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Blood Testing.. How many times?

J

johnstoc

Active Member
Messages
29
Location
oldham
Type of diabetes
Type 1
Treatment type
Insulin
Hi All,

Wonder if you could offer some advice on the amount I should be testing my BG.
I'm told, to test BG
When I wake up
Before every meal
Before I drive (and every 2hrs)
Before bed
Before / After exercise



On a normal working day this would see BG testing at:
0600 - Wake up
0630 - Before Breakfast
0700 - Before driving to work (1hr trip, so no need for a 2nd test during the drive)
1200 - Before Dinner
1730 - Before driving home
1830 - Before Tea
2200 - Before bed

This is 7 times a day, and thats without any Exercise, or additional driving to pickup the kids from their clubs.
Seems alot to test, so looking at narrowing them down.

For example the morning tests, three of them.
I could get rid of the 0600 test. Leaving just two in the morning.
I was then thinking I could get rid of the 0700 test, as I had only just tested my BG 30mins ago. and as the drive is only 1hr this would still be under the '2hrs' re-test for driving.

However I'm told that if I take Insulin after a BG test, and then drive, I need to re-test the BG before hand.

Many times do other Type 1's tests ?
 
I test this often and more. I was always told to test 2 hrs after food as well. My additional tests are because I'm really afraid of hypos so I always test at 3am also (I do have a pump and know other pump users who test during the night to make sure they're pump is behaving). So, although it's a lot of testing and a real pain, I'm sure you'll find other T1s who test this often too.
 
I'm sure many type1s do test this often but I'm also sure that many don't. I certainly don't test this often. I hesitate to say that you don't need to do that many tests in one day because if you feel you need to and it gives you better control, then carry on doing what you're doing. However, I do feel you may be able to keep just as good control and do less testing.

I'd say you could possibly skip the test on waking and the one before tea --- if you're testing before your breakfast, which is not very long after waking then the one on waking seems a little redundant (also, your blood sugar will naturally rise from where it is immediately on waking anyway so the one before breakfast will be a little more accurate). The test before tea follows quite soon after the test before driving home and unless you've done something dramatic like exercise then it shouldn't be too different an hour later before your tea.

Like I said, I don't want to 'advise' you to do less testing, but I do feel sometimes it can help to be a bit more relaxed about it, as long as you're comfortable doing so.
 
I test before and after every meal, before the drive home from work and before and after exercise. Think about it this way: if you don't test before you eat, how do you know how much insulin to take? Likewise, if you don't test after you've eaten (about 2 hours), how do you know you've given yourself the right amount of insulin?

If you take basal before bed you should test before bed and upon waking to make sure you've had the right amount of insulin. For me I can use the 2 hours after dinner and my pre-breakfast test for this. Also before and after exercise to make sure you've had the right amount of sugar. Also, for me work is over an hour's drive away, so before I drive home I test myself as I've gone hypo on the motorway before and it was not fun!

I normally test around 8 times per day, sometimes more sometimes less. For me, testing is critical for decent control.
 
cyrusbrian said:
I think Its Too much........man
Click to expand...

Without wishing to be rude, you are a newly-diagnosed type 2 on diet only, so I don't think you can tell a type 1 what is too much testing. They have an entirely different scenario as insulin users.
 
John

You also need to be testing 2 hours after meals as well...

Then you get the 'hypo' testing...
And the basal testing... This one is testing is a fasting test to see if your background is set correctly, that's 1 test per hour..

How many times I test per day, will depend on what I'm doing really, so ranges from a min of 6 upwards...

@cyrusbrain

It does sound alike a lot of testing, but Insulin is a powerful drug, get your dose wrong and you can very soon find you self in a very serious medical emergency, either from a hypo or a hyper (high) sending you into DKA...

We use the blood glucose information both as in a pro-active and re-active manner...

Re-active as in, we use the blood result at the time, to adjust insulin dose, or perhaps if needs be eat some carbs to prevent a hypo or if you have a insulin pump, turning the pump down..

Pro-active, we use all the BG Data, to see what changes we can makes, such as adjustments to our background insulin, perhaps adjusting our insulin dose, to a meal before or after exercise, perhaps eating more carbs at a meal or before or after exercise, so we maintain good control..

A newly T2 diabetic, should idealy be testing to a similar amount to a T1, not for the same reason purely because they can't correct an high BG in the same manner, but using the information to make lifestyle changes to eating habit's and exercise regimes to bring their BG's down over period of time, so they know what foods they can and can't eat, the impact of exercise etc, and once they got their levels down and well controlled then their testing regime is different and becomes a lot less than that of a T1...
 
Thank you for all the info it helps alot.
I did start with testing 2hrs are meals, however was told I didnt need to after a revie with the DN.

Please keep up the good and helpfull comments, it is really appreciated.
 
Where the bolus/basal insulin regime is concerned, I can't recommend bg testing enough really in order to be well when using it. Too much bolus insulin can very easily bring on a hypo and not enough can easily produce high bg levels. If diabetics don't test by choice or do not test because of restriction on test strips being prescribed, then serious problems can and will occur.

Any GP or DSN who educates diabetics to only test 4 times a day or less needs to be seriously questioned over the educational advice that they give as they are putting diabetic's lives at risk either from developing nerve damage complications or serious hypos. The only reason why GPs or surgery DSNs issue the advice that they give to people restricting the need to test bg, is to save money on their budgets. Altogether the analogue bolus/basal regime combined with the need to test bg regularly is costing our NHS an absolute fortune in money and will over the next year or so, pose the question as to whether there is a future for the bolus/basal regime to continue.
 
Hi,

I test approx 10 x per day. I'm not bothered about the amount, but what is frustrating is that GP's and PCT's are trying to reduce testing by limiting prescriptions.
 
Usually 4 times a day.

Think about it this way: if you don't test before you eat, how do you know how much insulin to take?
Click to expand...
That is misleading. BG isn't random, and BG after one meal will correlate strongly with BG before the next.

It really depends on how much your BG varies: If BG is really stable (4.5-5.5) before every meal unless the result after the preceding meal was way out of range, then you could get away with less (e.g. testing before one random meal each day). Similarly, if you notice that there's virtually no change between the 6:00, 6:30 and 7:00 tests than you could probably get away with fewer tests.

The greater the variability, the more you have to test. For example, I'll test 3x in an hour if I go swimming - because testing has shown that my BG may drop by up to 5mmol/l in 15min or so. Start by testing frequently.

Btw, I was told to do this (fasting in the morning and after each meal) by my consultant
 
6-8 times but can be more if travelling on long car journeys or feeling unwell.
 
Unfortunately, through no fault of their own, some do find that their BGs are more random on a day to day and hour to hour basis. For me at the moment it's put down to hormones. BSs can stay stable for 3 days and fluctuate massively for the next 4 with absolutely no difference in food and excersize. I just have to accept this, test regularly and adjust using the temporary basal on my pump as necessary. For me, testing more frequently before and after food is vital to make the additional adjustments needed.
 
I generally test before meals, before bed and before driving or exercise or if I feel strange in any way, so at least 4 times and often more.

I've never been told to do sperate wake up and before breakfast tests, although I generally have breakfast soon after waking up. Also if I test to drive the kids home from a club at 5pm I don't tend to bother testing again 45 minutes later before eating as I don't feel it would give me new information.

For me there are 2 reasons to test. One being I need to know my level now (eg before driving or because I feel hypo), the other being to make sure I have a picture of my levels over a few days. I don't test after meals all the time, but if I start getting pre meal readings that are on the high side I will do a 2 hour test for a while to see if my ratios need changing.
 
I check fasting
pre and post breakfast (sometimes skipping post breakfast if it is close to:)
pre and post lunch
mid afternoon sometimes 4 times as I will normally be exercising (5-10 mile walks or strength training)
pre and post dinner
pre bed
3am sometimes.

10-13 times then total, I suppose that makes.

Plus every 10 minutes if I hypo, every 1-2 hours if I am unwell, and every hour if I take more than 4 units of rapid acting at the same time - can be a bit random results for me.
 
AMBrennan said:
Usually 4 times a day.

Think about it this way: if you don't test before you eat, how do you know how much insulin to take?
Click to expand...
That is misleading. BG isn't random, and BG after one meal will correlate strongly with BG before the next.

It really depends on how much your BG varies: If BG is really stable (4.5-5.5) before every meal unless the result after the preceding meal was way out of range, then you could get away with less (e.g. testing before one random meal each day). Similarly, if you notice that there's virtually no change between the 6:00, 6:30 and 7:00 tests than you could probably get away with fewer tests.

The greater the variability, the more you have to test. For example, I'll test 3x in an hour if I go swimming - because testing has shown that my BG may drop by up to 5mmol/l in 15min or so. Start by testing frequently.

Btw, I was told to do this (fasting in the morning and after each meal) by my consultant
Click to expand...

I think "misleading" is the wrong term.
If I'm at 8/9/10 before eating, I'll want to take an extra unit of insulin otherwise I'll be at 8/9/10 after I eat too. Likewise, if I'm slightly low I'll either inject after I've eaten or inject a unit less than normal.

My levels are very dynamic depending on a range of factors: how busy I've been in work, how recently I've done exercise, if I'm stressed, etc. There is normally a +/- 2 mmol/l for given meal on a day-to-day basis. Testing with the frequency that I do has given me the agility to bring my hba1c down over 1%, down to 7. I'm happy with 7% and I know I can get it lower. For me testing frequently is the only way to understand what is happening. Sometimes I test an hour after eating too to make sure that the food I've eaten hasn't got a high GI.

I'll encourage anyone to test frequently, but only if you do something with those results and use them to improve your controll.
 
I test around 7 times a day sometimes more like today whilst under extreme stress.
 
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