MY IGNORANCE

[mind_doctor]

hello again,
being a relative newbie, i have been trawling through some of the existing threads and have come to the conclusion that i am quite naieve about the use of my monitor.
my specialist doctor told me to vary when i test myself and always do it before food.
the booklet he gave me spreads it out quite nicely and includes readings for 2 hours after food as well as before each meal time, before bed and during the night.
he scribbled them all out other than the before meals ones and told me to only test at these times and to ignore the other times.
from what i have read i should be testing afterwards too in order to see what foods have what reactions?
i am suprised by this as it seems i am being misinformed unless he is only concerned with my numbers reducing at the moment???
should i do as he says or test aftward too?
and i just realised i havn't taken my meds........ grrrrrrrrr.....bye

 

[lilibet]

Hi md

It really depends on what you are trying to achieve.
EG I have been told to test only before meals plus pre bed and fasting sugars, as the insulin I am on at present does not lend itself to 2 hour readings (in eyes of DNS) as I am not checking efficacy of a bolus insulin.
However. Whilst not checking all the time, i am checking at the two hour point to try and assess what food does what and as such can recommend that if you are assessing food impact on bg, plus maybe change in regime or whatever, then testing. Some people test more than this and of course when you are driving or feel funny its important to test.

General advice seems to be
Fasting
Before eating
1 hour
2 hour
This is recommended in order to ascertain how high you spike (as there is some thoughts that good A1c aside, spikes and transient hyperglycaemia also causes probs with small blood vessels) as well as what effects you.

Some type 2's might not test as much, some type 1's might test more - as I say, it depends what you are trying to find out but the above advice is quite insensive and might be a starting point, even for a short while

L

 

[sugarless sue]

MD to start with you should test first thing in the morning,then 2 hours after breakfast,just before lunch ,2 hours after lunch,just before dinner and 2 hours after dinner.Keep a food diary for a week,record all these readings as well and you will begin to see which foods are affecting your blood sugar levels.Once you are confident that you know how each meal is going to affect you then you may not want to test so often but in the beginning it is vital that you learn about the food you eat and how it affects you.

 

[Trinkwasser]

The stock reply is that the doctor only wants to see your fastings (and in some cases your 2 hour numbers) so he can watch how quickly you are progressing

YOU need more feedback in order to slow or stop the progression by modifying your diet and exercise appropriately - which he probably doesn't believe is possible

http://loraldiabetes.blogspot.com/2006/ ... djust.html

you can always test more and not bother telling him <G>

IMO the meter gives you feedback to obtain manual control over a system that is supposed to be automatic but no longer is

 

[Jem]

The last doctor I went to see seemed to think that testing twice a week at random times was sufficient diabetic control ...

I usually test first thing in the morning (to give me an idea of how to eat for the day "eat to your meter") if lower than 5 I can have slightly more carbs, if over 7 I really need to focus on keeping as low as possible ... these are MY rules and suit me and not advice, just the way I do it, which I thought my be of interest!

I also test 2 hours after each meal if I feel there's necessity (like it's a new food or if I feel ropey) however I don't bother if my morning bg was good and I've eaten a meal I've had before with good results (eg my breakfast of strawberries and thick cream *hmmmmm* which lowers my bg not raises it!)

I did A LOT of tests to begin with and now test a little less as I feel a little more confident ...

Best, Jem xox

 

[SilverAndEbony]

Surely the advice given to type 2 diabetics be different to that given to type 1s?
Plus a difference based on how long you've been diagnosed? Plus how you are trying to control your BG levels? Plus how well controlled you are?

I think advice to a well controlled type diabetic using diet and exercise alone to control their BG levels should be different to that given to Type 1s. Or am I mad? I've never had a hypo, and controlled by diet, exercise and metformin. I do not see the point of ME testing loads of times a day. I don't pretend to understand anything at all about living with Type 1, but I think that my 2 tests a week would be TOTALLY insane for type 1s.

I ask be cause it seems that that difference is being missed in some of the replys to the original post. I'm not talking about testing lots of times to see how your body reacts to different types of food. I'm talking about after you've done your experiments.

 

[Dennis]

SilverandEbony,
It may have escaped your notice but 4 of the 5 posters on this thread who all advocate regulat testing are type-2. Only one is poster type-1. Let me ask you what your normal daily levels of blood sugar are? As a diabetic, whether type 1 or 2 you should know. But if you are only testing twice a week then how can you possibly know. You say you have never had a hypo, so your levels don't drop particularly low, but how about hypers? Can you say for certain that in between the occasional tests that you do that your BS remains stable? Well, the rest of us can.

 

[hanadr]

The ideal would obviously be to test several times a day for T1 AND T2. However, T2s have to fund their own strips for this. (Ijust got 100 for £20 on ebay!)The PCTs say T2s don't need so many tests, because they don't want to admit anything that would necessitate them giving us the strips.
By my thinking, not allowing newbies to test is reckless and pretty much criminal. It's also against NICE guidelines. However we all know how much notice the PCTs take of those guidelines. If people become ill,because of poor control, the PCT can and will call them non-compliant. That essentially is how they get away with it.
Then you have the Health Care teams who haven't a clue about diabetes and give ridiculous and potentially harmful advice. They use the same technique. "The patient is non-compliant"
What no-one has yet done is to compare the long-term health of diabetics who test frequently and those who don't. And not just the Irish study!!!! :evil:
To my mind T2s should test at least twice daily at random times.

 

[hanadr]

Silverandebony.
Yout medication isn't going to cause a hypo, but you could easily run too high for a while. If you ate the wrong things, it might take a couple of days to get back into the "safe zone" i.e. below 7

 

[witan]

I'd say sue's advice for a newby is about right.

Maybe for two or three months - that's a time of learning and experimentation.

It not only teaches what foods do to you but also the typical variations that occur caused by your lifestyle. This will help determine how and when you test later on.

If you have a very stable routine with home prepared meals and regular exercise then minimal testing may be all that's required as long as you know for sure you won't go outside normal levels on that regime, of course if you get sick or do have an enforced change more testing will be required.

If your lifestyle is less stable, eating out, variable sports/exercise, chasing kids, changing shift patterns, stress and travel etc you'll still probably need to do three or more tests a day.

 

[Jenny]

I am T2 and get as many test strips as I need.

However, although my HBa1c was over 14 when first diagnosed I tested twice a day, pre breakfast and evening meal. I recorded all readings to watch how progress was or was not being made. I have never tested to see the impact of any particular food but I am very aware that some fruits raise the roof - so I avoid them. Reducing portion sizes coupled with some carb reduction and regular exercise has reduced my weight and HBa1c. No cheating either - although even the Consultant thinks that I am too strict.

I test probably around twice a week in the morning before breakfast. HBa1c is now between 5 and 6.

I don't wonder that some docs are reluctant to prescribe strips when you come across posts like one I recall when someone reported testing every 3 minutes for 2 hours after eating to see what changes were taking place.

 

[davege]

I'm T2 and was diagnosed in Oct last year.

First I tested FBG in the morning and worked on bringing that down to below 5.6. I then went onto testing food types by testing before, 1 hour and two hours after food. The targets I set are below 7.8 after 1 hour and below 6.7 after 2 hours. Before meals I like the level to be below 5.6 and will change food carb intake if not below all these levels.

In the long term I'm looking at testing once daily and I will test FBG and one hour after meals to watch for deterioration over 4 days. First day FBG, second day 1 hour after breakfast, third day one hour after lunch and forth day one hour after dinner. Continue rotation watching for deterioration.

First HbA1c was 8.3 when I was diagnosed with T2 and hopefully my next HbA1c will be below 7 and below 6.5 for the next one. My target is for a HbA1c below 6.5 and as close to 5.5 as possible.

Dave - diet, exercise and metformin 3x500mg XR

 

[JER]

I test 5-6 times a day, before each meal, before I take my Levimir evening injection and then before bed. Basically this follows the principles taught on the DAFNE course and it works!
Before I did the DAFNE course I tested at loads of different times of the day (I am a scientist and I like having data) but it really told me very little and didn’t help to improve my control. Following the above regime gives me an HbA1c of 6.5
So I would advise if you are Type 1 ask if you can go on a DAFNE course. For someone relatively new to Diabetes it would be very useful. I attended a DAFNE Course after 22 years of Diabetes and it really helped me.

 

[chocoholic]

As a Type 1, I'd like to test 2 hours after meals too but I am still only allowed 100 strips at a time and if I tested two hours after as well as before meals I'd soon run out. When I told my DN that I wanted to see what foods did to my levels, she just laughed and told me I was on the point of being obsessive about testing. :roll: She wouldn't even accept me doing that temporarily whilst i worked out what spiked me particularly.I've decided to wait until I can pretty much estimate pre-readings accurately and then carry out intensive post-meal testing. It's not ideal but hey-ho, I don't have a lot of choice.

 

[Angel Mariel]

I just don't get what the big deal is. If more frequent testing means that diabetics have greater control over the disease why not just give us the strips to do it?

Having greater control means that there would be less need for medication and fewer complications requiring treatment. Surely both of these would ultimately require LESS funding than giving us the strips?

Why is it necessary to make us feel stupid or obsessive for wanting to know what's happening to our own bodies?

Oh, I seem to be cross about this, LOL!

 

[Trinkwasser]

I just don't get what the big deal is. If more frequent testing means that diabetics have greater control over the disease why not just give us the strips to do it?

Having greater control means that there would be less need for medication and fewer complications requiring treatment. Surely both of these would ultimately require LESS funding than giving us the strips?

Why is it necessary to make us feel stupid or obsessive for wanting to know what's happening to our own bodies?

Oh, I seem to be cross about this, LOL!

Never met an accountant have you? <G>

The strips are a cost TODAY. Complications are a cost some time in the future (if you haven't died in the meantime) and are therefore someone else's problem.

Initially I tested a lot, now my variation is much less so my current protocol is to avoid the fasting tests (I'm usually within range) and concentrate on the 1 hour postprandials and also tests around extra exertion and illness, not to mention eating foods of unknown provenance, which are times I'm less confident about being predictable.

Then every few weeks I will run a whole day, fasting, postprandials and premeals, to see if there have been any long term changes. For my specific version of this disease that gives me maximal information at minimal cost. But I wouldn't be able to get away with this now if it hadn't been for the "obsessive" inital testing.

 

[Angel Mariel]

Perhaps if I married one I could afford to buy test strips, lol!!!

 

[Trinkwasser]

Perhaps if I married one I could afford to buy test strips, lol!!!

I DID marry an accountant.

She was absolutely appalling at managing money. Until it came to the divorce . . .