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How to test systematically

L

Lupf

Well-Known Member
Messages
259
Type of diabetes
Type 2
Treatment type
Diet only
I am a type 2 diabetic. As I mentioned in other threads on this forum, I have lost 10kg with 5+2 last year and I was also able to reduce my Hb1Ac so that I am off metformin now. When I received the test strips a year ago, I wasn't really given any instructions. As a scientist I know that you have to do measurements systematically. I was weighing myself once, max twice a week in the morning before breakfast thus decided to do the same with blood sugar measurements. However I have also been told in this forum that I should test before and after eating to find out what effects different food is having on me. As we are house bound due to the coronavirus pandemic - I am working from home - I could actually give this a try now. Thus I have a few questions on how to do these measurements correctly and systematically.
1) How much time after eating should I test, how critical is this timing? I've seen two hours on this forum, but I've also seen graphs where after 2 hours the levels are back to normal.
2) What is a good result, i.e. how much increase is ok. My pre-breakfast measurements are around 6.0 mmol/l with a standard deviation of about 0.7 mmol/l.
3) Should I do similar double tests before and after dinner.
3) Can you please point me to links where good procedures are written down. I would like to see some analysis of data as well.
 
Lupf said:
1) How much time after eating should I test, how critical is this timing? I've seen two hours on this forum, but I've also seen graphs where after 2 hours the levels are back to normal.
Click to expand...
I test my post prandial bgl within a 2 - 2½ window, it works for me.

I cant help you with your other stuff.
 

Hi @Lupf ,

I've been doing this for a fair few years. I don't live in a controlled environment. Though I have been spending a lot of time at home lately..
I test when I wake, before a meal. 2to 2.5 hours later & before bed. &because I'm T1 using insulin, before I drive & two hours consecutively if behind the wheel. & also to gauge hypoglycemia & the treatment there of.

Now I also use a CGM set up which really helps too.

With the best will in the world, there are too many variables to list.. Insulin sensitivity on any given time of day in any given climate? Food digestion? Not all foods metabolise on any given day aproximately the same.

You may read sometimes a member will say, "what the hey! I had my usual for breakfast & the BGs shot up?"

I don't look at comparing myself to peer reviewed paperwork.
I get to understand the only "rat" in the lab. Me?

I will tag in @Bluetit1802 regarding testing. & @bulkbiker who maybe able to help with some data you can work with?

Kind regards,

Stay safe.

Jay.
 
Hi @Lupf ,

As a previous poster said there are many variables. As someone with a science degree but not a scientist I would suggest trying measurements at 60 mins, 90 mins and 2 hrs. If at 2 hours the readings are still higher measure half an hour later. Try that with a few meals to see where you 'normally' peak. This is likely to be different for different food and activity.

As there are so many variables I think 2 hours works as it is likely near the peak of the increase. If it goes up too much- the end result while important is not as important as the message that that meal is not suitable for your body. If it is something you really like maybe see how much exercise you need to do to lower the peak and then you have something that you may be able to tolerate as an occasional treat.

I too have experimented with taking more readings on some foods- I like information and I want to remind myself how important it is not to carb creep.

Good luck
 
If I test postprandial it's almost always at two hours. If I missed a peak and it's back to normal by that time, then that indicates good metabolic function and it's highly unlikely I had an undesirable glucose excursion at all. The truest answer is that there is no answer. You will gain your answer only from experience with your own body. Test test test, and all shall be revealed in time.
 
For your own records, you want to be consistent.
So test just before your first mouthful and then decide on a standard time and stick with it.
Then record the results systematically. Lots of Apps available, but a well designed DIY spreadsheet is (for me) a thing of joy

regarding timing, I think the 2 hrs thing is based on standard targets
https://www.diabetes.co.uk/features/pre-and-post-meal-testing.html

But the reality is that we usually end up setting our own targets, and may rapidly learn that our personal food choices (fat, fibre, protein and carb combos) lead to slower or faster digestion.

I eat v few carbs at all, and my bg is likely to read highest at 2-3 hours, if it peaks at all (the line on my Libre is usually rather flat). But if I switched food choices I could see peaks much earlier, and higher. Today I will open my dark choc Easter egg and see a peak at around 90 mins . It will look like a speed hump in the road, not like one of those traffic cones because I will control the portion size.

so you get to design your own personal testing regime tailored for you, your life and your food choices.
 


hii
thanks for sharing this information
 
Hi @Lupf

I test a lot less frequently now but when I started out on this journey I'd test FBG and before and 2 hours after every meal noting what the meal was so I'd have some half decent data.
My early spreadsheets looked like this


The green denotes FBG after getting out of bed having a pee and weighing (which is my daily routine to this day)

As I started intermittent fasting along with greatly reducing cab consumption I rarely (if ever) have breakfast so mealtimes were lunch and dinner. These days I rarely eat anything before 2pm and just have coffee with double cream throughout the morning.
I also have kept a detailed food diary since 2017 that looks something like this



I have become a bit of a data nerd!

Edit to add the soy milk was a "new to this game" schoolboy error!
 
Last edited:
As others have said, it is an individual choice of when to test, but it needs to be consistent and more importantly, it needs to be recorded. I found the best way of recording is on a spread sheet with lots of columns and a space for notes. Whilst testing different foods, I also kept a food diary that contained all the ingredients of that meal and the portion sizes. I was testing before and after eating, fasting, and bedtime. My post meal testing included an hour, sometimes 90 minutes, and 2 hours after first bite, and continued if the 2 hour level had not come down enough for my liking.

I am over 6 years down the line now so no longer test out my meals or keep a food diary, but I do test 3 times a day still and record the results on my spread sheet. I just test my morning fasting, before evening meal, and bedtime, and I average each of these monthly to keep an eye on trends.
 
thanks all, this is very helpful.
I fully agree that you need to write down the results.
I am logging my data on a big spreadsheet, so will continue doing so.
In fact, there is a saying if you start measuring and writing down things, ...
you will improve your results, because you subconsciously want to win.
This can be the case for many things, be it blood sugar and weight loss,
but also shopping expenses or heating and electricity metering.
Apologies to anyone reading this where this wasn't the case.

Next question: By testing before and after meals, I will quickly run out of test strips.
In case I can't get these on prescription, can I bulk buy them myself at reasonable prices?
I am using the Accu Check nano-Performa
 
Lupf said:
In fact, there is a saying if you start measuring and writing down things, ...
you will improve your results, because you subconsciously want to win.
Click to expand...

That is precisely what I found. It was my biggest motivator.

As for testing strips, you may have to buy a new meter if you want cheaper strips. I will tag @Rachox who has more up to date details. Personally I use the Accu Chek Mobile and buy my replacement cartridges from ebay at a fraction of the price. I know many don't like the idea of this, but needs must when we self fund and the full retail price is exorbitant.
 

shop around.
If you aren't getting them on prescription, you will be amazed at the variation in cost for a pack of test strips.

the two best value brands I know, are the Tee2 and the Codefree meter.
I actually prefer to buy my own, since I don’t get free prescriptions, the cost of 50 strips in either of those brands is cheaper than paying for a single item prescription charge. So it saves the nhs valuable pennies and eliminates their handling/admin costs.
 
Hi @Lupf .
Here’s some info on UK meters, and to be clear I have no commercial connections with any of the companies mentioned. For a meter with cheap strips go for the Tee2 + found here:

http://spirit-healthcare.co.uk/product/tee2-plus-blood-glucose-meter/ with the strips found here:

http://spirit-healthcare.co.uk/product/tee2-testing-strips/

Some members have got a free Tee2+ by phoning up to order, with a large order of strips they often throw the meter in for free:

Phone number 0800 8815423

With more expensive strips is their Caresens Dual which I currently use, this one has the advantage of glucose and ketone testing in one machine, it’s to be found here:

https://shop.spirit-health.co.uk/collections/caresens-dual



Home Health have recently bought out this one, but I haven’t heard any reviews yet, links to strips and the meter:

https://homehealth-uk.com/all-products/glucose-navii-blood-glucose-test-strips-50-strip-pack/

https://homehealth-uk.com/all-products/gluconavii-blood-sugar-meter-glucose-monitor-starter-kit/

And to be totally transparent I used to use the SD Code Free from Home Health which has the cheapest strips available if bought in quantities of 5 or 10 pots with the codes below. However I found it to be becoming less and less reliable. Here it is for anyone wanting to give it a go, just bear in mind it seems they are replacing it with the Navii, details above.

http://homehealth-uk.com/product-category/blood-glucose/blood-glucose-monitor/

and here for the extra strips

http://homehealth-uk.com/all-products/sd-codefree-test-strips-to-be-used-only-with-the-sd-monitor/

There are discount codes if you buy in bulk.

5 packs 264086

10 packs 975833


Don’t forget to check the box if you have pre diabetes or diabetes so you can buy VAT free. (for all meters and strips)
 
I noticed that I posted this
https://www.diabetes.co.uk/forum/threads/how-reliable-are-hb1ac-tests.172402/page-3#post-2270649
in the wrong thread, so here it is again

The plot thickens.

First the good news: I managed to lose that couple of pounds I wanted to and keep it off; I am back at the same weight as before Christmas. The good weather helps as I do lots of cycling. I am also having online physiotherapy sessions for my shoulder, so fingers crossed on this front as well. With my weight my blood sugar levels - before breakfast - came down to about 6.0 mmol/l again. This was at the beginning of May, so I was rather pleased.

Then something happened for which I don't have an explanation. About a month ago my pre-breakfast levels jumped up to about 7.0 mmol/l on average. First I thought it was a blip, but by now it has stayed around that level for five weeks. The graph of the data literally looks like a step function of +1.0 at the beginning of May. I honestly do not recall changing anything at this time. Due to Covid my routine has been more stable than ever. Hence I am at a bit of a loss of what is going on. Any ideas anyone?

I also started to measure BS levels 2 hours after breakfast or 3 hours when I am stuck in meetings. While I need to do more measurements, it looks like my post brandial levels increase by 1 to 3 mmol/l. I hear that up to 2 is ok, but how bad is 3?
 
I found this post on this webpage
https://www.diabetes.co.uk/features/pre-and-post-meal-testing.html

What are the recommended pre-meal blood glucose levels?
The NICE guidelines for pre-meal blood glucose level targets are:
  • Type 2 diabetes: 4 to 7 mmol/l
  • ...
Your post-prandial blood glucose levels will largely be influenced by the meal you have eaten, the type and dose of medication you take and how sensitive your body is to insulin. Most people with diabetes can expect to see a rise in blood glucose levels for their after meal results.

The NICE guidelines state the following post meal blood glucose level targets:
  • Type 2 diabetes: under 8.5 mmol/l
  • ...
 
Lupf said:
I found this post on this webpage
https://www.diabetes.co.uk/features/pre-and-post-meal-testing.html
...
Click to expand...

That's the guide I've used, plus advice I originally found on the forum when first diagnosed, regarding further possible tests. e.g.
  • Test at approx 1 hour if eating something higher in carbs that you may want to check out
  • test at 3 hours or more if eating a combination of carbs and fats (aka the pizza effect!), as there may be a later spike or more likely a rounded hump - fat can slow down the faster, sharper glucose rises.
However, I've seen both types of rise around the one hour mark (vertical lines are hourly divides):
Spike peaking approx 30mins being given sugar water


Double bumps from high sugar and fat:


It's also worth being aware that it's not only food that affects our glucose levels, illness, pain, stress, exercise, heat, some medications e.g. statins and steroids, etc, can also do so, and I've sometimes tested at various times to check this sort of information too. I've actually found these non-food related variations interesting and possibly more useful than the food ones, and they've provided me with some answers to my "Why has that happened when I've not been scoffing carbs?" type puzzles. But the best method for seeing exactly what goes on 24/7 is to use Libre sensors for logging, if you can afford to do so - even if only occasionally.
 
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