HypoGlycemia and Plasma meters

[AndBreathe]

I started this thread, and you are missing the point I am trying to make. I have never had a hypo in the sense that you seem bent on describing, simply because I take steps to avoid getting to that stage Unlike you I am unable to apply dose correction, so I rely on getting warnings so I can take in carbohydrate to raise a low bgl. As a driver, it is important that I react to warnings, and my meters have in the past given me confirmation that my body is reacting to low bgl. Having experienced bgl drops of around 3 mmol.l in one hour due to my meds, I have to have headroom that I can rely on, So I am reliant on my meters to tell me, since my body can be fooled.

My NEO may be a bum steer or whole blood. It does not matter since I was able to trust it. Now I have a meter that seems to read higher at the point where it matters. I have a second meter but it is too erratic and misreading to be relied on. This is my concern, that my meters will give me readings above the magic 5, so I would feel justified in getting behind the wheel. I have had this many times now with my SD meter (PE), and yet it was clear to me that I should not drive without taking action.

I notice that the diagram and the article both show symptoms starting at about 2,9 mmol/l, but my body tells me different to this. Maybe having strokes has made me more sensitive but we are not all the same anyway.

Oldvatr, am I correct recalling you take Gliclazide still?

 

[Oldvatr]

Oldvatr, am I correct recalling you take Gliclazide still?

Affirmative. Reduced from 4 tabs/day to 1 tab/day. The 3,0 mmol/l drop mentioned in previous post is actually from the 1 tab dose. I was seeing 7+ drops with the 4 a day.

I still need it to get my daily average at around 6 to 7 mmol/l which is my current target. Today it is sitting at 6.4 but this is after binning my NEO and using my new Dual instead.

 

[Bluetit1802]

This may be a silly question, and maybe it has been answered before, but why can't you still use the NEO and buy your own strips? You could then stop using one of your other self funded meters to recoup the cost.

 

[AndBreathe]

Affirmative. Reduced from 4 tabs/day to 1 tab/day. The 3,0 mmol/l drop mentioned in previous post is actually from the 1 tab dose. I was seeing 7+ drops with the 4 a day.

I still need it to get my daily average at around 6 to 7 mmol/l which is my current target. Today it is sitting at 6.4 but this is after binning my NEO and using my new Dual instead.

In your shoes, if I were regularly battling hypos, I'd be investigating reducing my medication further. Perhaps it could be time for a trial without the Gliclazide? Might be worth a chat with your Doc.

 

[Oldvatr]

This may be a silly question, and maybe it has been answered before, but why can't you still use the NEO and buy your own strips? You could then stop using one of your other self funded meters to recoup the cost.

Not a silly question at all, and is obviously an option I could pursue. I am a pensioner, so cost of ownership is important to me. I can get NEO strips from my local pharmacy for £32/50 strips, but I used to do this and I had 2 successive bad batches, but could not get my money refunded. I can get them from the internet, and Amazon have them at £23/50. I had one batch of counterfeit strips from this source, but did get a refund. I am dubious of other sources such as eBay.

Compare that with the SD Codefree strips, which I can buy VAT Free, and with a discount code, at a much cheaper price) , My current test regime with extra DVLA needs means I get through about 100 strips every 4 weeks, i.e. 2.3 packs a month. This cost for the Codefree is one that is just about affordable at the moment, and is in my household budget.

The other option I have is to reduce my test regime. I have already cut out my Fasting bgl readings, but unless I drop the second meter, except for those occasions when I need to confirm a DVLA reading or a bedtime hypo alert, then I cannot afford to support my NEO habit (same as the NHS / CCG) I could stretch to taking on the new Dual meter but that would not help me since it is as yet unproven reliability, and seems to read a bit higher than my NEO anyway. I may need to consider this if I manage to drop my last Glic tab, thereby no longer qualifying for NHS support

OR ----- I can continue as I am proposing to do, but make a mental allowance for the Dual being slightly higher than the old NEO, and adjust my interpretation slightly. So instead of starting to take action to a meter reading of 3.9 or less, my new trigger point will be 4.7, and my DVLA target becomes 5.5 instead of 5. This is simple for me to manage, and will provide me the margins I need to maintain. I have never relied on my SD meter, since it is quite erratic and not reliable It is a simple sanity check, and up till now, was a good indicator of my next HbA1c which so far has fallen halfway between the NEO and the Codefree when averaged over the previous month. I think this latter calculation can be now taken from my new Dual meter which is already looking to be close enough on its own. This seems to be the best solution for me at this moment in time.

 

[Bluetit1802]

Personally, if it were me, I would drop the Codefree and reduce the testing. I have done something similar. Some Codefree batches/tubs are fine, but others completely remove my trust, and without trust there is stress. I have now gone over to using my AccuChek Mobile exclusively other than a few comparison checks, and have reduced my testing. Two reasons for this, if not three.
The AC Mobile is convenient due to everything being in the meter. No tubs, no disposal of strips, no handling strips, no contamination.
The Codefree reads much higher and has a tendency to be erratic.
I need to stop my testing obsession.

I use eBay for my Accuchek strip cassettes, have done for nearly 3 years, and haven't had any issues (yet). They are still expensive, so hopefully that will help rid me of this testing obsession and give me results I can trust.

 

[Oldvatr]

In your shoes, if I were regularly battling hypos, I'd be investigating reducing my medication further. Perhaps it could be time for a trial without the Gliclazide? Might be worth a chat with your Doc.

I discussed this with my GP at my last review, but it was decided that I continue with just the one to see how I get on after dropping a second Glic just in time for Xmas. It certainly drops my bgl well, but my lows are manageable and there is low risk of any serious follow on so long as I keep my present regime and timings. The Glic does seem to allow a higher carb intake than if I was not taking it.and my GP prefers this at the moment. I have a stated target to drop the Glic since it makes no sense to squeeze insulin from a compromised pancreas just to store excess fat that I do not need, which is how it acts to lower bgl. But my GP wants to make sure I can maintain LCHF diet for long period, since he obviously sees other patients who find dieting an anathema.

I am not worried about having bgl in the 3.2 to 3,9 NEO range as I have been in the recent past, It is manageable.

 

[Oldvatr]

Personally, if it were me, I would drop the Codefree and reduce the testing. I have done something similar. Some Codefree batches/tubs are fine, but others completely remove my trust, and without trust there is stress. I have now gone over to using my AccuChek Mobile exclusively other than a few comparison checks, and have reduced my testing. Two reasons for this, if not three.
The AC Mobile is convenient due to everything being in the meter. No tubs, no disposal of strips, no handling strips, no contamination.
The Codefree reads much higher and has a tendency to be erratic.
I need to stop my testing obsession.

I use eBay for my Accuchek strip cassettes, have done for nearly 3 years, and haven't had any issues (yet). They are still expensive, so hopefully that will help rid me of this testing obsession and give me results I can trust.

I use two meters in parallel for detecting the effect that happens when changing a batch of strips. I maintain running weekly averages on both meters, so if after a strip change there is a step change in one of these then if it is the same for both meters then it is probably diet or meds or routine, but if the other meter stays much the same then it may be a duff batch of strips or a flat battery.

I would love to give up the Codefree, but I can manage with the status quo, since it is all relative.