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monitor cgm and finally something happened the other night that validated my desire since i was diagnosed with type 2 diabetes to have a cgm it is extremely problematic to wake myself up in the middle of the night to use my stick meter to see what my blood glucose levels are so a cgm that takes measurements once every minute is exactly the right tool for this job i ve often wondered what my blood glucose levels are when i m sleeping and for the most part they ve remained stable but the other night something caused my blood glucose levels to drop close to 50 mg dl i have no explanation as to why this happened i don t take medicine or insulin injections to control my type 2 diabetes so i can t attribute a poor application of medication for this i didn t do anything odd that i know of with regard to straying from my paleo lifestyle and this drop occurred around 3 00 am so it s not like i jumped up and ran a 5k in the middle of the night on an empty stomach although i haven t found a causal explanation for this i ll be watching this closely now that i know this happens posted in diabetes paleo 4 comments comparing blood glucose measurements of abbott freestyle libre vs livongo posted on 14 jul 2018 by highvoltage i ve been using the abbott freestyle libre continuous glucose monitor cgm for about 9 days now and i ve had the opportunity to compare its blood glucose measurements with the livongo stick meter that i ve used for a couple of years now the following graphs show the comparison of blood glucose measurements between the freestyle libre and livongo meters line represents zero delta between measurements of the two meters i have several brands of stick meters that i routinely compare and there is always a delta of at least 10 20 mg dl so i m not surprised that these two meters don t measure the exact same blood glucose levels blood glucose meter accuracy is about 20 so even multiple measurements with the same meter won t line up exactly and can vary by 20 a blood glucose meter is no different than other meters that measure things like temperature pressure flow rates etc there is an accuracy stated for the meter but that accuracy may not hold true for the entire range that the meter can measure usually the meter manufacturer will have a tighter accuracy in a range where the measurement is more important for example with temperature it would be in the middle of the range where the temperature control system would expect to control while i can t find this information in the literature for blood glucose meters i d expect the accuracy of these meters to be tighter at measurements 75 mg dl because low blood glucose level can kill you quickly so while i m not surprised that the freestyle libre and livongo meters have deltas in their measurements i am surprised that the delta between the freestyle libre and livongo is always positive i would expect some to be positive and some to be negative as the natural variation in measurement accuracies play out but the fact that 12 of the 13 comparisons were positive 1 comparison had a delta of 0 leads me to assume that one of these meters has a consistent offset now it should be stated that i have no idea which meter is closest to my actual blood glucose levels but that really doesn t matter as long as the deltas continue to be consistent with frequent blood glucose monitoring the absolute value of these measurements isn t what s important what you should be looking for is trends in the measurements that can be correlated with a diet or lifestyle change as i stated in an earlier post i intentionally went off my typical paleo diet for the first week of using the cgm so i could see what my blood glucose levels were after non paleo meals but next week i ll return to my normal paleo diet and i will be interested in seeing if the delta between these two meters decreases as more of my measurements are 100 mg dl if my theory about blood glucose meter accuracies being tighter at the lower range is true this should play out in the data as my blood glucose levels drop to those lower ranges posted in diabetes paleo 3 comments first experience with cgm posted on 08 jul 2018 by highvoltage as i ve written about recently i m coming up on my 5 year anniversary of abandoning prescription medicine treatment of my type 2 diabetes by using the paleo lifestyle and followers of this blog should have noticed that i ve done that by using data to drive my decision making process and while i ve tried on occasion to take frequent measurements per day to assess what impacts diet and exercise have on my blood glucose levels there hasn t been a way to monitor my blood glucose continually i e every few minutes and it s just too much of a hassle to prick your finger dozens of times a day and expensive there have been continuous glucose monitors cgm out on the market for many years now but they have mainly been used to pair with insulin pumps and that really doesn t help type 2 diabetics out who don t need insulin injections but recently two new cgm devices have been approved by the fda that don t need to be paired with insulin pumps dexcom g5 and abbott freestyle libre i recently got the freestyle libre and started using it yesterday and i d like to share some of my initial findings what s in the box first off the freestyle libre system involves two devices a reader and a sensor the meter is a handheld device that looks very similar to a normal strip reader and while you can use abbott strips to perform instant readings of blood glucose levels the beauty of the cgm lies with the sensor the sensor is a disk that has a needle that inserts below the skin and this is how it takes glucose measurements every minute inserting the sensor each sensor can be used for up to 10 days and they come packaged individually with a special application device and alcohol wipes the sensor can only be installed on the back of the upper arm where your triceps are and i didn t need help with this as it was easy to do you pick up the sensor with the applicator and then push the applicator against the skin to ensure the needle and sensor properly attach to your arm there is some sort of adhesive that makes sure the sensor is securely attached more on the quality of this attachment later full disclosure i m not a guy who likes needles and i m quite the pansy in that regard and i m not particularly proud of that with that being said i will say that there was a brief amount of pain that lasted a few seconds when the sensor was applied and there was a dull ache pain for about an hour but after that i forgot the sensor was there obtaining blood glucose data after you insert the sensor you then activate it through the reader but for some reason you have to wait 12 hours before you can take your first reading i don t know if this 12 hour delay is only for the first sensor you apply or for each new one and i ll find that out in about 10 days but after the 12 hour delay you can download data from the sensor by turning on the reader and placing it about 1 2 inches from the sensor the reader beeps and then you see a graph of blood glucose levels for the past 8 hours you can add notes such as info on the meal you just ate and insulin injection by tapping the pencil icon which takes you to other menus glucose readings compared to stick meter i use the livongo meter to take instantaneous glucose meters via the traditional finger prick stick method and i compared blood glucose measurements ug dl between the livongo meter and the freestyle cgm 4 times over the past 24 hours livongo freestyle libre cgm 150 157 129 143 111 111 104 129 as you can see the freestyle libre cgm was mostly higher than the livongo meter with an average of 11 5 mg dl now it should be noted that the livongo meter like all glucose meters have a larger margin of error than i d like to see and i m sure the freestyle libre cgm and livongo are no different that is why i ve always said to pay attention more to trends than the absolute values of individual measurements but this is something i ll continue to watch to see if this delta continues or if the average goes to zero as the sample size gets larger i will say that i have good confidence in my livongo meter because i ve seen good correlation with my a1c measurements i get from my doctor s office during my visit last month i had an a1c reading of 6 0 which corresponds to a blood glucose level of 126 ug dl and from my livongo data i ve averaged 127 ug dl for the last 90 days the beauty of cgm data ok so that is the extent of my experience for the first 24 hours using this meter and expect many posts in the future as i dive into this new treasure trove of data but i couldn t wait to analyze this data since this was my first experience with a cgm i wanted to really put my body to the test by deviating from my paleo diet and eating a couple meals of high carbs and follow that up with exercise to see how my body reacted for the past two days prior to exercise i have eaten a breakfast that consisted of 4 eggs and three pieces of ciabatta toast with butter and blackberry jelly grains and jelly are basically verboten for me under paleo but i have previously discovered that i can eat those prior to intense physical activity with no detrimental effects to my blood glucose levels but that was when i measured my blood glucose levels after exercise and i had no idea what happened between the 2 hours after the meal and the end of my exercise now with the cgm i can see what happens the two physical activities i planned were golf on 06 jul 18 and riding my bike for 20 miles on 07 jul 18 golf is not nearly as strenuous as riding a bike for 20 miles so i mainly want to focus on 07 jul 18 for right now as you can see from the screen cap from my fitbit app it took me about an hour and a half to ride 20 miles the manual for the freestyle libre states that the sensor is water proof up to 3 meters but swimming should be limited to 30 minutes during the bike ride i was subjected to rain for the entire hour and a half of the ride and the sensor not only maintained its electrical functionality but stayed firmly attached even after the shower after the ride so the robustness of the sensor to water was validated i finished my breakfast on 07 jul 18 around 10 30 and left on my bike ride at 11 05 as you can see from the graph below my blood glucose level peaked around 250 ug dl at 11 20 but then came down to 97 when i finished my ride at 12 35 it should also be noted that i had a dinner of pork zucchini and mashed potatoes that caused my blood glucose levels to peak at 173 approximately an hour after the meal potatoes are bad for me as they cause my blood sugar to spike more than if i ate something with a high content of sugar i should also add that the freestyle libre has an app program that you can download to your computer to export the data to reports and the options available are shown in the pic below so much more to come regarding my new cgm later but after the first 24 hours i m extremely happy to have this new technology to help me control my type 2 diabetes posted in diabetes paleo 5 comments paleo 5 year anniversary posted on 15 jun 2018 by highvoltage it s been almost 5 years since i abandoned the treatment for my type 2 diabetes prescribed by my endocrinologist janumet and adopted the paleo lifestyle and i m happy to report things couldn t be better i went in for my annual physical recently and my a1c is still in the high range of a normal person without diabetes or to 6 0 and this is much better than the insane guidance from the american diabetes association that says folks with type 2 diabetes should have an a1c less than 7 which they push can only be obtained through medication red line signifies when i went off mediation and adopted the paleo lifestyle everything in my comprehensive blood work was normal but i d like to make a point that my triglycerides came down from a high reading the previous year these readings should be below 150 mg dl i attribute this to both the lack of exercise i had in early 2017 as opposed to the increased exercise regime i adopted toward the end of 2017 and continue today i signed up for a group relay race that amounted to me running two 10k legs with only a 5 hour break in between and i m convinced that the training that led up to that race helped drop my triglycerides back to normal levels that is the only explanation as my diet didn t change in the past 2 years and the only variable was the amount and intensity of my exercise i should also note that when i was starting to train my body to be accustomed to running twice in a single day i ve been a runner for the past 19 years of my life and i can attest that running twice in the same day is no easy task i noticed that i had to deviate from my paleo diet and eat grains and a higher level of carbs during the days i pushed myself to run twice at first i stuck to paleo on the days i ran the doubles but when it came time for my 2 nd run of the day my legs were dead and i had no energy so allowing myself to cheat on those days gave me more energy for that 2 nd run and my blood glucose levels on those days never strayed from levels associated with someone without diabetes they were routinely around 100 mg dl it was amazing that i could eat pancakes muffins and pasta on those days and it was like i got a free pass even with my body s dna which predisposes me to be insulin resistant increasing my exercise drastically compensated for that and my body found a way to clear the glucose in my blood stream and metabolize it in my cells i guess this is why you never hear of professional athletes who contract type 2 diabetes because their exercise regime prevents buildup of glucose in the blood stream posted in diabetes paleo 4 comments older posts follow cosmoscon com blog via email enter your email address to follow this blog and receive notifications of new posts by email email 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