Advice bg levels

Wow, I've never experienced BG that low. I am sure somebody will be along soon with some useful thoughts. Don't despair.


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Well done @jaym your numbers are fantastic.
The new standard for meter accuracy is +/- 15%, it used to be 20%
so if you check out the tables on this page http://www.diabetes.co.uk/blood-glucose-meters/blood-glucose-meter-accuracy.html you can see that even if you have a meter which meets the new standards, a reading of 4 could be anywhere between 3.17 to 4.83.
So as long as you're not taking any meds that could cause hypo's and you feel ok, enjoy your low numbers.
Take a look at this site for more info on sugar levels http://www.phlaunt.com/diabetes/16422495.php

Hi. It's possible you have naturally low'ish blood sugar levels but also moving down quickly can cause a temporary overshoot until the body gets used to the new diet regime. It's highly unlikely you will go into a full hypo and the body can often dump glucose to help anyway.

You may have to speak to your GP because of the rampiril.
If they are blood reduction meds, your dose may have to be adjusted.

jaym said:

Hey everyone I'm type 2 diabetic diet controlled! Blood sugar after I finished work yesterday was 3.4! Two hours after eating went up to 4.7! Today my fasting result was 3.7! Been on a low carb diet for the last 2 or 3 months! But bg levels have never been this low! Also taking ramapril for high blood sugar!

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Jaym, I am making the following comments, assuming you are not taking and diabetes medication, just the Ramipril for your blood pressure.

Firstly, what a great photo collage. I am assuming that's your image journey since getting things in hand?

Secondly, provided you felt fine with those numbers, I would be supremely unconcerned. Personally, I run low and see lets of 3s, skip loads of 4s and rarely 5s, and the 5s are a short while after eating.

It could well be your body is just recovering extremely well from the diabetic assault it had on it's hands for a while. Certainly keep a good eye on it, and be mindful of how you feel. I've had a few readings in the 2s, but to be honest, they've always been when I am absolutely starving and dinner is taking longer to arrive than planned!

I usually just eat and drink as normal, but if I do have that very empty feeling and food is still some way ahead, I have a cup of tea, just with some milk to satisfy my system, pending proper food. I have never knowingly had a hypo, and I have never treated my hunger with sugary anything. I don't believe I need it, but then again, I don't take any medication either.

Good luck with it all. If you have concerns, just log everything down and have a chat with whomever advises you about your diabetes. I think you're probably doing extremely well.

Yay!

jaym said:

Hey everyone I'm type 2 diabetic diet controlled! Blood sugar after I finished work yesterday was 3.4! Two hours after eating went up to 4.7! Today my fasting result was 3.7! Been on a low carb diet for the last 2 or 3 months! But bg levels have never been this low! Also taking ramapril for high blood sugar!

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I believe Ramapril is for lowering blood pressure, and should have no effect on your blood glucose. It is not a drug for diabetes per se I think you meant to say blood pressure. It will not be causing your low bgl.

So your only bgl control seems to be diet. If a low carb type of diet, then well done, your bgl levels are good, but as pointed out, it may be your meter is reading high.

Is it an SD Codefree or an Accuchek by any chance? I ask because these manufacturers use a different calibration which makes their meters read 12% higher than the guidelines normally published by NICE or DVLA or @daisy1

Oldvatr said:

Is it an SD Codefree or an Accuchek by any chance? I ask because these manufacturers use a different calibration which makes their meters read 12% higher than the guidelines normally published by NICE or DVLA or @daisy1

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Where did that information come from?

Bluetit1802 said:

Where did that information come from?

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It is a topic that has been discussed in several threads already. It is to do with calibration for whole blood or plasma.

Oldvatr said:

It is a topic that has been discussed in several threads already. It is to do with calibration for whole blood or plasma.

Click to expand...

Have you any links to show that Codefree and Accuchek calibrate differently from other makes of meters as regards plasma/whole? There is a conversion for doing this on the main website.

http://www.diabetes.co.uk/whole-blood-readings-to-plasma-converter.html

Bluetit1802 said:

Have you any links to show that Codefree and Accuchek calibrate differently from other makes of meters as regards plasma/whole? There is a conversion for doing this on the main website.

http://www.diabetes.co.uk/whole-blood-readings-to-plasma-converter.html

Click to expand...

http://www.joslin.org/info/plasma_glucose_meters_and_whole_blood_meters.html
https://www.accu-chek.co.uk/gb/news/14april10.html
My SD Codefree leaflet declares it as Plasma calibration.
My NEO meter does not define its calibration, but for the last 6 months it has consistently read about 10% lower compared to my SD on the same sample. There are minor differences due to different strip batches and natural sampling variations.

When I have symptoms of hypo, it is usually with my NEO reading between 2.8 to 3,9, but my SD will be reading between 5 and 6.5 I have just taken a reading 20 minutes ago, and my NEO read 4.1 and my SD read 5.6. i am just getting faint physical indications of low bgl, so am munching some carbs. So my NEO is close to the NICE and DVLA limirs, and is whole blood. My old XCEED meter is definitely the old whole blood calibration, and it agrees with my NEO using the same strips.

I have no records of how other meters are calibrated. There is no simple chart or table I have found yet. I think that if a meter allows alterate site testing, then it is probably plasma calibrated, but you will need to check with manudacturer, and give them your meter serial number. I tried with Abbott, but they had no idea there were 2 standards. They just said if it passes their calibration fluids, then its ok. But I know its not The error allowance in the fluids is too wide that it only detects major failure. Both my SD and my NEO pass the fluid tests with flying colours.

My GlucoRX provided by the GP gets tested every week with the solution provided. It states the range should be 4-7 with said solution which seems very wide in terms of calibration variance. Every week the test results are between 7.8 and 8.0, so significantly even their flexible range. I've told my DN who said its fine, just do the test,merits it in your book and work out the maths...all your actual BGs are all around 12% lower. When I explained they are 12% lower based on their upper range of 7, she had no suggestions. The manufacturer, as in Oldvatr case seemed just as non-plused. Do you have any additional thoughts re my own meter? Or should I supplement with another one.


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@jaym

Hello and welcome to the forum As tagged above, here is the information we give to new members and I hope you will find it useful. Ask more questions when you like and someone will be able to help.


BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you’ll find over 150,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.
There are two approaches to controlling your carbs:

• Reduce your carbohydrate intake
• Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes-and-whole-grains.html

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes

LOW CARB PROGRAM:
http://www.diabetes.co.uk/low carb program


Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 8.5 mmol/l

Blood glucose ranges for type 1 diabetes (adults)

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 9 mmol/l

Blood glucose ranges for type 1 diabetes (children)

• Before meals: 4 to 8 mmol/l
• 2 hours after meals: under 10 mmol/l

However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

• structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
• self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to bloodglucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic

Note: This post has been edited from Sue/Ken's post to include up to date information.

@Oldvatr

Thank you for those links.
I have both the Codefree and the Accu Chek Mobile, which more or less agree with each other. I take it then that the readings I get are, or should be, in line with my HbA1c tests. (Sadly this has not been the case for me) My codefree and accuchek leaflets both specify it is calibrated for venous/plasma blood.

KevinPotts said:

My GlucoRX provided by the GP gets tested every week with the solution provided. It states the range should be 4-7 with said solution which seems very wide in terms of calibration variance. Every week the test results are between 7.8 and 8.0, so significantly even their flexible range. I've told my DN who said its fine, just do the test,merits it in your book and work out the maths...all your actual BGs are all around 12% lower. When I explained they are 12% lower based on their upper range of 7, she had no suggestions. The manufacturer, as in Oldvatr case seemed just as non-plused. Do you have any additional thoughts re my own meter? Or should I supplement with another one.


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I think it is terrubly irresponsible of manufacturers and the regulatory authorities that they allow 2 different standards, without either requiring all meters to state clearly which they use, and making it clear to users. I have had many occasions where according to one meter I should not be driving, indeed I invalidate my insurance, yet my other meter says I am perfectly entitled to drive.

As regards using 2 meters, this is what I choose to do. My GP funds one, and I fund the SD Codefree privately. Having 2 meters gives me security and confidence. I can detect a misread on either meter since I track the differences in my program, and I know what difference I expect on each reading. I can also detect when a new batch of strips has an offset that I can make allowance for: I make a note where one meter average changes compared to the other since this is the offset for the new batch.

When it comes to HbA1c time I make a note of both meter running averages for previous 3-months on the day blood is drawn, and so far If I take an average of the two 3-mothly averages, then this has so far been within 0.3 mmol/l of the HbA1c result. So I have confidence in predicting my next forthcoming HbA1c.

As an Engineer I was familiar with spreadsheets, so this is not a major nettle for me to grasp. It is, perhaps, me being more anal than usual, but its how I deal with things. As say, I need to have confidence so I can make decisions for my own care independently of my HCP's. I can also make decisions more quickly since I can detect changes within a couple of days without waiting for blood tests.

It works for me, but you must make your own decisions with regards to any second meter. At least yoy know now that the SD Codefree or Accuchek meters are Plasma, and can make allowances for that. In reality it is only when you get to the low readings that it becomes important (i,e, hypoland and DVLA) where that 12% difference takes significance.

Oldvatr said:

I think it is terrubly irresponsible of manufacturers and the regulatory authorities that they allow 2 different standards, without either requiring all meters to state clearly which they use, and making it clear to users. I have had many occasions where according to one meter I should not be driving, indeed I invalidate my insurance, yet my other meter says I am perfectly entitled to drive.

As regards using 2 meters, this is what I choose to do. My GP funds one, and I fund the SD Codefree privately. Having 2 meters gives me security and confidence. I can detect a misread on either meter since I track the differences in my program, and I know what difference I expect on each reading. I can also detect when a new batch of strips has an offset that I can make allowance for: I make a note where one meter average changes compared to the other since this is the offset for the new batch.

When it comes to HbA1c time I make a note of both meter running averages for previous 3-months on the day blood is drawn, and so far If I take an average of the two 3-mothly averages, then this has so far been within 0.3 mmol/l of the HbA1c result. So I have confidence in predicting my next forthcoming HbA1c.

As an Engineer I was familiar with spreadsheets, so this is not a major nettle for me to grasp. It is, perhaps, me being more anal than usual, but its how I deal with things. As say, I need to have confidence so I can make decisions for my own care independently of my HCP's. I can also make decisions more quickly since I can detect changes within a couple of days without waiting for blood tests.

It works for me, but you must make your own decisions with regards to any second meter. At least yoy know now that the SD Codefree or Accuchek meters are Plasma, and can make allowances for that. In reality it is only when you get to the low readings that it becomes important (i,e, hypoland and DVLA) where that 12% difference takes significance.

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Thanks Oldvatr


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Bluetit1802 said:

@Oldvatr

Thank you for those links.
I have both the Codefree and the Accu Chek Mobile, which more or less agree with each other. I take it then that the readings I get are, or should be, in line with my HbA1c tests. (Sadly this has not been the case for me) My codefree and accuchek leaflets both specify it is calibrated for venous/plasma blood.

Click to expand...

The plasma calibration only corresponds with a venous sample taken on the day which the lab processes as a bgl sample, but it will not correlate directly with an HbA1c, which is a different test. See my response to Kevin Potts that I just uploaded which shows how I get close to being able to predict my next HbA1c based on current readings I have been 'accurate' 4 times in succession now and it seems to be repeatable. Since both your meters have the same calibration, it may not work for you, but certainly you would need to average over the previous 3 months to get close to the HbA1c test. I also have a test regime of (4 per day x2 meters) so this also gives me a better average daily value. I expect this test regime is too onerous for most, as well as being expensive. My own readings are predicting my next HbA1c to be around 36 mmol/mol (5.5% USA) which is plumb on the figure I agreed with my GP last week as my new target.