20-something T1D Starting CGM

Hi everyone. This is my first post here. I’m thrilled such a community exists for Type 1 patients, and I’m glad to be here. Obviously I am Type 1 (diagnosed at 11) and have just turned 23, which marks more than half my life living with the disease. I started with MDI but now use a Medtronic 670G. My management has been here and there, with my A1C usually being 7-8% but falling as low as 6.0% before the pandemic–ironically when I tested my glucose the least. Now it’s 2 years post-COVID, and I’ve put on some extra weight AND my A1Cs have crept up to 7.2 again.

Obviously nobody wants to be overweight and sedentary in their 20s, so I’m trying to cut back and get my A1Cs back in the 5.5-6.5 range. To that end I have looked into the Freestyle Libre 2 CGM sensor and gotten a free trial, which I’m grappling with now. So far the sensor has been a mixed bag–about half the time it’s worked fine, but the phone app is terrible and throughout the first night it read constant (false) hypos and is doing so again as I type this the next evening. I took some Benadryl on the hunch that it might stop the body fighting with the sensor, but that’s obviously not a long-term solution. Has anyone else had experiences like this with the Libre 2? Does it improve over time? And did I make a bad choice? Any anecdotes or suggestions would be greatly appreciated.

Hi Duncan! @duncan_s I have the freestyle Libre 14 day. It doesn’t have the alarms and probably has a different app for the phone. I have noticed some sensors will give me lower readings than the finger stick. On those occasions, I call up Abbott and they send me a new sensor. However, there are a few things to keep in mind. A CGM measures the sugar in the fluid between your cells. This means that the reading you are getting is 10 minutes behind a current finger stick check. Because of this, Abbott recommends you only compare glucose numbers when the arrow is pointing level (to the right). Also, during the first 24 hours the Libre can be off as much as 30%. I have noticed, as time goes on, that the sensor becomes more accurate. And, using products with salicylic acid will give you lower readings. I had to give up my beloved face wash! :confused: One last thing, I have noticed that the Libre is more accurate for me in the back/side of my upper arms. It is still in the area which is approved, just more on the side of my arm. I hope this helps!

Hi @duncan_s . I have a Tandem pump and use a Dexcom CGM but I’ve used Freestyle as a backup - both the original and the Freestyle2. I wasn’t able to get the phone app to work - maybe because the meter was a sample from my doctor’s office - but I prefer to use the handheld receiver anyway and it worked fine. My numbers have been close to the fingerstick value when I’ve done comparisons. You might check what medications can interfere with the readings for the Freestyle. I hope you find a solution!

Hi Duncan @duncan_s , I concur with what Courtney said, and will add one more “possibility” for you to consider. “Compression Low”, which occur with sensors when outside pressure is imposed, very often when sleeping and rolling onto the sensor and pressing it into your body. These false low readings can also occur when awake and engaging in activities.
I haven’t used Abbott sensors, but I often noticed these false lows with Dexcom Sensors when I placed them on my arms.

I also use the Libre 2 and can offer some advice. The first night of a new sensor I almost always get false lows. At first it was annoying but now that I know what to expect I adjust the alarms accordingly.
I do agree the phone app is less than perfect. But for me anyway, not bad enough to switch to something else.
I would say if you can, give it a month so that you can get used to the trends and what the sensor tells you in relation to how you feel. The best parts of the Libre to me: it’s an easy way to reaffirm your treatments/dosages are correct, and catch any rapidly changing high/lows before they get out of control.

Thank you all for your advice and recommendations. I’ve now been using the free trial sensor for about 4 days and it has been enlightening. The sensor has grown more accurate, but it generally reads about 20 mg/dL lower than the fingerstick number on my OneTouch regardless of trend. I may give Abbott a call and see if they’ll replace it, but otherwise it’s been more than manageable. Hopefully this can be a tool for better control and fitness too.

Is there any reason you got a Freestyle instead of the Guardian that goes with Medtronic 670? I have 670 too and have tried to think of ways to switch out the CGM, which is problematic for me.

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Dee @HighHopes , it is your decision to change to a Freestyle rather than staying with the Guardian which you say is not in your best interest. You are in charge.

Your first step is to discuss the matter with your physician and ask her/him to write the necessary prescription. Once you stare your Freestyle discontinue buying and using Guardian. Keep in mind, that most Medtronic devices proprietary meaning that they will not intergrade - interoperate with anything but Medtronic. I expect that the little extra effort when using the Abbott Libra CGM and a MiniMed pump should be well off-set by less frustration imposed by Guardian.

I’m undecided about what to do. I’ve gone around and around on this dilemma. My Endo was all on board with me switching to T slim and Dexcom, but since we met, I discovered that I have another year under warranty on my with Medtronic! :weary:

Hi Duncan, I’ve been using the Freestyle Libre system since it was FDA cleared in 2017 (my first ever CGM), and started with the Libre 2 a few months ago. I don’t use my phone, prefer to use the reader. I had major problems (error messages) with the first, then second reader and got replacements through Abbott. I’m certain the first two were “lemons” as I had no such problems with the prior Libre systems. Now that it’s working right, I’m thrilled.
Here are my tips: I use two readers so that during the first 24 hours with a new sensor, I still have the older one working which is much more accurate. It takes 12-24 hours for accuracy to kick in. I also turn the alarms off on the new sensor for the first 24 hours (while I’m “overlapping). Since the first reader is free through Abbott, hopefully your insurance will cover the second one (mine did).
This sounds like a lot of effort but it works for me, and I love the Libre system. I tried Dexcom G6 and hated it. If they ever come out with the DexcomG7 I’ll try it, but will stick with the Libre until then.
Good luck !

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Hi @HighHopes . I had quite a bit of time left on my Minimed pump when I discovered Tandem many years ago. I was eager to make the switch so couldn’t wait for the time to run out but in my case it was desire that drove me, not dissatisfaction as I gather is yours. The one thing I can suggest - which sounds completely contrary to using a smart pump - is to use a CGM for the numbers only and make your own corrections. Some people can manage that - others may be truly reliant on the loop. All the best to you!

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I’ve been a diabetic since I was 3 and I’m 34 now. I use the Dexcom G6 (used for almost 3years now) and I’ve NEVER had an issue with mine. Very easy to use and pretty accurate readings from the moment I got it. There was NO waiting 24 hours for it to adjust or anything. You set your alarms for when you want it to go off (high/low blood sugars) or to change out your sensors. Like I said I love the Dexcom G6 and would definitely recommend to anyone!!!

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@Tamara88 Hi Tamara, and a warm welcome to the JDRF TypeOneNation Forum! Thank you for your post, and please continue offering tips and suggestions from your long experience living with diabetes.

Like you, I’ve had a very good experience with the G6, and the G5 for a short while before, and trust the Dexcom reading to be more accurate than any finger-stick BGM.

I appreciate your comments about Dexcom. Do you have a pump too? I’m still working on trading to it and Tandem from my Medtronic 670G. There’s so much on my plate……work, aging parent responsibilities, etc. and recently tore a meniscus and need surgery. It’s still a priority though. It helps to know that a better option is available.