MegaSack DRAW - This year's winner is user - rgwb
We will be in touch
I have out a lot of time into researching diet etc, combining low GI carb foods with good fats / protein to slow down absorption rates and have found that as i have become fitter, that my body can tolerate more carbs as long as they are eaten at the right time, are low GI, and with fibre, fats and protein.
The main finding from the Zoe program is you can change how you absorb sugars / breakdown food by changing your gut biome, which involves eating foods which favour 'good' bacteria/microbes and avoiding foods which favour 'bad' bacteria.microbes in your gut. So, over time you can reduce the peaks by making your gut less able to extract glucose quickly from certain foods.
Although obvs to see this you'd need to use CGM for a lot longer than two weeks and make an effort to cultive the right microbes etc.
I think the conclusion is if you eat loads of crap your get gets very good at breaking down crap quickly, whereas if you eat nothing but spinach for 6 months it will loose all the 'mars bar' friendly microbes...
So far, my biggest take is that there seems to be a massive variation eg I can eat the same breakfast day in, day out and get response X and then suddenly I get a massive spike and have absolutely no idea why. Hence I want maybe 3 months worth of data to draw any conclusions.....
Scud, my youngest started on a closed loop system at Christmas. The biggest advantage is night time… where it keeps them in range all night. Amazing stuff, and hopefully available to more people on the NHS in coming years. Freestyle Libre 2 is very popular,
We live in Norfolk, so funding from NHS for these things always seems to be 6-12 months behind other NHS Trusts, we are currently looking at privately funding a closed loop system, as to be honest going through puberty her well-controlled BG levels before, have gone haywire, so we are often up 3-4 times a night to her, and some days wife and i look like something out of the Walking Dead, not that we'd ever begrudge doing it.
I've been like that for years. Haven't managed to adjust back to sleeping properly yet. They are sleeping soundly though!
I'd say keep pushing at the NHS door. We'd done a few months here and there on self funded CGMs (Dexcom and FSL) when we couldn't get the NHS to supply them... but a closed loop system is big money... because it includes the pump. Crossing my fingers for you and yours.
I’ve bought some more FSL as I’m not done playing with them
I intend to do this too. I found the feedback from Zoe was very interesting, across glucose control, fat control, gut microbes and how different foods affect all these. It is certainly changing how I eat, although I think I was already doing a lot of things they advocate.
One cycling example is I found my club road ride lunch stop strategy of having a cake followed by a savoury dish was giving me a big (for non diabetics) glucose peak followed by a dip. This explained why I often felt quite feeble about 15mins after a stop, and was easy to fix by eating fatty/savoury food first.
anyone without a medical need for this does seem to be playing at being diabetic
No Tom.
but a closed loop system is big money… because it includes the pump.
Friend has two daughters on the closed loop system via the NHS (both T1).
New sensors every 10 days and new pumps every 3 days IIRC. And one of the daughters is allergic to the sensor glue so scratches them off regularly. Must be costing the NHS a small fortune.
There are savings over other ways of controlling things though... eg vastly reduced use of finger prick test strips... those aren't free. Then there is the reduced incidence of requiring hospital stays/treatment. And a closed loop system only uses the same hardware as a (transmitting) CGM and insulin pump... they just talk to each other, and use better software.
I'm signed up for some survey work on closed loop systems - don't have 1 but think I'd like to use 1...hopefully they'll become more readily available but they aren't cheap!
There are savings over other ways of controlling things though… eg vastly reduced use of finger prick test strips… those aren’t free. Then there is the reduced incidence of requiring hospital stays/treatment. And a closed loop system only uses the same hardware as a (transmitting) CGM and insulin pump… they just talk to each other, and use better software.
I think prior to the pumps they were just injecting.
But yes, probably cheaper overall. I guess I just think of the NHS as being used for acute things, whereas there are people with chronic conditions who end up as rather expensive lifelong customers...
Somebody needs to come up with a way to regenerate Beta cells.
I’ve previously commented on this topic about using the Libre 2 and said I was moving onto the Medtronic Guardian 4 at some point. I have now been on the Guardian 4 for a week and I’m pretty impressed so far but I’m still learning how to use it and it’s learning how to correct me.
Installation - pretty fiddly with one person and on the back of the arm. Good news is that an all in one sensor/applicator is meant to be out in approx 6months.
Usage - I’ve had a couple of highs and a couple of lows, the low corrections are different and don't really require carbs as the pump has stopped insulin delivery long before the low it seems. With high bloods it seems to do lots of little corrections and increases basal rates but it’s an iterative process and it learns from each time it happens updating the algorithms.
Not had a graph like this for a while for that long! 
Saw the Libre3 out in the wild this week. Really small.
We're having issues with supply of Libre2 with my son's pharmacy. They owe him 4 (two months supply). Useless they are.
Meant to add we'll be chatting with his DSN to see if a CGM is possible. He is 22 though, so they might not talk to me. He's somewhat lazy at checking and probably has ADHD (referral made).
Yeah it got to a point where I had to take over and make those sort of decisions. I’m 28 now and glad I did have the conversations with my diabetic nurse!
Medtronic Simplera CGM to replace Guardian 4
“ It is a disposable CGM that follows the stying of FreeStyle Libre, being easy to apply and half the size of a Guardian 4 sensor (but similar to Libre 2, not the newest Libre 3 sensor. “
We’re having issues with supply of Libre2 with my son’s pharmacy. They owe him 4 (two months supply). Useless they are
Not as simple as that. The sensors are not available through the usual same/next day wholesalers. Only available for pharmacies to order direct from Abbott and then shipped by UPS. Can wait nearly week for deliveries, especially with bank holidays. At my work, our monthly bill for Libre 2 sensors is £4000! My boss orders in once a month but you can understand why pharmacies don’t want that much stock of one item sitting on a shelf.
Not had a graph like this for a while for that long!
Show us your percentage in range! That’s exciting to watch in the first month as it gets bigger and bigger.
Medtronic Simplera CGM to replace Guardian 4
Oooo… the Guardian is pain in the ____ to apply single handed.
This is my time in range from today which I’m fairly happy with for now with it being so soon going onto it. 
I must admit i’m struggling with the new way of thinking when it comes to correcting hypos and the pump wanting to give me insulin even though my bloods are low.
Just picked one of these up to use over next few months to try to improve my diet a little and see if it gives me a little more energy as have been feeling lethargic recently
As expected, my average is in a healthy range, but some of my spikes look a bit sinister. Baked potato and pineapple cottage cheese for lunch today shot it up to 10 for a couple of minutes before dropping back shortly after. I dread to think what’ll happen next time I eat a bit of cake!
interestingly the highest spike in todays daily graph is around 8.5, it’s not showing the 10 reading. Does it not map the very short peaks, and if not how do you know you’ve had them unless you are watching the numbers in real time? Is there a way to review the peak numbers?
is the goal to avoid peaks? Or are peaks fine as long as they come down quickly and the average is in normal range?
There will be an overview piece where it should report time in range (whatever you've set that as), time above and time below range.
Spikes are going to be short-lived for a non-diabetic, so it may not show it on graphs unless you zoom right in to the timeline (if you can).
If I don't eat anything, the pump and Dexcom solution is working very well indeed. I'm needing to work on the food intake - I seem to get a spike that takes a while to come down so I suspect my dosing solution isn't quite right, so something I'm experimenting with. Really wouldn't go back though, it has been a brilliant improvement.
@J-R Yep. About 6 months ago I noticed my hba1c was on a bit of an upward trajectory so coupled with fact I was having a few low energy moments on the bike, decided to get a set of these and make steps to better diet. Had them for months in the cupboard so finally thought I’d test them out
My fasting blood sugar appears to be fine, my ‘post 2 hrs after dinner’ appears to be fine, but every time I eat anything it shoots up to over 9, albeit only for a few minutes before dropping down again. No idea if that’s meant to happen to tbf, Certainly I’m not running round the room on some kind of sugar rush
for some reason I thought my graph would be far more ‘flat’ than it is..OP’s seems pretty wavy also.
Yes, that sounds normal...eat any carbs and there will be a rise, but it shouldn't last long. Depending on how fast acting and how many carbs you eat, the spike may go up a bit higher or a bit lower...
My fasting blood sugar appears to be fine, my ‘post 2 hrs after dinner’ appears to be fine, but every time I eat anything it shoots up to over 9, albeit only for a few minutes before dropping down again. No idea if that’s meant to happen to tbf, Certainly I’m not running round the room on some kind of sugar rush
Mine only spiked if I ate simple carbs eg a load of white bread, if I ate a 'healthy meal' it would rise a bit, but no where near 9.
are you taking the ‘not above 9’ number from the graph on the app, or from the libreview page? My app graph has never been above 8 but I’ve seen readings of 10.
So clearly the app doesn’t capture peak values if shortlived.
I used a CGM from the ZOE study for a couple of weeks. What they say and what I learned along the way is:
- With exactly the same intake of carbs individual non diabetic people's responses varies widely, from almost no response to a big peak followed by a dip below normal levels. ZOE says this is at least partly caused by variations in individual's gut microbiome.
- You may get low energy periods a while after taking in a lot of simple carbs (such as cake at a coffee stop) because your big peak is followed by a glucose crash. I've certainly had this happen to me a few times. Your body starts to make lots of insulin to get rid of the big blood sugar peak and you start exercising - with both these mechanisms working together most of this sugar gets eliminated and you get a blood sugar low until the body eventually returns to equilibrium.
- Methods to control this include avoiding simple carbs (eg cake), or only eat the simple carbs immediately before you restart your ride so the extra sugar is immediately used in you muscles as it gets into your bloodstream, or eat something like nuts 10 mins before any simple carbs, take in your carbs as part of a meal including plenty of fats because this reduces the rate at which your body digests and absorbs glucose. Generally this seems to work for me, but we are all different so it may not work for you.
That’s really insightful
sounds like are you saying that if you are one of those folks that have a higher peak you’ll be more likely to suffer after a cake stop . Which I can relate to unfortunately
Maybe worth looking at Jessie Inchauspé instagram or website to get an idea of the variaton in glucose graphs and some of the factors that can influence the level of spikes.
I see a few people on here are doing the Zoe thing.
One question.
1. Do you think it's worth it?
Of course, I'm assuming no one lies about Q1 just to make a bit of a saving.
So the trial is £300 from what was said ☝️
A pal suggested that just paying for the app / advice subscription for 4 months (at £50/month) gave you all the knowledge and feedback you needed. Is that what others think?
So it would be £500 for that...same question as @Onzadog, do folk that have done it think it's good value?
Looks to be £300 for the initial test kit and then a sliding scale of monthly subscription depending on how long you want it.
No denying it's a big chunk of cash but if it really is personalised then maybe it's worth it.
I've seen others online suggest that you might as well just buy his book and eat better, but it's not clear if those people actually went through Zoe or are just bagging on it.
1. Do you think it’s worth it?
Having done it, no, not worth the money.
Was interesting, but I would recommend just buying a Free Style Libre yourself.
Think I paid something like £450 all in. Their App is just shite - whatever you eat it's bad for you, unless you only boiled cabbage and broccoli for the rest of your life. Anything which tastes of anything and it tells you you're poisoning yourself. I've never come across anything so demotivating in my life before. I just deleted it.
Just buy his book and you can read about how you're poisoning yourself with everything you eat for £425 less...
Thanks for that, a very definite stance there 😃. So the gut biome bit didn't really make a difference?
So the gut biome bit didn’t really make a difference?
The initial results were interesting, but not really worth £450.
The App and the continual monthly thing isn't worth anything IMO.
The basic message is you want a good gut biome and for that avoid processed foods and try and eat as varied a diet as possible eg 20 different food types a day, 40-50 a week.
NB Not as hard as you think as nuts, seeds and spices each count as one, so a handful of mixed nuts and seeds and 6 spices in a curry can get you half way there...
We've both changed what we eat as a result as I try and vary my diet much more than I used to eg I have eaten the same sandwich for lunch for several years on the trot every day! Now I make sure it's different every day of the week.
The other weakness of Zoe, is you don't get a second gut biome test, so they score you on day 1 and then you change your diet, but never find out if it worked...
Also, f*** me nuts are expensive. Now have a handful on my cereal in the morning and costs a small fortune...
Book plus nuts it is then 👍