At what point would one say you are testing too much?

[MeiChanski]

Hello diabuddies,

I didn’t want to derail a recent thread on “how many times do you test your blood glucose?”

I had an interesting conversation with my therapist in regards to my blood sugar testing.
As previously said since my accident in 2013, I test near enough to other type 1 diabetics - 8-12times a day. Whatever my day is like, whether I’m active or not, whether I’m sleeping or not, I test quite frequently. You could say poor fingers but I was the same with a libre. I would constantly scan as well.

There have been times where I test but test again after 10 mins or so, not because I forgot about my previous test but it’s that “you are okay” feeling is quite short lived.

My therapist did note that it is a complex issue because we as type 1 diabetics do need to test our blood sugars, but he feels I am stepping into a deep anxiety territory. It is complex in a way that my diabetes team have never commented to say “hey look you are testing too frequently”. I assume they think my frequent testing is a good thing because it provides them more information?
It’s hard to say whether I am obsessively testing or testing because I need to. I guess the difference between other diabetics and myself who do test 8-12 times a day is they sleep, whereas with me, give or take I fit in a few hours of sleep.
But anyway it is something I am working on and I have been trying to sleep. I have been doing okay for the last few days, but it is hard not to test or test less.

 

[michita]

Hello diabuddies,

I didn’t want to derail a recent thread on “how many times do you test your blood glucose?”

I had an interesting conversation with my therapist in regards to my blood sugar testing.
As previously said since my accident in 2013, I test near enough to other type 1 diabetics - 8-12times a day. Whatever my day is like, whether I’m active or not, whether I’m sleeping or not, I test quite frequently. You could say poor fingers but I was the same with a libre. I would constantly scan as well.

There have been times where I test but test again after 10 mins or so, not because I forgot about my previous test but it’s that “you are okay” feeling is quite short lived.

My therapist did note that it is a complex issue because we as type 1 diabetics do need to test our blood sugars, but he feels I am stepping into a deep anxiety territory. It is complex in a way that my diabetes team have never commented to say “hey look you are testing too frequently”. I assume they think my frequent testing is a good thing because it provides them more information?
It’s hard to say whether I am obsessively testing or testing because I need to. I guess the difference between other diabetics and myself who do test 8-12 times a day is they sleep, whereas with me, give or take I fit in a few hours of sleep.
But anyway it is something I am working on and I have been trying to sleep. I have been doing okay for the last few days, but it is hard not to test or test less.

Well... I have been told that I was testing too often by docs and nurses. It’s quite difficult but they don’t know you as much as you know you. I am a detailed person and I wanted to check as often as I wanted. Being told off about checking too often was the last thing I needed and didn’t like that they were stressing me out saying that. If you are T1 I think you should check as often as you feel needed. Having a good control is important, you need to check to know your level. Once you have a good control, you will be checking less.

 

[Deleted Account]

Do you do anything with the results when you test?
My attitude is as long as I test for a reason, I am not over testing.
I test 8 to 10 times a day. This is testing to check I am safe to drive and exercise, to test for corrections before I eat, wake up and go to bed, to spot any trends and if I think I feel weird because my BG may be too high or too low.
If I do nothing with a test result, I am testing too often. Otherwise, I am fine with my testing.
This was confirmed by my dsn. She and my consultant were happy I needed to test this often and prescribed the Libre.

 

[LooperCat]

With my BG on my watch, I suppose I’m constantly aware of my levels - not dissimilar to being always aware of my speed when I’m driving. Sometimes I’m so focused on what I’m doing that I’m not though - so I’ve set discreet curate alarms to warn me if I’m sliding out of range, just in case. I get a buzz at 4.3 to tell me to switch my pump off for half an hour, and another at 6.6 to nudge me to take half a unit or so.

 

[Mad76]

Nurse told me i was testing too often/obsessivly
I have the libre
I find testing frequently reassuring. So i do.

 

[Scott-C]

It's a good question, @MeiChanski , and one I've thought about since getting cgm.

I wonder sometimes whether we're over-thinking and worrying unduly about levels, and whether newly dx'd T1s are getting led astray in striving for very strict levels.

I've been astonished, and saddened, by the number of recently dx'd who seriously think they can't eat fruit or have a steak bake or a baked potato.

I've been doing this for 31 yrs now, and, as you know, we've got folks on the T1S'r'Us thread who've been doing it way longer than that, 40, 50 yrs.

Looking back at my historical a1cs, there was a scary few 80s up until about 15 yrs ago, then 50'ish since then until about 3 yrs ago when I got cgm, since when it's gradually dropped to 28.

The interesting thing is that there is no way that the old timers, using the primitive measurement techniques of the day, were running tight 4 to 8 ranges 100% of the time, but have all emerged without any serious complications.

I know that in my earlier days, there was plenty of times where I'd be hoofing around for several hours in the mid-teens, because I wouldn't know about until a test for the next meal.

But it doesn't seem to have done me any harm longer term.

I suppose the difference might be that a lot of folks burned out and didn't care if they were in the 20s for days on end, whereas others just had brief excursions for a few hours.

Now that I've got cgm, I have lots of information about what dose and timing for a particular meal, and keeping in a 4 to 8 range becomes easier just on account of that - seeing so many cgm traces over 3 yrs just seeps in.

But I do wonder sometimes whether I'm worrying too much about the out of range fliers. I'm generally quite relaxed about the occasional 9 to 14 - even after 30 yrs, I've still not figured out fish and chips!

I put a fair bit of thought into bolus amount, timing, and corrections, I'm not advocating not paying attention to levels, it's always preferable to be generally 4 to 8, but are we over-worrying the occasional fliers to 10, 12 for a few hours?

Sometimes when I'm looking like I'm going to be on song for a 100% in range 24 hrs, I've taken steps to maintain it in that range, but I'm doubting now whether that is necessary.

Perhaps now I'm doing that just for the aesthetic value of seeing a nice line, rather than medical necessity?

I'm reminded of that quote from a doc on diatribe: he said that from wearing a cgm as a non-T1, he realised that a fully functional pancreas is far from perfect, and we are holding ourselves to too high a standard.

It all comes back to how newly dx'd T1s should look at this. While it is fun to do the #competitiveflatlining every now and then, I worry that they are getting too highly strung about how their results compare, and start needlessly limiting their food options just to avoid an occasional flier.

 

[MeiChanski]

Well... I have been told that I was testing too often by docs and nurses. It’s quite difficult but they don’t know you as much as you know you. I am a detailed person and I wanted to check as often as I wanted. Being told off about checking too often was the last thing I needed and didn’t like that they were stressing me out saying that. If you are T1 I think you should check as often as you feel needed. Having a good control is important, you need to check to know your level. Once you have a good control, you will be checking less.

Hello, That is true and I am after good control, but at a cost of my own sleep. Is there a fine line between good control and just testing because anxiety said so?

Do you do anything with the results when you test?
My attitude is as long as I test for a reason, I am not over testing.
I test 8 to 10 times a day. This is testing to check I am safe to drive and exercise, to test for corrections before I eat, wake up and go to bed, to spot any trends and if I think I feel weird because my BG may be too high or too low.
If I do nothing with a test result, I am testing too often. Otherwise, I am fine with my testing.
This was confirmed by my dsn. She and my consultant were happy I needed to test this often and prescribed the Libre.

If it's within the 4hr window, no I don't do anything unless it's a hypo. I am most of the time testing without a solid reason why, other than giving me the okay. I guess I am testing irrationally out of fear and worry.

With my BG on my watch, I suppose I’m constantly aware of my levels - not dissimilar to being always aware of my speed when I’m driving. Sometimes I’m so focused on what I’m doing that I’m not though - so I’ve set discreet curate alarms to warn me if I’m sliding out of range, just in case. I get a buzz at 4.3 to tell me to switch my pump off for half an hour, and another at 6.6 to nudge me to take half a unit or so.

I'll be the type of person to keep tapping on it like instagram. Just upping my screen time y'know.

Nurse told me i was testing too often/obsessivly
I have the libre
I find testing frequently reassuring. So i do.

It is reassuring but at the cost of my own sanity and sleep.

It's a good question, @MeiChanski , and one I've thought about since getting cgm.

I wonder sometimes whether we're over-thinking and worrying unduly about levels, and whether newly dx'd T1s are getting led astray in striving for very strict levels.

I've been astonished, and saddened, by the number of recently dx'd who seriously think they can't eat fruit or have a steak bake or a baked potato.

I've been doing this for 31 yrs now, and, as you know, we've got folks on the T1S'r'Us thread who've been doing it way longer than that, 40, 50 yrs.

Looking back at my historical a1cs, there was a scary few 80s up until about 15 yrs ago, then 50'ish since then until about 3 yrs ago when I got cgm, since when it's gradually dropped to 28.

The interesting thing is that there is no way that the old timers, using the primitive measurement techniques of the day, were running tight 4 to 8 ranges 100% of the time, but have all emerged without any serious complications.

I know that in my earlier days, there was plenty of times where I'd be hoofing around for several hours in the mid-teens, because I wouldn't know about until a test for the next meal.

But it doesn't seem to have done me any harm longer term.

I suppose the difference might be that a lot of folks burned out and didn't care if they were in the 20s for days on end, whereas others just had brief excursions for a few hours.

Now that I've got cgm, I have lots of information about what dose and timing for a particular meal, and keeping in a 4 to 8 range becomes easier just on account of that - seeing so many cgm traces over 3 yrs just seeps in.

But I do wonder sometimes whether I'm worrying too much about the out of range fliers. I'm generally quite relaxed about the occasional 9 to 14 - even after 30 yrs, I've still not figured out fish and chips!

I put a fair bit of thought into bolus amount, timing, and corrections, I'm not advocating not paying attention to levels, it's always preferable to be generally 4 to 8, but are we over-worrying the occasional fliers to 10, 12 for a few hours?

Sometimes when I'm looking like I'm going to be on song for a 100% in range 24 hrs, I've taken steps to maintain it in that range, but I'm doubting now whether that is necessary.

Perhaps now I'm doing that just for the aesthetic value of seeing a nice line, rather than medical necessity?

I'm reminded of that quote from a doc on diatribe: he said that from wearing a cgm as a non-T1, he realised that a fully functional pancreas is far from perfect, and we are holding ourselves to too high a standard.

It all comes back to how newly dx'd T1s should look at this. While it is fun to do the #competitiveflatlining every now and then, I worry that they are getting too highly strung about how their results compare, and start needlessly limiting their food options just to avoid an occasional flier.

Hello Scott, Thank you for the reminder. We are not all perfect and striving for perfection is difficult. I feel there is a point I am constantly testing out of no reason, fear and worry. It is something I cannot shake off because in my early years of diagnosis, DSN at the time kept banging on about testing and I saw the dangers of not testing. It is a difficult line to draw between anxiety and the need to test.

 

[LooperCat]

Sleep is too important to me to be up testing if I don’t need to, so I’ll confess to totally relying on my alarms to wake me if there’s a problem. Most nights I sleep soundly.

 

[Scott-C]

It is something I cannot shake off because in my early years of diagnosis, DSN at the time kept banging on about testing and I saw the dangers of not testing.

Yeah, Mei, I suppose the way we were introduced to it by our teams at dx can make longer term differences to our approaches.

I was pretty lucky. My doc at the time (Prof Ian Campbell, I didn't realise it at the time, but he's a world class authority on T1) sat me down and said, right, Scott, try to keep between 4.7 and 7.4, have some sweets if you get too low, have some insulin if you get too high, see Sister Carmichael on the way out, she'll teach you about Digestive biscuits.

It was as simple as that, just some guidance on the basic rules, no fear about complications.

I wonder whether it would be worthwhile you just saying to yourself, ok, I feel like testing just now, but I feel fine, there's no high or low indicators, it's consistent with my last bg test, so no need to test?

 

[MeiChanski]

Yeah, Mei, I suppose the way we were introduced to it by our teams at dx can make longer term differences to our approaches.

I was pretty lucky. My doc at the time (Prof Ian Campbell, I didn't realise it at the time, but he's a world class authority on T1) sat me down and said, right, Scott, try to keep between 4.7 and 7.4, have some sweets if you get too low, have some insulin if you get too high, see Sister Carmichael on the way out, she'll teach you about Digestive biscuits.

It was as simple as that, just some guidance on the basic rules, no fear about complications.

I wonder whether it would be worthwhile you just saying to yourself, ok, I feel like testing just now, but I feel fine, there's no high or low indicators, it's consistent with my last bg test, so no need to test?

If the lack of hypo awareness is in the mix, it'll amp up the need to test. If lets say I'm testing every 4 hours and taking into account carb counting correctly, a lot can happen within 4hrs, right? With your input on CGMs, Would a CGM be like wearing a bulletproof jacket? while it helps us, does it solve the root cause of our inconsistencies in our BG readings? I love the idea of CGMs and I love it does save lives. I know there are some diabetics who are hypo unaware and I know there are some techniques to regain awareness back. It also provides us that information to work with that a blood meter would not. I remember my consultant on the phone saying a pump and a cgm wouldn't help my hypoglycemias and I wanted to know why.

 

[Scott-C]

remember my consultant on the phone saying a pump and a cgm wouldn't help my hypoglycemias and I wanted to know why.

Wow, what a strange thing for him to say! I've found that having cgm lets me see more about how certain doses work with certain foods, lets me check basal, how effective a single dextrotab can be in pinning a slow slide, and just generally understand better how insulin works, all of which adds up to way fewer hypos.

 

[becca59]

Personally I don’t think it matters how much you test if it makes you feel better. I wonder wether the medical people saying it is too much would feel the same if they were type 1s. As I always say, in the past we didn’t do this or that, because we didn’t have access. We do today, so why not use it.

 

[CearaRed1073]

wow, you guys are making me re-think some things. I have two friends who are also T-1s, one who tests all the time (she's on a pump, too) and the other who thinks I test too much. so I suppose I'm in the middle of them, but then again, I've had longer than both of them (40 years last October, 16+ on a pump) and the only complication I've had is cataract surgery three years before my mother in 2008.

so on top of all that, I've also been incredibly lucky up to now, so far as this is concerned. don't get me started on the rest of my life, I could go on for hours, especially if it means I can write about it rather than show you...EEK

 

[bmtest]

Put simply test when you think it is necessary and if your current situation demands you should for your own peace of mind, if you want to reduce testing and it is safe to do so set your self a goal on a stable day.

I for instance dont test before breakfast do one test mid morning to see I am on track and once before finishing work and once before bed. I make any corrections mid morning with insulin and that's it.
On non standard days the testing can be doubled depending on the risk, it works for me and I have had type 1 for 40 plus years with never passing out and no complications.

I tend to use the body's own sensors as a rough guide i.e if I cannot make decisions easily or lock onto one track thinking I may need to test, if vision acts like a television on the blink I am low and various other crude measurements.

One test I always do is before bed before Lantus dose as I not a lover if waking up from deep sleep sweating as it's a narrow window making it downstairs to kitchen for food, you might ask why I dont have food upstairs well the wife moans if I wake her eating digestives to bring blood sugar up.

But in summary its free to test and the safest option.

 

[Jc3131]

I test around 8 to 10 times a day, sometimes less, and sometimes if I'm having a battle with my blood levels, I have tested 15 plus times.

My dr says its fine to test a lot as I have tight control (not great, but not wayward like a lot of her patients) plus I drive and work.

I will carry on testing as I want to know where I'm at and also it gives you the experience on how to manage your results etc.

It's our body and the more you know about it, the better you will look after it.

 

[Oldvatr]

When one says Ouch! I have tested at least 6 times a day regularly for 4 years now, and I do not have any issues with it, I only use my right hand fingers for sites.