Finger prick tests wildly different

[Humminglime]

Hi all.

I've had type 2 diabetes for 6 years, spurred on after a prolonged infection from an operation.

Since Christmas I have been testing my sugars after a stressful and chaotic year 2024 and my hba1c rocketing to 78. I've managed to get it down to 60, still working on getting between 52-58. That's my goal for now.

I have been having soke issues with the testing, I rocket very high after any sort of carbs. I'm talking 17's,18's,19's, even 20+ sometimes.
If I have a balanced meal my numbers either stay the same or drop by 0.5 so I only lower my sugars by eating no carbs.

I've been told not to do the keto diet by the GP.

Anyone else have issues with their prick tests? I'll feel fine for example, usually get a raging headache when I'm high but the test will say I'm high, if I test immediately again I'll gey a different number etc etc. These number so far have differed by up to 4.5mmol!
And they're all taken within seconds of each other.
I have calibrated the machine, even got a brand new one from my GP and it's still doing the same? For example last night after dinner I got 18.1mmol, 14mmol and then 16.7mmol??
But I had maybe 2 tea spoons of rice, and a home made lamb curry with butternut squash and peas? No major carbs, not major sugar etc.

Anyone got any invite as this doesn't seem right to me.

 

[KennyA]

Hi

The tests and meters are not completely accurate. There's an allowable 15% variation in result, 95% of the time. So a true BG value of 6.0, for example, could generate results of anywhere between 5.1 and 6.9. And one in twenty results could be outside that, and the meter would still be within acceptable accuracy.

Obviously for higher figures, you'll get wider (percentage) variations, so a true 15.0 BG could generate a result anywhere beween 17.2 or 12.8. And your BG levels are dynamic and respond not only to food but also to stress - and testing can itself cause stress.

I'd advise not getting hung up on individual readings but to look at building up a pattern of readings over much longer periods of time. One of the reasons that they don't like T2s testing (although I think cost is the main one) is that people can become fixated on a single set of results.

If I was getting those sorts of results as you're reporting I think I'd conclude that whatever there was in the meal, there were too many carbs for my system to deal with at present. I'd be looking at the rice, the peas and maybe the squash as being potential issues, plus there were possibly onions and tomatoes in the curry etc. If you used a prepared sauce, there might well have been sugars and carbs in that. And I wouldn't eat it again, at least until I was sure I understood which bits were the real problem. I have a similar problem with pastry - so I don't eat it.

So I guess I'd believe what your meter is telling you, which is that you go unacceptably high after such a meal, and if you want to lower your BG generally that's the sort of meal you need to think about not having, or altering a bit. It really doesn't matter all that much whether you got a reading of 13 or 16. Either would be leading to the same conclusion.

 

[lovinglife]

Lots of GPs & HCPs advise against low carb/keto diet, but the tide is turning and many are now getting on board with the idea that it’s the best way to deal with T2 diabetes. My GP surgery is an advocate for it and my DSN told me her most successful T2 patients are all on low carb or keto.

You’ve discovered yourself with testing that what’s best for your own BG is not to eat carbs so why eat them if you don’t want to? Did your GP give you a reason why not to do keto? If it’s the “fear of the fats” because sometimes when they hear the word keto they think we’re eating massive amounts of fat. I don’t, I eat normal fat but not loads. So fat on meat, avocado, oily fish like salmon good virgin olive oil in dressings etc. a few nuts, full fat Greek yogurt, a little bit of cheese, butter & cream - I do limit dairy a bit because I find for me personally it can stall or make me gain weight.

It’s your diabetes and it’s in your control, no one else’s and it seems you’ve found what works for you is reducing your carbs. You could give it a try for say 3 months of reducing your carbs and see what results you get?

I agree with @KennyA that there’s quite a lot of hidden carbs in the meal you had. I make my own curry powders by mixing spices and even those have carbs I have to count - I make a masala one that the spices add up to 2.5g carb so even cooking a curry from scratch it can become quite carby if not careful

 

[JoKalsbeek]

Hi all.

I've had type 2 diabetes for 6 years, spurred on after a prolonged infection from an operation.

Since Christmas I have been testing my sugars after a stressful and chaotic year 2024 and my hba1c rocketing to 78. I've managed to get it down to 60, still working on getting between 52-58. That's my goal for now.

I have been having soke issues with the testing, I rocket very high after any sort of carbs. I'm talking 17's,18's,19's, even 20+ sometimes.
If I have a balanced meal my numbers either stay the same or drop by 0.5 so I only lower my sugars by eating no carbs.

I've been told not to do the keto diet by the GP.

Anyone else have issues with their prick tests? I'll feel fine for example, usually get a raging headache when I'm high but the test will say I'm high, if I test immediately again I'll gey a different number etc etc. These number so far have differed by up to 4.5mmol!
And they're all taken within seconds of each other.
I have calibrated the machine, even got a brand new one from my GP and it's still doing the same? For example last night after dinner I got 18.1mmol, 14mmol and then 16.7mmol??
But I had maybe 2 tea spoons of rice, and a home made lamb curry with butternut squash and peas? No major carbs, not major sugar etc.

Anyone got any invite as this doesn't seem right to me.

Quite with Kenny on this one... The deviation is within the acceptable range, so the meter is working correctly. Your blood glucose is a bit too high, and you already know dropping carbs could help. Keep in mind that GP's spend about half a day learning about nutrition and diet; it's kind of an afterthought. (To be fair, they do need to learn a whole lot about a whole lot.) I know mine's never heard of autophagy, glucogenesis or any other term related to foods and fasting, so yeah... Maybe read Dr. Jason Fung's the Diabetes Code? He's quite the expert, and actually knows what he's on about. Not saying you have to do what he says, but it would help you, possibly, to know exactly why your body responds to certain foods the way it does, and how to maybe help it get back to good.

I was told by my specialist that I didn't have the spine for a low carb diet (not even keto...), so yeah. It can get discouraging. Its your body, you have a meter, you can see in real time what works for you and what doesn't. Just saying. You have to live in it for the rest of your life, after all, and it'd be nice if it functioned to the best of its ability.

Hugs,
Jo

PS: My GP has ONE patient who got her bloods under control without medication. Out of a practice of several thousand people. *Raises hand and points to herself* That'd be me.

 

[Humminglime]

Hi

The tests and meters are not completely accurate. There's an allowable 15% variation in result, 95% of the time. So a true BG value of 6.0, for example, could generate results of anywhere between 5.1 and 6.9. And one in twenty results could be outside that, and the meter would still be within acceptable accuracy.

Obviously for higher figures, you'll get wider (percentage) variations, so a true 15.0 BG could generate a result anywhere beween 17.2 or 12.8. And your BG levels are dynamic and respond not only to food but also to stress - and testing can itself cause stress.

I'd advise not getting hung up on individual readings but to look at building up a pattern of readings over much longer periods of time. One of the reasons that they don't like T2s testing (although I think cost is the main one) is that people can become fixated on a single set of results.

If I was getting those sorts of results as you're reporting I think I'd conclude that whatever there was in the meal, there were too many carbs for my system to deal with at present. I'd be looking at the rice, the peas and maybe the squash as being potential issues, plus there were possibly onions and tomatoes in the curry etc. If you used a prepared sauce, there might well have been sugars and carbs in that. And I wouldn't eat it again, at least until I was sure I understood which bits were the real problem. I have a similar problem with pastry - so I don't eat it.

So I guess I'd believe what your meter is telling you, which is that you go unacceptably high after such a meal, and if you want to lower your BG generally that's the sort of meal you need to think about not having, or altering a bit. It really doesn't matter all that much whether you got a reading of 13 or 16. Either would be leading to the same conclusion.

Thank for for the detailed reply. That makes a lot of sense.. as often I will get the higher number but not sure what to record as they're all different! I think like you said I need to work on overall lower numbers and not fixate on the number itself!

Many thanks.

 

[Humminglime]

Lots of GPs & HCPs advise against low carb/keto diet, but the tide is turning and many are now getting on board with the idea that it’s the best way to deal with T2 diabetes. My GP surgery is an advocate for it and my DSN told me her most successful T2 patients are all on low carb or keto.

You’ve discovered yourself with testing that what’s best for your own BG is not to eat carbs so why eat them if you don’t want to? Did your GP give you a reason why not to do keto? If it’s the “fear of the fats” because sometimes when they hear the word keto they think we’re eating massive amounts of fat. I don’t, I eat normal fat but not loads. So fat on meat, avocado, oily fish like salmon good virgin olive oil in dressings etc. a few nuts, full fat Greek yogurt, a little bit of cheese, butter & cream - I do limit dairy a bit because I find for me personally it can stall or make me gain weight.

It’s your diabetes and it’s in your control, no one else’s and it seems you’ve found what works for you is reducing your carbs. You could give it a try for say 3 months of reducing your carbs and see what results you get?

I agree with @KennyA that there’s quite a lot of hidden carbs in the meal you had. I make my own curry powders by mixing spices and even those have carbs I have to count - I make a masala one that the spices add up to 2.5g carb so even cooking a curry from scratch it can become quite carby if not careful

My gp decided against keto because they're worried about the knock on affect to my liver and have said they generally stay away as its not sustainable and you need carbs and theats what fuels your brain.

I love carbs and have limited portions, I rarely eat rice or pasta but if I do theyr never bigger than the palm of my hand.
To be completely honest I did keto once and while my number looked great I was so depressed and miserable. Lost my appetite and ate only enough at meals to keep going sort of thing.

I've worked on my relationship with food a lot over the year and feel I've definitely improved but I want to be able to have a little something here and there if I can. I've cut carbs from breakfast as that rockets me so it's just sad meat and eggs for me

I made my own curry and I've never had an issue with butternut squash before so used that as the base, added my own spices etc.

Seems to be OK with peas usually. The most was little corn flour because I was lazy and didn't reduce the curry

 

[lovinglife]

You have to do what’s best for you and is sustainable for you personally but your numbers are high so something has to change, either diet or perhaps meds? There’s no one way to do things & no shame in taking meds to be able to have a few more carbs if that’s what you need to get your numbers down

But have to personally disagree with your GP on this one

My gp decided against keto because they're worried about the knock on affect to my liver and have said they generally stay away as its not sustainable and you need carbs and theats what fuels your brain.

I’ve been low carb coming up 15 years dropping down from 130g when on maximum Gliclizide to keto of less than 20g carbs for coming up 7 years so it’s definitely sustainable. As to the liver, and this is my personal experience only. From November to beginning February I was quite ill with another condition and had to have an almost no fibre diet so I had to up my carbs a little bit, my ATL shot up and I’ve had to have lots of blood tests and scans. I’ve been back in my full keto 6 weeks and my ATL is back down to where it’s always been & my liver is fine

You don’t need carbs to fuel your brain, once fat adapted your brain will run just as well if not better on fats & protein, carbohydrates are the only macro that the body doesn’t need at all

Have a read of the link below explaining how your brain can run of fats & protien

How to Boost Your Brain Health with Low Carb and Ketogenic Diets

Discover how these diets can improve brain health and function in people with epilepsy or Alzheimer’s, other possible benefits, and more.

www.healthline.com

Edited to add link

 

[JoKalsbeek]

My gp decided against keto because they're worried about the knock on affect to my liver and have said they generally stay away as its not sustainable and you need carbs and theats what fuels your brain.

I love carbs and have limited portions, I rarely eat rice or pasta but if I do theyr never bigger than the palm of my hand.
To be completely honest I did keto once and while my number looked great I was so depressed and miserable. Lost my appetite and ate only enough at meals to keep going sort of thing.

I've worked on my relationship with food a lot over the year and feel I've definitely improved but I want to be able to have a little something here and there if I can. I've cut carbs from breakfast as that rockets me so it's just sad meat and eggs for me

I made my own curry and I've never had an issue with butternut squash before so used that as the base, added my own spices etc.

Seems to be OK with peas usually. The most was little corn flour because I was lazy and didn't reduce the curry

Basically, what @lovinglife said.

As for the liver, I don't know what's wrong with yours, but I was diagnosed with non-alcoholic fatty liver disease 9 years ago. It should've had me in my coffin quite a few years back, by the endo's estimate, but I'm still here. Thing was, with high blood sugars, the body tends to store whatever it can't burn or wee out... And it gets stored in fat cells. And my liver was packed so full of engorged-with-glucose fat cells, they initially thought it was one big tumor and I just had weeks to live. Then it turned out to be a fatty liver, and weeks turned into maybe a year or two, tops, so not really a big improvement. I went low carb, my blood sugars went back into the normal range, and the fat basically melted off my liver. The only way to see it ever was wonky, became an ultrasound, because the bloodwork went back to normal, liver function was fine. Then something else threw a wrench in, (kidney stones, long story short), my blood sugars went back up, and my liver went back to being fatty as well. So since about half a year I've been working on getting my liver back to good. Mainly by eating a keto diet. And it does seem to be working, because it's not hard and painful anymore, and not keeping me up at night. (Y)

As for the brain, well... If a body needs glucose for the brain to work, it can make it out of the proteins you eat. It takes a little more effort from your body to convert it, but I've done a completely zero carb diet for a while (Carnivore, so just animal fats and protein), and my brain didn't shut down. Far as I can tell, anyway. And all that's nice and whatever, but if you're miserable on a keto diet, then you're miserable on a keto diet. And I can go stand on my head and extoll the virtues of low carbing, but you'd still have no enjoyment in life. So... Considering the height of your blood glucose, you do need to do something... Diet is a good way to go, but it's not for everyone. If it makes you unhappy, that just doesn't help matters. There's lots of meds out there yet to try, maybe insulin...? But you really do want to get in a better range, because right now, your blood glucose is likely harming your insides. So maybe something to mull over and discuss with your nurse/GP?

Good luck!
Jo

 

[KennyA]

My gp decided against keto because they're worried about the knock on affect to my liver and have said they generally stay away as its not sustainable and you need carbs and theats what fuels your brain.

I love carbs and have limited portions, I rarely eat rice or pasta but if I do theyr never bigger than the palm of my hand.
To be completely honest I did keto once and while my number looked great I was so depressed and miserable. Lost my appetite and ate only enough at meals to keep going sort of thing.

I've worked on my relationship with food a lot over the year and feel I've definitely improved but I want to be able to have a little something here and there if I can. I've cut carbs from breakfast as that rockets me so it's just sad meat and eggs for me

I made my own curry and I've never had an issue with butternut squash before so used that as the base, added my own spices etc.

Seems to be OK with peas usually. The most was little corn flour because I was lazy and didn't reduce the curry

Five years, four months keto now. I am unsure where this "not sustainable" thing comes from as it is so easy to disprove. And for me it put my HbA1c back to normal (36) within four months. Plus 90lbs of fat loss over the following years.

For most people glucose is what fuels your brain, and also, in excess amounts, what causes nearly all the nasty diabetic symptoms as well. Your liver will happily make all the glucose your body needs out of other stuff, and carbohydrate is the one "macro" food we can completely do without. The NHS dietitian on my "welcome to Type 2" course in 2020 readily confirmed that.

I happen to think we wouldn't have evolved to be able to do without carb if it wasn't both necessary and useful, and I'd also guess the last eighty years or so is the first time ever that most people have had carbohydrate - particularly sugars - readily available in quantity.

[Edited: to change "with" to "without" in the final paragraph - crucial difference!]

 

[Angela64]

Have you tried a Still on monitor? You can try a free one from Libre. I’m trying one at the moment because I had Op on 20/3 and it’s affected my readings.
I am low Carb, high protein, have been since I was diagnosed. Only take Empagliflozin. Really really do not want insulin until I have too.

 

[Melgar]

@Humminglime , I wouldn't get too hung up on the fluctuating finger prick readings. Your blood sugars fluctuate. They can fluctuate minute by minute. This can be seen if you wear a CGM device that continuously monitors your blood sugar via readings from your interstitual fluid . They change constantly when viewed over very short periods of time. The cgm graph that is generated from the accompanying app shows these fluctuations, but over a 24 hour period however, the graph can look more even, so you don't see these movements.

The organs responsible for blood sugar homeostasis, the pancreas and liver, are constantly working to adjust your blood sugars, even when you don't eat, for instance during your night time fasted state. So add food into this mix you will see these organs working, trying to maintain 'normal' blood sugars homeostasis and the inevitable fluctuations.