Blood sugars

dawn28378

Active Member
Messages
25
I'm very much aware that blood sugar testing is also about keeping the blood sugars with in a normal range but if you will recall, my original question was in fact, when was the best time to test his sugar after eating a meal. I don't particularly want to pick this post apart! I'm not into playground behaviour. I prefer the meter which I do in fact find incredibly accurate and the one we use came recommend and read as accurately as the readings he had at the hospital. You obviously worship the sticks you use....so lets leave it at that!

As for using the lancets multiple times amd not becoming infected...I have seen enough patients come into us with infected sites from using the same needles or lancets multiple times in needle sites or port sites and becoming infected to know that the skin does not hold its own septic qualities or at least not enough to fight of a proper infection introduced through using a lancet or needle in such a way. If you introduced a Staph infection through your finger using a lancet..your 'skins natural disinfectant" couldn't fight it off". You have natural flora on your skin...yes...but not thing that will fight off a proper nasty infection that was doing the rounds.
 

Thundercat

Well-Known Member
Messages
2,406
Type of diabetes
Type 1
Treatment type
Insulin
I check before eating and injecting and 2 hours after eating. With regard to visual strips - I appreciate that they work for some but I have had diabetes lomg eenough to have used them before meters became freely available and I would not go back. As mentioned, they are not accurate but also give a ballpark figure. For me personally there is a big difference between 4.1 and 4.9. Maybe it's just psychological but I like the decimal point. Not everyone has perfect bg all the time so the notion that they are inaccurate over 8 would give me no peace of mind. I know everyone is different but that's my tuppence worth. I would like to add, at the risk of having my head taken off, that I think it is inappropriate to suggest to someone when they should pm. We are all just pooling our knowledge and the more input the more knowledge we receive.

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Neil Walters

Well-Known Member
Messages
265
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
not being Grumpy
Dawn if it is the peak you are looking for then perhaps one hour and two hours after food will give you a better profile? There are occasions when even more regularly than that might be required but I think you are looking for the peak and two hours after starting the meal seems to find it for me.

Your little chap might be different - test, test, test and you will find the right time in time.

The best advice I could give you today would be that on occasion simply breathing out and ignoring what you have just read is the most sensible thing to do but as I write that it sounds so patronising which is not how I meant it sorry.


Diagnosed Type II 1998 1 x 80 mg Gliclazide, 4 x 500mg Metformin and 1 x 100mg Sitagliptin - HbA1c - 48 mmol/mol
 

dawn28378

Active Member
Messages
25
It's not patronising at all. And I appreciate everyone input. It is after all why I asked my original question. I am very new to this and want to do what is best for my wee man. I know in time I will find what works best for him but asking questions is what wilk help me find things out in the meantime and it helps to know there are patient, helpful people out there. :smile:
 

Hellbunny

Well-Known Member
Messages
240
Type of diabetes
Type 1
Hi Dawn, I test 2hours after eating as I sometimes inject 20minutes before eating if its a high GI food. Really ignore all this visual test strip lark, I've had the lecture on here and it seems whenever someone asks a question in regards to testing they get bombarded with the visual test strip ritual, and rye bread too, I've used blood sugar meters since being diagnosed and there's no way I would change to visual read strips for the sake of the NHS saving money, I think he has shares in them or something.

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mo1905

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4,334
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Dawn, it doesn't really matter exactly when you test, before or after eating. The main thing is what suits you best. It is patterns and trends that you are looking for, not individual readings. There is no right or wrong time to test. Some test 2 hours as they begin to eat, some 2 hrs after finishing eating. Just pick what you prefer and stick with it. Good luck !
Mo


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Messages
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dawn28378 said:
My 5yr old has only been diagnosed T1 for three months and I wondered if someone could clear something up for me. One DSN has told me to check his blood sugars two hours after his pre meal insulin and one has told me to check it two hours after he has actually finished eating. What do you usually do? I am going to ask his DSN's but I'm curious. X

Hello dawn and welcome. I test 2 hours after I have finished my meal.

I just wanted to say that any advice or information given on here by any member, especially regarding a child's medication or how you are controlling it, should be taken lightly and always check with your DSN/Hospital consultant or your own GP.

It should get a little easier in time with your child's diagnosis, it can be harder for the parents then the child. Children are tough little cookies and I'm sure he will have a full and happy life.

If you have any more questions, there are plenty of other parents on the forum who may be able to help, as they have or are going through probably the same thing. Good luck.

Take care and best wishes RRB :)
 

dawn28378

Active Member
Messages
25
Mo, Hellbunny, RRB and Neil....thank you. I know I can only take the advice given on here at face value but it is good to hear what other people do and how they cope with their diabetes. It could be that something someone does with their diabetes might show me an easier way of doing something with my boy. Or maybe asking questions on here about snacks or mealtimes or exercise might help me figure out why he's going high or low or something. It can help to have an unbiased eye sometimes. I would never change my son's regime or medications because of advice given on here and I really think it would be silly of anyone to do that.x
 

mo1905

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dawn28378 said:
Mo, Hellbunny, RRB and Neil....thank you. I know I can only take the advice given on here at face value but it is good to hear what other people do and how they cope with their diabetes. It could be that something someone does with their diabetes might show me an easier way of doing something with my boy. Or maybe asking questions on here about snacks or mealtimes or exercise might help me figure out why he's going high or low or something. It can help to have an unbiased eye sometimes. I would never change my son's regime or medications because of advice given on here and I really think it would be silly of anyone to do that.x

Well said Dawn and good advice from RRB regarding checking with your healthcare providers. As you rightly say though, knowledge and experience from others could just lead you to either understand your docs advice better or to ask the right questions. There are some excellent docs out there but there are also a few that have given shoddy advice to a few here too.
RRB is also totally correct in that children are very adaptive and resilient and will generally cope much better than parents lol ! Good luck.
Mo
 

dawn28378

Active Member
Messages
25
Thanks Mo! My son (Toby) has been amazing! Since his diagnosis in April he has learnt to take his own blood sugars and he's learning to recognise the signs of hypo's and hypers. He recognises on his meter when his sugars are low and he knows if his readings show he's in a hypo. He's just not all that great at recognising it physically yet. He aleady knows the foods he needs to refuse when he's visiting friends or at birthday parties and quite openly says "I can't have that because it will make me ill". He has a wobble now and then when he wants something and his sugars are high and says "I don't want to have diabetes anymore" but in all honesty, I sometimes think he's adapted much better than we have. :smile:
 
Messages
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dawn28378 said:
Thanks Mo! My son (Toby) has been amazing! Since his diagnosis in April he has learnt to take his own blood sugars and he's learning to recognise the signs of hypo's and hypers. He recognises on his meter when his sugars are low and he knows if his readings show he's in a hypo. He's just not all that great at recognising it physically yet. He aleady knows the foods he needs to refuse when he's visiting friends or at birthday parties and quite openly says "I can't have that because it will make me ill". He has a wobble now and then when he wants something and his sugars are high and says "I don't want to have diabetes anymore" but in all honesty, I sometimes think he's adapted much better than we have. :smile:


Hi You both sound as though you are handling diabetes very well and your son is doing remarkably well, even though he was only diagnosed in April, well done to you both :clap:

I hope you have a good weekend

Best wishes RRB
 

JontyW

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Messages
89
Type of diabetes
Type 1
Treatment type
Insulin
Dislikes
Ignorance & Arrogance.
I have been Type 1 for 43 years with no complications since I've kept my HbA1c < 7.5%. My target was higher than usual since I used to have a vulnerability to unexpected hypos, but that has been totally eliminated now (in the last year) since I have been accurate carb counting following DAPNE guidelines using basal/bolus regime. My last HbA1c was my best ever at 6.3%. So I know exactly what carbs I'm eating, also know the Insulin-Carb ratio (Humalog units per 10g of carbs), and adjust my Humalog based on the Ratio from the previous and average of previous 3 days achieved BG compared to my target of 5.5 after 4 hours, prior to next meal. This works really well and but I realise you can do similar things using a smartphone app.

I record everything (insulin dose, carbs, achieved BG before each meal etc) on a daily basis in a detailed spreadsheet which updates trend graphs and provides excellent visibility of how well I'm doing within my target levels. I of course always use an electronic meter, which in my extensive experience is easily the quickest and most accurate (displays exact BG numbers, always repeatable within a small margin of 10% and which Excel understands and uses to calculate projected insulin dose needed for next carbs)! Not way should a Type 1 be using the visual strips .. what is that all about!

Anyway, in answer to "dawn28378's" original question ..

My 5yr old has only been diagnosed T1 for three months and I wondered if someone could clear something up for me. One DSN has told me to check his blood sugars two hours after his pre meal insulin and one has told me to check it two hours after he has actually finished eating. What do you usually do?

You haven't stated what Insulin regime Toby is on, so much of what i say later on may not yet apply if not on a basal/bolus regime. The recommendation from many people that I have seen, is that the time should be from .."When you start eating i.e. the start of the meal" e.g. "2 hours (after 1st bite) seems to be the industry norm - when to test after meals" is one I've just found, and this assumes that the quick acting insulin has been taken just before the meal.

Nearly all the diabetes web sites just say "2 hours after the meal", rather than saying at the start or the finish. If the meal is eaten quickly, as most Americans do, then it hardly makes much difference, but with a young child like yours I can imagine meals can take longer. Personally I always test after 4 hours, just before the next meal, since that tells me exactly how effective my insulin/carb value actually was. I will sometimes test after 2 hrs, after the start of the meal, just to check particular food types which are new to me. The key point is to always do it based on the same (start or finish time) and repeat for at least 3 days to get a consistent picture since often the same carbs/dose can vary day-to-day due to varying absorption rates and other factors.

Anyway, your son is probably not yet on a basal/bolus since it is not always considered suitable for young children, but at some stage in the future he will be migrated to that. So here a few links that you might find useful to increase your knowledge (for diabetes management, knowledge is indeed power!)....

Books you should consider purchasing:-
Carbs & Cals: A Visual Guide to Carbohydrate & Calorie Counting for People with Diabetes (Chris Cheyette)
Buy this excellently illustrated book that provides clear pictures, portion sizes & weights plus carbohydrate values of nearly every food you might need.
http://www.amazon.co.uk/gp/product/0956 ... 01_s00_i01

Type 1 Diabetes in Children, Adolescents and Young Adults (Ragnar Hanas)
A comprehensive book with great detail in all aspects of managing diabetes with emphasis on children. This is easily the best book I have ever read about managing Type 1 diabetes, so if you only buy one book …. this is the one.
http://www.amazon.co.uk/Type-1-Diabetes ... gnar+Hanas

Documents available on the internet:-

An introduction to carbohydrate counting and insulin dose adjustment

https://shop.diabetes.org.uk/store/lite ... -book.aspx
An excellent introductory document from Diabetes UK that covers all aspects of diabetes, and the method of carb counting, insulin adjustment and insulin-carb ratios is covered in Chapter 2 (Carbohydrates) and Chapter 3 (Insulin). Even if you are not doing carb counting, you should definitely read this!

Basal Testing … how to check your Lantus or Levemir dose is correct
In the absence of food, exercise and mealtime/bolus insulin, basal insulin should hold the blood sugar steady. Any significant rise or fall in blood sugar during a fasting basal test probably means that the basal rates need to be adjusted - even if the blood sugar winds up near normal by the end of the test. This is how to check it ….

http://www.diabetes-support.org.uk/info/?page_id=120

Children with Diabetes in the UK (online support group)
http://www.childrenwithdiabetesuk.org/

Last point: someone earlier mentioned about being wary of some of the advice given on this site, and I would strongly agree with that, so I tend to find this diabetes support better from that point of view. It is supported by the main charity Diabetes UK ... have a looksee...

http://www.diabetessupport.co.uk/

Hope you find this useful, but ALWAYS CHECK with your DSN before making any changes, just to be sure.

Best of luck to Toby ..

JontyW
 

dawn28378

Active Member
Messages
25
Hi Jonty...I already have the Carbs and Cals book and find it very useful. We are doing quite a bit of carb counting with Toby already. We keep him to around the same amounts for his meals and snacks. He's not on a proper carb counting regime yet as he is still in the "Honeymoon period" so he's on set doses of Insulin that gets adjusted by his DSN's if they feel he needs it. His doses just now are quite small. Levimir 1mmol in the morning, Novorapid 2 mmol before breakfast. Novorapid 0.5mmol at lunch and Novorapid 1mmol before supper. But that could all change tomorrow as he's so unstable. Two weeks ago he was hypoing through the night and all last week he was hitting the 20's during the and all through the night. It's very frustrating. Thank you for the books titles, I shall copy them down source them. The other book I have is "Diabetes for Dummies"! ...not the best! And I'll have a look at those links. Thanks for being so helpful. Its very much appreciated. X
 

JontyW

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89
Type of diabetes
Type 1
Treatment type
Insulin
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Hello Dawn,

Just a quick point about the UNITS that are are used for the various measurements in diabetes control.

You state hear the the insulin your son has is e.g. Lemimire 1mmol in the morning. Insulin is always measured in "insulin units" and you have confused this with the units used for blood sugar.

Blood sugar units are:-

1) Recorded on the meter is mmol/L e.g. a good value would be 5.5 mmol/L

2) Long term (last 3 months) HbA1c test taken by the hospital or nurse is mmol/mol (new units) or % (old units).
So a good value for HbA1c, showing you are under good control for last 3 months, would be 6.5% or 48 mmol/mol

There is so much to learn about diabetes in the early days, so no one is surprised if you get such things mixed up slightly, and in case it is no big deal anyway. But I think you seem to have the right attitude and Toby is also getting to understand well as such an early stage. If you read those links I sent you will gain a lot of knowledge which will put you up the learning curve much faster. His insulin dose is really small at present, and that makes it more difficult for accurate control. In my case my total daily insulin is about 60 units, but everyone's requirements are different.

Jonty
 

dawn28378

Active Member
Messages
25
Thank you Jonty. It helps to have friendly advice and someone to point out little things. And your right, there is SO much to learn! His DSN's changed his insulin again today as he's had a pretty rough time the last 4 days of being quite high. So he's now on 2 units of Levimir and 2.5 units of Novorapid in the morning and I unit of Novorapid at lunch and supper. So...fingers crossed he starts feeling better soon. Thanks for your responses Jonty. Much appreciated.x
 

DeeNJai

Active Member
Messages
25
Hi
I have just looked at the stripes the lady said about where you dont need the meter are dearer than SD Codefree testing stripes. I paid £13.98 for 100 stripes. I have to buy all my stripes as I am classed as Pre-Diabetic. My sugar levels are all over the place at the moment. The hot weather has been playing like anything, the hotter it is the lower it has been is 3.6 mmol/l but I struggled to stay above 4.4 mmol/l as this when I start feeling like I am going into a hypo. I am due to see the dietitian again in September. I have lost 2.5 kgs but I have been having problems with gaining a kilo in the last 4 weeks. I am trying to keep to 1400 calories a day. I seem to be keeping to this but i am not losing anything at the moment.

Good luck to your son and getting his blood sugars under control.
Dee
 

Pamzy2

Member
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24
Type of diabetes
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Thank you MichaelDavid for the link to the test strips - very useful for me - I am type 2, don't get any help with meters, or strips for them, but want to monitor my blood sugar levels, so I can prevent it getting worse quicker than it might. Thank you very much, very useful!
 
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tomvonc

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228
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Insulin
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Are you on commission from this company or something? Not everyone wants to buy test strips, especially if we get them free on prescription.
I, along with many others, have to show my Consultant 3 months worth of tests on my machine for DVLA so such tests would be totally unsuitable.
I think he has Rye futures as well ;-)

Tom
 
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