for both Libre and any test meters, I regularly have Libre reading 2-3 units above actual,  sometimes 2-3 below actual and sometimes starting high, then dropping low during the 14 day life of a sensor. My overall Libre failure rate is 50% and I accept that my body doesn't get on well with Libre. So I'm constantly mentally juggling to picture what my Libre is telling me against what is actually happening.  It is brilliant that the tech allows this, but it is one more thing to keep in sight. If I didn't do this mental adjustment, my D management would become even more confusing as I might think I'm making the appropriate response, yet not getting the appropriate result.


StephanieMLW said:


> Have other people had the same experience? Or have you set up your libres by yourself? I'm keen to be on a CGM asap, especially as I don't have much hypo awareness and I have various work trips in the next few weeks where I will be travelling alone.
> 
> Any advice much appreciated - thank you


Got to dash, I'll post the thread about Libre limitations later today. Good luck, Libre is great despite my personal difficulties with it.


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## Proud to be erratic (Oct 8, 2022)

Amity Island said:


> Hi, what I was trying to explain was that for those diagnosed today, they won't have to change their management style, because they will go straight onto the libre.


Yes, and my apologies I phrased that badly. My first read of your post made me pause and say to myself whoa ... but I completely get where you were coming from. 

I also happened to be hurrying to get out for flu jabs and I'd just had my classic scenario of Libre telling me I was almost 9, but finger prick saying below 6 - so having to bolus using actual BG not Libre and hence a tiny bit more mental maths!! Inevitably when in a hurry things aren't routine; I almost hadn't bothered to test, then thought I'm going out so be cautious, otherwise I would have added a correction for the Libre value and over-bolused. That in itself is not a big problem if I'm home; a 2nd cup of frothy coffee and a cookie resolves that potential hypo before it becomes a real hypo.


Amity Island said:


> For me, moving from finger pricking to libre took quite some getting used to.


For me that was less of a problem. I'd been finger pricking for a year but with truly erratic results and very little understanding; I was being told by my DSN to alter doses, but not getting any explanation. I couldn't see any particular pattern from my logbook. So Libre revealed so much and, even though my finger pricking didn't marry up with Libre, it was so helpful just seeing daily graphs and the various reports. Almost instant reconciliation of action and effect - so useful. My D management improved very rapidly from that.


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## everydayupsanddowns (Oct 9, 2022)

I started self-funding the libre waaaay before it was available on prescription (2014 if memory serves), so while some of the information and pointers available from the NHS are very helpful, it is certainly something you can do by yourself.

There are also excellent online resources like the DTN video series I was asked to make an introduction to - where highly qualified specialist consultants and nurses from all over the UK take you through all aspects of Libre. It’s like having an endo version of The Avengers to help you out (and some numpty PWD doing a basic intro)  






						DTN-UK Education: Flash Glucose Monitoring | ABCD (Diabetes Care) Ltd
					






					abcd.care


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## Bloden (Oct 9, 2022)

nonethewiser said:


> Didn't have any training, so easy to set up a child could do it, you learn as you go along like all things in life.


Same here. I was self-funding the Libre to begin with, so I just read the instructions booklet, slapped it on and started the sensor. My endo and team weren’t involved at all.


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## PhoebeC (Oct 10, 2022)

Well I didn’t self fund. I have been on it since just before the first full
lockdown in the uk.

My call with the practice nurse was my annual review at a new surgery as we had just moved. She offered the libre on prescription and said I would be able to collect from my pharmacy the same day. 

Libre have great videos etc if you are stuck buy the instructions are pretty simple too.
Good luck!


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## StephanieMLW (Oct 10, 2022)

Thank you so much to all of you for this advice - it has been super useful!

I managed to get hold of the diabetes hospital team on Friday, who sent me a link to do some webinars online - @Robin it was very much the setup that you explained, that they wanted to make sure I entered their code for tracking etc . I have also looked at some of the links shared on here, which have given me that extra bit of info (thanks @everydayupsanddowns - the link you sent provided me with lots of bedtime reading!). I must admit, it took me about twenty minutes to pluck up the courage to apply the sensor after I saw the needle applicator  I've always had a needle phobia to the point that I'd faint at the sight of them - being type 1 has pretty much cured me of that, but I had a bit of a wobble at the Libre!! I then however felt like a complete wimp as it was totally painless 

@Amity Island your point around the timings is really interesting - I was amazed that in the first 24 hours of wearing my Libre 2 my blood sugars dropped very quickly to 4 or less five times. I suspected I'd been having night time hypos, and it turns out I have been, I had two (3am & 5am) the first night I wore it. I sense checked the result the third time with my finger pricks, as I don't 'feel' my hypos very well at all. After a bit of experimentation, I worked out that for me there appears to be about a 5 minute time lag between my blood and libre readings. I'm looking forward to having a review with the diabetes team this week, as my Libre has shown me some pretty unexpected readings so far - these extreme drops seem to correlate with finishing a meal or they're in the middle of the night, so although all my medical team have said my carb counting is spot on, there's something to discuss here.

Thanks again for your replies - this forum is really helping with my sanity!


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## rebrascora (Oct 10, 2022)

everydayupsanddowns said:


> I started self-funding the libre waaaay before it was available on prescription (2014 if memory serves), so while some of the information and pointers available from the NHS are very helpful, it is certainly something you can do by yourself.
> 
> There are also excellent online resources like the DTN video series I was asked to make an introduction to - where highly qualified specialist consultants and nurses from all over the UK take you through all aspects of Libre. It’s like having an endo version of The Avengers to help you out (and some numpty PWD doing a basic intro)
> 
> ...


Mike, I found that "numpty PWD"'s input very useful when I watched those DTN videos and that was the NHS requirement for me to get Libre on prescription, despite self funding and successfully using it before that. Of course I had already picked up lots of useful tips and info from that same "numpty PWD" and others of course here on the forum, before I watched those DTN videos. Just want to say how much I appreciate all your input in helping us real "numpties" or at least newbies find our way forward with diabetes. A huge "THANKS" to you for all the work you put into supporting others with diabetes.


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## Bruce Stephens (Oct 10, 2022)

StephanieMLW said:


> I suspected I'd been having night time hypos, and it turns out I have been, I had two (3am & 5am) the first night I wore it. I sense checked the result the third time with my finger pricks, as I don't 'feel' my hypos very well at all.


Same happened to me (with Libre 1, so I just got to saw I was having hypos the next day). Which explained why I was feeling tired during the day, and fortunately reducing the night time hypos also let my hypo awareness return.


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## StephanieMLW (Oct 10, 2022)

Bruce Stephens said:


> Same happened to me (with Libre 1, so I just got to saw I was having hypos the next day). Which explained why I was feeling tired during the day, and fortunately reducing the night time hypos also let my hypo awareness return.



That's reassuring to hear - I've been waking up feeling like I have a mild hangover most days, which I am presuming is the night time hypos (I don't drink!)


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## PhoebeC (Oct 10, 2022)

StephanieMLW said:


> That's reassuring to hear - I've been waking up feeling like I have a mild hangover most days, which I am presuming is the night time hypos (I don't drink!)


This is what I was having and I had no idea. 

I would wake up in range on my blood monitor so I didn’t know. As soon as I got my libre (even before 2 with alarms) we could see that 3am drop and it explained why I always was so tired. 

I get less of them now. I have zero hypo awareness at night, and I had no idea.

It’s literally a life saver; as is this forum


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## everydayupsanddowns (Oct 10, 2022)

rebrascora said:


> Mike, I found that "numpty PWD"'s input very useful when I watched those DTN videos and that was the NHS requirement for me to get Libre on prescription, despite self funding and successfully using it before that. Of course I had already picked up lots of useful tips and info from that same "numpty PWD" and others of course here on the forum, before I watched those DTN videos. Just want to say how much I appreciate all your input in helping us real "numpties" or at least newbies find our way forward with diabetes. A huge "THANKS" to you for all the work you put into supporting others with diabetes.



Awwwww! Thanks @rebrascora ***blushes***


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## everydayupsanddowns (Oct 10, 2022)

StephanieMLW said:


> That's reassuring to hear - I've been waking up feeling like I have a mild hangover most days, which I am presuming is the night time hypos (I don't drink!)



Let us know how you get on @StephanieMLW

And yes… you aren’t alone in it taking a while to pluck up the courage to apply them. Not helped (for me) by the fact that it takes a fair bit of pressure for the applicator to ‘fire’.   

Interestingly according the the product development boffins I’ve chatted to, the big ‘click’ you hear is actually the withdrawal. The insertion makes very little noise apparently


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## Rob Oldfield (Oct 10, 2022)

Hi @StephanieMLW ... just to check something... have you figured out how to set up alerts on the Libre?


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## rebrascora (Oct 10, 2022)

My biggest fear on my first few Libre sensors was that I would make a mess of it and waste £50 worth of sensor that I could ill afford. Took me ages to psych myself up, but I reasoned that I was also wasting it leaving it sitting in the box. I read through the instructions numerous times and took it one step at a time. I think now watching You Tube tutorials would be a more reassuring way to do it.


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## rayray119 (Oct 10, 2022)

helli said:


> Given how many people self fund Libre, you should be able to set it up yourself.
> However, some areas won't prescribe it until you have had the training.
> I also had to sign a form to confirm that I would scan at least 3 times a day, report failures to Abbott, etc.


Wow only 3 when I was on the libre I had sign something saying I would scan at least 8 times a day.


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## rebrascora (Oct 10, 2022)

rayray119 said:


> Wow only 3 when I was on the libre I had sign something saying I would scan at least 8 times a day.


The 3 times a day is to ensure you catch as much data as possible ideally scanning every 8 hours to collect all the data. It is the absolute bare minimum, not the number of times they would ideally like you to scan or a recommendation of the number of times to scan.


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## rayray119 (Oct 10, 2022)

rebrascora said:


> The 3 times a day is to ensure you catch as much data as possible ideally scanning every 8 hours to collect all the data. It is the absolute bare minimum, not the number of times they would ideally like you to scan or a recommendation of the number of times to scan.


Interesting My nurse at the time said scanning at least 8 times a day was a requirement to keep the libre. Although unfortunately it didn't seem to suit me(I mean as they never lasted)


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## Bruce Stephens (Oct 10, 2022)

rayray119 said:


> Interesting My nurse at the time said scanning at least 8 times a day was a requirement to keep the libre. Although unfortunately it didn't seem to suit me(I mean as they never lasted)


Yes, before April 1 there were conditions, and that was one of them. (The idea was not to waste money on people who didn't seem to be using the things.) I'm sure it varied between CCGs (and between patients) but that was one of the conditions I had to agree to. (At the time I was scanning ~40 times a day, so it wasn't really an issue.)


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## StephanieMLW (Oct 10, 2022)

Rob Oldfield said:


> Hi @StephanieMLW ... just to check something... have you figured out how to set up alerts on the Libre?


 
Hi Rob, yes I’ve got them set up  I’ve currently got my low alert set to 4.3, so that I have a chance to address my sugars if they’re dropping towards a hypo (due to my lack of awareness), which has helped me avoid full hypos a few times. I’m not always entirely sure what to do when it gives me a ‘high’ alert, but I’ve found I’m quite responsive to exercise so it generally means my dog gets an extra walk, which he’s happy about!

I’ve also set the alerts up on my husbands phone too - I think as I’m still very new to this it gives my family peace of mind.


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## Rob Oldfield (Oct 10, 2022)

StephanieMLW said:


> Hi Rob, yes I’ve got them set up  I’ve currently got my low alert set to 4.3, so that I have a chance to address my sugars if they’re dropping towards a hypo (due to my lack of awareness), which has helped me avoid full hypos a few times. I’m not always entirely sure what to do when it gives me a ‘high’ alert, but I’ve found I’m quite responsive to exercise so it generally means my dog gets an extra walk, which he’s happy about!
> 
> I’ve also set the alerts up on my husbands phone too - I think as I’m still very new to this it gives my family peace of mind.


Excellent stuff.  You will hopefully find that, over time, avoiding hypos will improve your awareness.  Highs are far easier to deal with if you have a pump where it's easy to take a quick correction dose (though that still does mean, of course, you have to take the dog out for the extra walk).


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## Bruce Stephens (Oct 10, 2022)

StephanieMLW said:


> I’m not always entirely sure what to do when it gives me a ‘high’ alert, but I’ve found I’m quite responsive to exercise so it generally means my dog gets an extra walk, which he’s happy about!


Yes, I used to have mine at 12, but someone suggested it's more useful as a warning that you forgot your bolus and to have it quite high (mine's currently 15).

I think I was better with it at 12 and as you suggest maybe use it as a trigger for a quick walk or something. (I don't forget to bolus nearly often enough to worry about that!) (By the time Libre reads 15 it can take some effort to lower it (extra bolus and a bit of exercise) whereas at 12 things are usually much easier.)


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## Proud to be erratic (Oct 11, 2022)

StephanieMLW said:


> Hi Rob, yes I’ve got them set up  I’ve currently got my low alert set to 4.3, so that I have a chance to address my sugars if they’re dropping towards a hypo (due to my lack of awareness), which has helped me avoid full hypos a few times. I’m not always entirely sure what to do when it gives me a ‘high’ alert, but I’ve found I’m quite responsive to exercise so it generally means my dog gets an extra walk, which he’s happy about!
> 
> I’ve also set the alerts up on my husbands phone too - I think as I’m still very new to this it gives my family peace of mind.


Hello Stephanie,

I have my low alarm set at the upper limit of 5.6. That gives me the maximum time to respond and manage my BG well before I get even near hypo. Also, your sensor is reading your interstitial blood glucose (BG) which lags your actual  BG by anything from 2.5 minutes to 15. So if you should be falling rapidly an alarm at 4.3 may only be confirming what your body should already be telling you - but you said your awareness is not good. Further reason for a higher alarm threshold.

The great thing about Libre is being able to get ahead of what is happening with your BG and that comes from looking at the trend arrows just as much as the actual number displayed. Indeed, neither Libre or any blood testing meter are really accurate (and for that to be so the manufacturing costs would be prohibitive). So scrutiny or comparison of a Libre reading against a finger prick reading (only doable when the trend arrow is horizontal and indicating not much change is happenening at that moment) could mislead you anyway. There is a view that either of such numbers (Libre and test meter) should be rounded up or down to the nearest whole number anyway, since that reflects the maximum accuracy that can come from the permitted tolerance of such devices. So 4.3 may sound very accurate, but it really isn't.

Coming back to an alarm at 5.6. My optimum target is 6; my Endocrinologist keeps telling me that is a tough target if I want to avoid the hypos that were formerly blighting my daily living and I should settle for 7. When my alarm goes off at 5.6 I look at the trend arrow: if it is _sloping_ down I'll eat about 5-7 gms of slower acting carbs, such as a small biscuit. If _vertically_ down I'll possibly eat a single jelly baby or a dried apricot or prune - which are faster acting carbs. For a horizontal arrow I don't eat; BUT for all 3 of those scenarios I  monitor much more closely with flash scanning. If my BG rises, fine; the alarm will tell me the next time I reach 5.6. If it continues to fall then I eat another small snack. Previously I experienced hypos daily and more, some of them pretty deep with BG in mid 2s. This last 10 months I've had no deep hypos and less than one per month of a mild nature. My LibreView reports show several low glucose events, but these are from sensors not reading at all accurately and providing misleading statistics. At the start of this year I was watching and alarm listening like a hawk, but today I'm a fair bit more relaxed, I trust the alarm to warn me and then I'm fairly diligent about monitoring. While sleeping I have my Libre Reader perched on top of an empty small plastic box which provides great volume amplification; it wakes me, but not my wife!

I'm not saying you must use 5.6, it's your personal choice and that choice should be what works for you. But I do think 4.3 is low for comfort at this stage, particularly if your hypo awareness is suspect. A further advantage of using 5.6 for me is that if I find I'm wobbling around that level, but generally stable, I can and do reset it at something like 5 or 4.8, knowing that a rapid drop is unlikely. It gives me a 2nd "tripwire", so to speak.

I promised to send you info about the limitations of Libre and failed. Sincere apologies. Here is a link from a post earlier this year, most of which I stole from @helli,a lady with many more years of D management wisdom than myself.


			https://forum.diabetes.org.uk/boards/threads/hi.99293/#post-1159652


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## StephanieMLW (Oct 11, 2022)

Proud to be erratic said:


> Hello Stephanie,
> 
> I have my low alarm set at the upper limit of 5.6. That gives me the maximum time to respond and manage my BG well before I get even near hypo. Also, your sensor is reading your interstitial blood glucose (BG) which lags your actual  BG by anything from 2.5 minutes to 15. So if you should be falling rapidly an alarm at 4.3 may only be confirming what your body should already be telling you - but you said your awareness is not good. Further reason for a higher alarm threshold.
> 
> ...



Thank you @Proud to be erratic - I had been thinking about setting my alarm a little higher actually as when things drop they seem to be dropping very fast. Your advice here does seem to confirm that could be a good shout! 

Interesting how you approach things with the arrows - I’m starting to build a technique here too, so far I’ve found that if my reading is around 5 and trending down (diagonally not vertically), if I have a small hot chocolate, a little box of raisins or two fruit pastilles it sets things back on track without going into that dreaded under 4 territory. I’m sure that with practice and over time I’ll be able to work out more of these strategies so they become second nature 

An interesting one last night - my low alarm went off at 2am, but the arrow showed I was stable at 4.2. I kept an eye on it and the reading went up to 4.5, but to prevent being woken again if it fell I had my normal quota of hypo correcting sweets. From my chart it looks like that pushed things up to around 6, where it then started to decline again slowly overnight to a 5 upon waking. I do however have the ‘hangover’ feeling today, so I’m looking forward to catching up with the nurse this week, as it seems that even if I don’t hit an actual hypo, the low dips at night are making me feel a bit rotten.

So much to learn but thank you again for your advice - it does feel like some form of normality is now within reach


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## Proud to be erratic (Oct 11, 2022)

StephanieMLW said:


> Thank you @Proud to be erratic


You are welcome. A few nuances in your reply that I'll try and offer suggestions or comments. I'm T3c, with no pancreas, so have no experience of the early days of T1, but my treament is as if T1, ie insulin dependence.


StephanieMLW said:


> - I had been thinking about setting my alarm a little higher actually as when things drop they seem to be dropping very fast. Your advice here does seem to confirm that could be a good shout!
> 
> Interesting how you approach things with the arrows


For me, because my body and Libre aren't good friends, I use the arrows more than the actual number. This morning as I woke up Libre and Actual were very close, 20 minutes later they were almost 3 pts apart; some of that could be lag from Foot on the Floor symptoms (a surge of glucose from the liver on waking) and some just because .....; but it's pretty normal for me to get very little matching of interstitial with actual.


StephanieMLW said:


> - I’m starting to build a technique here too, so far I’ve found that if my reading is around 5 and trending down (diagonally not vertically), if I have a small hot chocolate, a little box of raisins or two fruit pastilles it sets things back on track without going into that dreaded under 4 territory. I’m sure that with practice and over time I’ll be able to work out more of these strategies so they become second nature


I'm sure you will. It does take time and experimenting to find these things out and no one day is necessarily the same as another. 
Do you have half-unit pens, which are reusable pens with disposable cartridges? Less wasteful for the environment and need gamblers fridge space. If not I suggest these would be helpful to you, because some of you bolus doses could be very small and half-units help. Also the pens have a memory cap, that tells you what your last dose was and roughly when; most useful when you have that "did I or didn't I" take my basal or bolus ..... Its easy to get distracted by "things that interrupt" while planning or taking an injection.

I like the little boxes of raisins, they are a good alternative to a dried apricot or prune and less sticky! Fruit pastilles are taking over from jelly babies, for me, as my go to mild hypo response; certainly in the car, where they don't melt in hot weather. I always have a mini pack of haribos in every jacket pocket and/or my trousers pockets. I bulk buy just before Halloween when they are ridiculously cheap for the trick or treats; last year Asda sold them in bags of 42 mini packs, which worked out at 10.2p per 100 gm. JBs are typically 50p per 100gm.


StephanieMLW said:


> An interesting one last night - my low alarm went off at 2am, but the arrow showed I was stable at 4.2. I kept an eye on it and the reading went up to 4.5, but to prevent being woken again if it fell I had my normal quota of hypo correcting sweets. From my chart it looks like that pushed things up to around 6, where it then started to decline again slowly overnight to a 5 upon waking.


If that gradual drop becomes a regular occurrence, it would suggest to me that my basal is a bit too much. Ask your DSN about this. Its very early days for you, so tempting as it s to interpret every movement on your libre graph it is better not to. There are so many other things that can affect one's BG and while sleeping your brain is working at its hardest in any 24 hours, doing all the housekeeping on one's body and the brain only uses glucose, no fats or proteins; so if glucose is in short supply your brain will get protein, fat into carbs - or even  get muscles to release glucose. All of that happening while you sleep, plus any dreams triggering forms of stress and response to stress triggers glucose release ... So not just your snack might be influencing BG activity; it's a complex disease!


StephanieMLW said:


> I do however have the ‘hangover’ feeling today, so I’m looking forward to catching up with the nurse this week, as it seems that even if I don’t hit an actual hypo, the low dips at night are making me feel a bit rotten.


It could be, as your body adjusts to a more even pattern and more in range, that it should adjust to give you better hypo awareness and less symptoms of feeling rotten. Sometimes one's body overreacts and indicates you are hypo, with those horrible feelings, even when your actual BG is fine; if that applies to you, it should settle down. So finger pricking when feeling low, or Libre indicating low is essential to get a true snapshot. If Libre says low that can induce a feeling that you are low and when the fp says not, those feelings magically go!


StephanieMLW said:


> So much to learn but thank you again for your advice - it does feel like some form of normality is now within reach


Yes normality is in reach. It takes time, you've started on a marathon and sprinting is not recommended for any marathon runner. Good luck with everything.


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