Advice bg levels

[Bluetit1802]

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.

I think I can beat you in the testing department. I test FBG, after breakfast, before lunch, after lunch, before tea, 2 or 3 times after tea, and bedtime, plus some random ones for exercise and more frequently if I have a new food. My post prandials are split between an hour, 90 minutes, 2 hours and if necessary I keep going.

I use Excel, I average daily, weekly, monthly and 3 monthly. I stick to one meter but use the other for comparisons if I get unexpected numbers. I have been doing this for 2 years. My HbA1cs are always, without fail, higher than my averages might indicate. I am flat over night in the low 5s (my sensor has confirmed this, and also agrees more or less with my own averages) I rarely see a 7mmol/l at any time of day, yet my last HbA1c came back at 44, equivalent to 7.3mmol/l. What?????? My previous HbA1c was 42, an average of 7mmol/l. This is impossible.

I am not anaemic and have normal results on my blood counts. So I read up about haemoglobin glycation, and it seems there are high glycators and low glycators, with everyone else somewhere in the middle. A high glycator will see HbA1cs well above expected, and likewise a low glycator will see HbA1cs lower than expected. I am still trying to get my head round all this. I did bring it up with my DN and she went blank. I asked for a fructosomine test and was told they don't do them. If the same thing happens again at my next test I will ask to see the diabetes specialist GP (never seen any GP since diagnosis)

 

[Oldvatr]

I think I can beat you in the testing department. I test FBG, after breakfast, before lunch, after lunch, before tea, 2 or 3 times after tea, and bedtime, plus some random ones for exercise and more frequently if I have a new food. My post prandials are split between an hour, 90 minutes, 2 hours and if necessary I keep going.

I use Excel, I average daily, weekly, monthly and 3 monthly. I stick to one meter but use the other for comparisons if I get unexpected numbers. I have been doing this for 2 years. My HbA1cs are always, without fail, higher than my averages might indicate. I am flat over night in the low 5s (my sensor has confirmed this, and also agrees more or less with my own averages) I rarely see a 7mmol/l at any time of day, yet my last HbA1c came back at 44, equivalent to 7.3mmol/l. What?????? My previous HbA1c was 42, an average of 7mmol/l. This is impossible.

I am not anaemic and have normal results on my blood counts. So I read up about haemoglobin glycation, and it seems there are high glycators and low glycators, with everyone else somewhere in the middle. A high glycator will see HbA1cs well above expected, and likewise a low glycator will see HbA1cs lower than expected. I am still trying to get my head round all this. I did bring it up with my DN and she went blank. I asked for a fructosomine test and was told they don't do them. If the same thing happens again at my next test I will ask to see the diabetes specialist GP (never seen any GP since diagnosis)

Gosh ! A T2D who tests more than I do ! How are your fingers holding up? And another EXEL user to boot.

I have no idea how your HbA1c is higher than your plasma reading meter. My SD average is approx 1 mmol/l higher than my HbA1c each time. But I have seen others reporting something like this.

 

[Bluetit1802]

Gosh ! A T2D who tests more than I do ! How are your fingers holding up? And another EXEL user to boot.

I have no idea how your HbA1c is higher than your plasma reading meter. My SD average is approx 1 mmol/l higher than my HbA1c each time. But I have seen others reporting something like this.

I use the Fastclix pen for the pricking. They are easier on the fingers. I do have to give them a rest from time to time. I know full well I am OCD and OTT about it, but I am a data freak, I love my stats, and that is my main motivation. It keeps me on the wagon.

 

[Oldvatr]

I use the Fastclix pen for the pricking. They are easier on the fingers. I do have to give them a rest from time to time. I know full well I am OCD and OTT about it, but I am a data freak, I love my stats, and that is my main motivation. It keeps me on the wagon.

Ditto. You are not alone.

 

[Salvia]

I didn't realise that meters could be calibrated differently, but after reading through the comments here, I checked to see which way my meter is set. I have an SD Codefree, only purchased it in February, and the user instructions say that it measures whole blood. This seems to be a bit odd, because others say that their SD meters measure plasma, so I'm wondering why my meter is different, particularly as it is new. Does anybody have any ideas ? and should I be bothered about it, or not?

 

[Oldvatr]

I didn't realise that meters could be calibrated differently, but after reading through the comments here, I checked to see which way my meter is set. I have an SD Codefree, only purchased it in February, and the user instructions say that it measures whole blood. This seems to be a bit odd, because others say that their SD meters measure plasma, so I'm wondering why my meter is different, particularly as it is new. Does anybody have any ideas ? and should I be bothered about it, or not?

The Technical Specification on Page 73 of my User Manual shows Calibration as being Plasma equivalent. The leaflet does indeed say whole blood and capilliary sample. All I can say is that my SD definitely does not tie up with the whole blood ranges for hypo, which is how I check mine. If My SD says I am over 6 mmol/l, but I am getting hypo symptoms, and my NEO says I am under 4 mmol/l, then I know which I need to take notice of. My SD is certainly behaving as a plasma calibrated meter.

If you look at the thread I started in Success Stories entitled My Personal Journey, then I uploaded a graph that quite clearly shows a consistent offset between my SD and my NEO over the last 6 months

 

[Salvia]

Thanks so much for this info, @Oldvatr. Following your lead, I've had a look at the spec on page 73 of my manual & it's the same as yours. Previously I had been looking at the text sections on how to use the meter. So it seems there's not much for me to get hot under the collar about. I'll go take a look at your success story & the graph you mention - I love success stories.

Cheers, and thanks again for your reply

 

[Oldvatr]

Thanks so much for this info, @Oldvatr. Following your lead, I've had a look at the spec on page 73 of my manual & it's the same as yours. Previously I had been looking at the text sections on how to use the meter. So it seems there's not much for me to get hot under the collar about. I'll go take a look at your success story & the graph you mention - I love success stories.

Cheers, and thanks again for your reply

Thats why we are here. To convert Plasma back to the old system, I think you need to divide the SD reading by 1.12

 

[Salvia]

Thanks again.

 

[Bluetit1802]

Thanks again.

There is a quick converter here

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

 

[Oldvatr]

There is a quick converter here

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

It is good to have this ready reckoner, shame the limits shown in the blurb are in mg/dl. Surprising for a .co.uk site?

What this thread shows, is that what we need is a simple table showing the current status of meters,i.e. which meters are plasma, which are whole blood. Any researchers out there? I did find a USA table, but none of the meters were available in UK, but of course with online shopping that may change. However, if purchasing from abroad, need to check the scaling (mmol/l or mg/dl)

Perhaps readers here could post what meter they use, and which calibration it states it uses, so we can collate the data in this thread. Or should we start a specific thread? it has to be standard thread, not poll since we need manufaturer/ model/ calibration info for each. We also need year of purchase, since age is another factor. Older meters were whole blood, but some have recently changed to plasma.

It is further complicated by some of those changes being via the strips and codefree meters will self adjust without making any changes to the meter itself. (for example , Accuchek did the change through strips in 2011, so an Accucheck would read whole blood on old stock (pre 2011) strips, but automatically show plasma with new stock)

This is not a problem once the stock of older strips has been used up, but could apply if a manufacturer has recently upgraded to plasma. Also may apply if strips bought online that turn out to be rebranded out of date stock, such as one batch I had that were fraud.
It also applies to people using an old meter such as an Accucheks, who are not aware that this change has been affecting them since 2011.

 

[Yorksman]

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!

Ramipril is normally taken for high blood pressure, not high blood sugar, so I'm not sure what that is all about.

Eating very low carb will reduce your BG levels but, if you have lost a lot of weight, you may have re-awoken some of your slumbering insulin producing beta cells, before they pegged out permanently and this improvement in insulin production and a continuing low carb diet is resulting in the readings in the 4s. I think the 3.4 was probably an error associated with the finger prick sample. Sometimes you get other fluids on capiliary samples mixed in with the blood.

I lost 30kg and wake up to 4.7 - 5.3 even if I have had a mars bar the night before. The point is, not to push it. If you get away with it now and again, it doesn't mean you can do it whenever you feel like it. That's what caused the diabetes in the first place.

I also cycle 30 mins per day and that helps a lot with the sensitivity to the insulin produced, ie making the most of what you've got. Fingers crossed, you won't be even on the diabetic scale when you have your next HBA1c.

 

[Yorksman]

Thanks so much for your reply I'm feeling really good! Have lost just under 3 stone since being diagnosed with type 2! Have my diabetic review next month! Will be my first one! Hba1c was 51 when diagnosed. No medication just for blood pressure as you said! Hoping I will get off these the more weight I lose! I have been determind to reverse my diabetes through diet! I'm hoping my hba1c has gone back to normal levels. I also go on holiday next month and really looking forward to it now I feel better and have lost some weight! Still have a bit to go but I'm getting there

Ah, just seen this.

51 isn't that far into diabetic territory and you reacted immediately losing weight and changing diet, so it is not a suprise to me. I was 86 when I started.

Just remember, if you have reversed your diabetes, you don't recover all your beta cell function, some function is still lost, but not enough to put you into a downward trend over time. So you can relax somewhat but just don't return to your old ways.