Hatching a plan with my diabetes expert

I had an appointment last Wednesday at Northern General Hospital with my diabetes consultant. This will be the first time I have seen my doctor since deciding to undertake the challenge.

I had two main points to discuss, number 1 the problem I am having with my CGM of which I keep getting sensors going faulty (the company suggested I spoke to my consultant) and secondary the action needed to try and keep my blood glucose levels stable / up during the ride.

I initially told the expert about my challenge and went on to the sensors. She did tell me that generally there were no widespread problems but some patients do seem to have problems with sensors? Howerver there is no known reason.

Due to my challenge and these issues she suggested I looked at an alternative manufacturer. The system is called Dexcom system. There were several advantageous to the Libre.  The main one is that it communicates to android and Apple phones which warns of impending lows and highs via Bluetooth. This would be great whilst cycling as I would not have to swipe my arm with the handset and I could do something about my glucose intake before I hit rock bottom. Also you can share all your patterns with your doctor.

I did ask her that instead of looking at Facebook at night does she check on all her patients and send a quick message at 2 am if she identifies a problem? Apparently not at 2 am !

The main advantage would be massive to me. Howerver there must be negatives as normal. They are only negatives in comparison to the Freestyle Libre product and No. 1 is cost.

The sensors are around the same price, howerver they are only guaranteed for 7 days and not 14 days like the Libra. Apparently although providing you keep calibrating they normally last patients 2 -3 weeks !

Also on top of this you have the Bluetooth transmitter which sits on top of the sensor, these needs replacing every 3 months. The cost of this is over £200 per three months. So over all I would estimate it to be twice the cost compared to the Libre.

The next problem is phone compatibility. I currently have an Android HTC10 which is relatively new. Howerver Dexcom don’t support any HTC products. So In the end that’s the end of that unless I want to shell out twice the cost and buy a new phone I don’t want.

I then went on to managing diabetes whilst cycling etc. It was certainly obviously that shovelling 10-15 portions of carbs down my neck was not correct and I would probably not lose any more weight.

My expert advised me to cut down on my long acting morning insulin on a cycle day and balance this by using more quick acting before the bike ride.

Simple way to understand this is that you need a tiny amount of insulin all the time to function, the way this is achieved is by using some slow acting insulin throughout the day and night. This releases a very slow amount to enable you to live. Then when you do eat some carbs you use quick acting insulin to combat what you have just eaten.

Yes it sounds too easy. The thing is you learn how much quick acting you need per carb. A good example is in a morning I have one unit of insulin per 10g of carbohydrates. However, at lunch time I have 1.25 units for 10 grams. So the ratio of quick acting compared to what carbs you eat changes throughout a day and I can’t use the same ratio when using a less amount of background insulin.

So I tried this the following day and I had some success in terms of the ride but not in the day time. My insulin levels whilst munching on a couple of cereal bars over 2.5 hours did not fall. Hooray!

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As you can see I did run a little high inthe day time due to lack of long acting insulin. You can see where I had my dinner and then I did some corrective quick acting and was reading 7 when I started at just after 5pm. I need to re-learn what ratios to use on a ride day. Hopefully this will do the trick.

More experimentation to do but I am 50% there!

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