Testing before meal

[Smiffy1969]

Hi, I have been diagnosed type 2 for about 5 years but only recently started using Insulin. When i was on tablets and diet i was told to self test 2 hours after a meal by my Doctor. Now i am on insulin my diabetes nurse is telling me to only self test before a meal and not after. Could anybody tell me why this is as I'm confused as i can't tell what food is affecting me if I'm testing before and not after.
Thanks in advance.

 

[Cragwood]

The test before your meal tells you whether your basal (long acting) insulin is working well. If it is you should be between 4 and 7. If you are taking fast acting with meals then the test afterwards will tell you if you took enough insulin to meet the carbs in your food. That should be less than 9. Personally I do both as I don't find all carbs are equal. I can eat basmati rice without too much problem but have to be more careful with pasta or potatoes, for example. It's your control, do what you need to do.

 

[Smiffy1969]

Thanks for the reply, im not taking basal just yet just the fast acting and this is what i cant understand why she is only telling me to test before a meal and not after, i would have said that common sense says test after a meal. she has slowly taken me off glimipiride and as from today just taking 2 x 750mg metformin and novorapid insulin per day.

 

[Cragwood]

Thanks for the reply, im not taking basal just yet just the fast acting and this is what i cant understand why she is only telling me to test before a meal and not after, i would have said that common sense says test after a meal. she has slowly taken me off glimipiride and as from today just taking 2 x 750mg metformin and novorapid insulin per day.

Has she told you how much to inject each meal and how to work it out? I think I'd test before and after if I were you, at least until you are happy with what you are doing. My Fitness Pal lets you log all your food and work out how many carbs you are eating. The link below is a good website to have a look at to work out how to match carbs and insulin. Good luck!!

http://www.bdec-e-learning.com/welcome.asp?M=LOG293&Err=293&CID=C20041119145024-839850473

 

[Smiffy1969]

Has she told you how much to inject each meal and how to work it out? I think I'd test before and after if I were you, at least until you are happy with what you are doing. My Fitness Pal lets you log all your food and work out how many carbs you are eating. The link below is a good website to have a look at to work out how to match carbs and insulin. Good luck!!

http://www.bdec-e-learning.com/welcome.asp?M=LOG293&Err=293&CID=C20041119145024-839850473

She has told me to only inject with my evening meal, i am upto 14 units so far. she is deciding that from my reading that i take before i goto bed (about 10pm). my bedtime readings are usually between 9 and 14mmol. She has told me to up my units by 2 every three days until i get it to about 7mmol. i take 1 750mg metformin at 7 am and 1 750mg met forming at 6pm. my Father was diabetic before he passed, my sister is diabetic, i have a long family history and i have never known for any of them to test just before a meal and not after. do you think it would be a good idea to get a second opinion ?

 

[Cragwood]

She has told me to only inject with my evening meal, i am upto 14 units so far. she is deciding that from my reading that i take before i goto bed (about 10pm). my bedtime readings are usually between 9 and 14mmol. She has told me to up my units by 2 every three days until i get it to about 7mmol. i take 1 750mg metformin at 7 am and 1 750mg met forming at 6pm. my Father was diabetic before he passed, my sister is diabetic, i have a long family history and i have never known for any of them to test just before a meal and not after. do you think it would be a good idea to get a second opinion ?

I think I would, just to put your mind at rest. She does seem to be taking a strange approach. Are you eating the same amount of carbs every night? Has she told you what to do with the reading you take before your meal?

@noblehead , you are more expert than me. Can you help?

 

[slip]

If you are on insulin you should test when ever you feel the need, but definitely before taking any quick acting insulin and then 2 hrs after eating.

Are you adjusting your insulin to cover the carbs in your evening meal? What's your fasting BGL in the morning like? and post breakfast and lunch? Personally I'd be doing intensive testing until I get a handle on things and under control so before every meal and 2hrs post meal, before bed, first thing in the morning - and log everything.

Would be interesting to understand the reason for your 'odd' regime - but if it works for you then fine!

 

[noblehead]

Thanks for the reply, im not taking basal just yet just the fast acting and this is what i cant understand why she is only telling me to test before a meal and not after, i would have said that common sense says test after a meal.

Of course it's common sense, only by testing postprandial will you know what effect food has on your bg levels so you can adjust your insulin accordingly.

Don't forget you mentioned to your nurse your pre-bed bg levels and they have advised you to increase your insulin to bring your levels down, if that isn't prove that postprandial testing is important then I don't know what is.

 

[Smiffy1969]

She has told me just to send her my readings every Friday so she can see them and decide what to do next. My fasting BG in a morning is usually around 7-9 but this morning was 11.2. Im going to ring her tomorrow and ask her why she doest want me testing after meals. I remember when i was first put on Insulin just over a month ago she said that BG levels usually go up about 3mmol after eating and i thought that was weird to say as different foods affect BG different. She has told me to eat nomore than 50g of carbs each meal with i never do anyway. prob about 15g for breakfast 30 for dinner and about 30-40 for tea. only time i have a treat is on a Friday and thats usually a couple of bickys or half a bar of 85% dark chocolate.

 

[donnellysdogs]

Its unlikely that as a T2 that they will be able to see anybody else other than their staff at the GP Practice, unless they have a community diabetes team which some CCGs now have. however, this does not stop the OP raising questions to the Nurse or asking to see another.

May I ask though what the rest of yourbreadings are like throughout the day? To me if they are above 6.7 then you would be artificially high before you even inject for evening meal..

My other concern here is whether the nurse actually realises quick acting insulin is out of the body at about 5 hours... So she needs to be very wary of a hypo within 5 hours from that evening dose so testing after the meal is needed...

Very strange way of thinking to me but without a days readings and morning ones its difficult to give 100% advice..

Also though why wait until 2 or 3 days as Novorapd does not work like long acting insulins??

 

[donnellysdogs]

Glad to hear Twoplayer. In our CCG they are putting T1's under GP care and when I first moved to the area despite being under consultants for almost 30 years (i was so good when diagnosed that they put me back to GP care for a long while) I literally had to beg to see a consultant. Even then the GP referred me to a Community Nurse who had to assess whether I needed a consultant or whether she could manage my T1 with my GP..
Crikey 2 of my GP's can't even follow Directions from the Consultant to precribe the correct insulin that the Consultant recommends!

Glad one T2 can get a refferal easier than a T1!!

 

[Lou73]

I'm under the care of a DSN at our hospital as my GP surgery don't have anyone who deals with diabetics on insulin. I was offered to be discharged into the care of the community nurses but I declined. Due to other illnesses it's not easy to keep my blood sugars under control.


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