'Discussion' with my doctor about glucose testing

hya,
i was told i dont need to test 4 times a day but i do and often more if i feel hypo

HI,
it DOES sound like your doc's trying to dictate your life. If you drive apparently you're supposed to check before you drive, add to that keeping your children safe, excercise, hormones and normal life. Trouble is docs read from a text book and think they know it all. You know more than your doc about your own life, and he should not be forcing you to reduce testing and therefore taking risks with your life. You may also want to point out to your doctor that it is commonly known, and your doc should be aware, that people on synthetic insulins often lose 'hypo awareness'. Therefore you may not be aware when your blood sugar is low-see what he has to say then :evil:
A lot of people on this forum have had same experience with their GPs, including me, and it's unnacceptable. Tell him so, and stick to your guns.
Best of luck
Jus

move to France. They insist on at least 4 times a day, and have no problems with more if you want to. To be honest, I feel the care I get over here is far far superior to the care I ever got in the UK. It's one of the few bonuses of having to move here for work

secrettheatre said:

but I still think a max of 3 times per day isn't right. 5-6 times doesn't seem unreasonable.

Thanks for all the replies so far, by the way.

C.

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Your fingers will start to hurt after a while doing that many. I think 4 a day is enough - when you wake/eat b'fast, before lunch, before evening meal, before you sleep.
If you are sticking to your diet (amount of insulin v amount of food), there really isn't any need to do more. I think your biggest issue may be working out how much you need to eat, and what insulin you need to take for that amount of food, rather then simply doing lots of blood tests, and eating more food/taking more insulin when it's wrong. Testing itself doesn't actually mean better control. It just means you are more aware of when your balance isn't great. Sort out the balance, you're hypos will diminsh, and you won't have to concentrate all your time on checking yourself.

I'm with you Chris. I test 5 times per day minimum. Why else would they make 'em in strips of 5? :wink:

fergus

I have some days when I test only 4 times, before meals and bed. I don't know how you can get away with less than that. You need to know the premeal level to adjust the mealtime dose and at bedtime you need to make sure that you're not going to bed with too low a level.
Most days I test more, for exercise, hypos etc. I get through 200 strips a month.

My specialist told me all Type 1's should be allowed to test up to 6 times a day if they need to.

You're the only one who knows your own body and how it responds. Just keep plugging away at your doctor. I've never had that situation, yet, knock on wood!! Then again I don't live there but I've never had a problem regarding strips or any other D related items/meds. I could say buy an extra box yourself but that is a costly alternative unless your're rolling in money which all of are not. All the best, Carol

Upon waking, before breakfast, before driving to work, before lunch, mid afternoon, before driving home, before evening meal, before bed. I couldn't possibly test any less than that and have no intention of doing so either. No way could I live my busy life on just 3 or 4 tests a day and I don't see why I should have to be hypo or hyper to save a few test strips. What really bugs me is that they quibble about test strips but happily hand out boob jobs on the NHS because of a sore back or low self esteem. Go figure!!!!

Caitycakes x

(sorry for length of this post )

the thing that bothers me is that your insulin doesn't work that quickly. if you are testing as someone above says 'when waking, before b'fast, before driving to work' - that can only be a space of an hour at most. Insulin works for around 3 hours after taking it - it peaks 1.5 hours after taking it. So for example, you get up at 8am. Do a blood test, take your Lantus. Get showered, dressed, etc. Prepare your b'fast, do a blood test, take the appropriate amount of insulin for your bs and food. Eat b'fast, clear up, get ready to leave for work. Do anther blood test - is this 3 hours after you've eaten b'fast? Or 30 mins later? The result you get will be affected.

Maybe this only works for the insulin I'm on,though. As I said, I feel my treatment here in France is way superior to that I was getting in the UK. The doctor has no problem with me testing my blood as many times as I like. However, she has told me that testing before eating, and three hours after if it's felt necessary is ample.

You should know your own body. You should be able to feel if you are running high or low. When you test your bs, and it's normal, make a note of how you feel. Do the same when you test and it's high/low. Once you know how you are feeling, you should know when you need food/insulin/nothing.

I'm not having a go at any of you who prefer to test your sugars more frequently, but I can't help feeling it is a real restriction on your life, and how much you enjoy it.

Try to speak to a nutritionist, and your doctor. They should be able to tell you how much insulin you need for the amount you are eating. Stick to the recommended number of carbs they are telling you to eat each meal, and take the appropriate amount of insulin for that amount of carbs. You should then be able to know 'ok, I had 30 carbs for b'fast, therefore I need * units of insulin' After a while, you'll find your sugar levels level out - eat the right amount of carb, take the right amount of insulin, and you will rarely need to adjust stuff, and will therefore not need to do the bloodtests so often.

Although cost obviously comes into it, I know that my doctor is more concerned with my quality of life than how much I am costing the health service. To her, if I prefer to reduce the number of tests I do, and I am usually balanced ok, there is no need to 'hurt' myself doing unnecessary tests every half hour.

Secrettheature - you need to speak to your doctor/nutritionist - find out how many units of insulin you need for the amount of carb, and how many units of insulin you need to reduce your blood sugar by a particular amount ie humalog (for me, anyway) 1 unit = 2,3 BS. I have no idea whether this is the same for everyone, but can't be far out.

secrettheatre said:

But the problem is if you're losing hypo sensitivity, as I am, your body is not giving you adequate warning of when you're going low.

Actually I'm due to go on a DAFYDD course soon, which I hope will finally help me sort out the relationship between my carb intake and insulin dose. I have made an awful lot of improvements in the last few months after years of total mismanagement (leading to mild retinal changes). So I'm still learning, you see.

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Hmm aren't there some devices out there that warn you when you are about to go hypo? they work on skin temperature or something? Might help you out a bit

Have fun on the course I did that late last year - it was decided it would be useful for me, since I'm in a different country now, with different foods. I really enjoyed it, and found it gave me lots of info I didn't know before Hope you find it useful.

Sweet3x said:

I'm not having a go at any of you who prefer to test your sugars more frequently, but I can't help feeling it is a real restriction on your life, and how much you enjoy it.

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Personally, I find frequent testing is not a restriction, it's freedom. Since I did DAFNE and hence started testing more, my quality of life is better than when I tested twice a day. Because I have better control, with fewer bs swings, I feel better, have more energy, general health is better, and I am controlling my diabetes rather than the other way round.

Sweet3x said:

(sorry for length of this post )
After a while, you'll find your sugar levels level out - eat the right amount of carb, take the right amount of insulin, and you will rarely need to adjust stuff, and will therefore not need to do the bloodtests so often.
.

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That's the theory. But in practice, things do change. Some women need considerable changes in basal and meal boluses due to their menstrual cycle. Testing frequently helps clarify if its the bolus or the basal that needs changing. I don't need to test so frequently every day, but I need to have strips available so I can test as and when I need. Someone with a history of sleeping through night hypos shouldn't assume a high morning reading means more basal is needed, they may actually need less, so need to test in the early hours.

If secrettheatre can explain her reason for doing each test, and how the result was used, that's what matters.

Twice a day is wasteful if you don't act on the results. 8-a-day is justified if you did them with good reason and used the results wisely.

Do they impose an insulin dose we must take because that's what suits other people? No. Do they limit the insulin dose of a very insulin-resistant T2 on cost grounds? No and nor should they. So why limit tests that way? Everyone's different. T1s may do more tests than T2s, but we're likely to be using less insulin, so if cost is the issue they should look at the whole picture.

I agree that carb-insulin ratio is important but also that it doesn't always go the way you want.. Things like stress, excercise a meal out can all alter your levels. I have had diabetes now for 39 years have been very well controlled for at leas 25 of these, I can test my blood from anything between 3 and 8 times a day due to the fact that I work, I drive and also have young children aged 6 and 2.5 that need to be taken care of, taken to and from nurey and school etc. And as for someone saying that you should be aware of being high or low well they are wrong as I used to be able to tell but have lost awareness of hypos untill it is too late