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I'm not really sure how best to use my new code free meter.

gardengnome42

Well-Known Member
Messages
212
Location
Yorkshire
Type of diabetes
Prediabetes
Treatment type
Diet only
Dislikes
diabetes and dieting
I was told at my annual hypertension review that the HbA1c was 43 and the nurse I saw said to have another test in a year. No point waiting to tip over into full diabetes I'm thinking yet don't really need to lose any weight so am not sure of the best way to go. Hence the meter. Meanwhile I test first thing in the morning before breakfast and consistently get a reading of over 6.5. None higher than 6.8 but I do wonder what it is telling me? Obviously things are not quite normal - or are they? If I then test before a meal and 2 hours after the numbers vary enormously: I assume it depends on what I've eaten?
Any advice on the best way to use the thing would be appreciated.
 
I think the most useful information to be gained from home testing is when you test before eating a food and then retest 2 hours later - the difference between the two readings tells you how much that food increases your blood sugar and that information helps you make decisions whether or not to carry on including it in your diet - big rises are best avoided and are often, but not always or exclusively, produced by foods with a high carbohydrate content like pasta, bread, sweets, rice etc
I found initially testing individual foods was more useful than testing whole meals as then I could be certain which food was causing the rise - I could then move on to testing combinations of foods
 
Fasting blood levels i.e. first thing in the morning before eating are affected by something called the dawn phenomena. It's where our livers help us to get out of bed and go food gathering by giving us some energy. It also happens during the day you'll see it called a liver dump. I think that if your body normally runs at around 6.5 then that's roughly what your liver is going to start it up at. (I'm sure that someone will correct me if I've got this wrong).

You can search the forum for more info on these. There is loads of info about it on here.

For eating testing. Some people aim for a rise after 2 hours of no more than 2. What you are trying to avoid is a glucose spike. This is when your bgl rises fast and then drops fast.

Taken from this website.

>For the majority of healthy individuals, normal blood sugar levels are as follows:

  • Between 4.0 to 6.0 mmol/L (72 to 108 mg/dL) when fasting
  • Up to 7.8 mmol/L (140 mg/dL) 2 hours after eating
 
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I would advise you to keep a record of the following :
time - reading - food eaten - reading 2-3 hours later
Doing so allowed me to make the most of the information I got from my meter, to spot patterns pretty quickly by reviewing those records and, importantly, armed me with information I could discuss with my doctor. Initially, I tested quite a lot to establish what was happening to my blood sugar levels in general. I now test at most 3 times a day, often just before and after my main meal because things are well under control. We all differ but I would suggest that you bear in mind any meds you are on and that you alter your diet appropriately based on your readings (eg. if it spikes more than say 3mmols two hours after a meal, you may be eating too many carbohydrates). I am tagging the wonderful @daisy1, who will provide you with some very relevant info.
 
One more thing, your fasting level on waking is often the last and trickiest to get a handle on and can be affected by poor quality sleep. My advice would be to concentrate on your readings before and after meals so that you learn what I call your 'trigger' foods and your 'safe' foods. It sounds like a faff but you will soon be doing it like a pro. Good luck.
 
All good advice above. I'd just add that I spent about 3 months writing a detailed food diary and testing before each meal and (where possible) at one hour after first bit eand at two hours after. The code free has alarms you can set I think. This very quickly shows you how your blood glucose levels are affected by food. The foods that will be affecting it are those containing carbs. The worst offenders are usually bread (white or wholegrain is little difference) rice, pasta, potatoes., oatmeal. Also below ground starchy veg (starch = carbs), fruits (which have fructose and can be very sweet - it's all sugar to the body) etc. As it became clear which foods were the worst offenders I'd drop them or test the food I thought might be causing the spike, individually - sometimes a very small portion of such a food isn't so much of a problem.

If you eat starchy foods along with a lot of fat then it can delay the spike considerably so a test at 3 hours can sometimes reveal a surprising spike.

After a while you learn what foods you can eat and you don't have to test every meal as you probably eat similar meals every few days or weeks.

I had similar Morning BG levels to you but a Glucose Tolerance Test showed I had an abnormal response to glucose.
Do have a look at Dietdoctor.com - you do not have to pay or sign up to access the basic info on low carb foods and some fantastic meal ideas for low carb meals and there are links to all the science behind it as well.

I went very low carb/ketogenic and my morning levels very quickly dropped to about 4.5
However that did not last long and it is now apparent that my morning levels are (contrary to what most of the NHS believes) NOT the lowest of the day (due probably to the liver dumping glucose prior to getting up). Before my evening meal my levels are often around the 4.5 mark whereas my morning levels still run about 6.5

Having read that it is levels above 7.8mmol at which damage can start to occur to blood vessels, my main aim now is to keep spikes below 7.8 mmol or to get any above that down as quickly as possible.

A little tip if you do start testing and are concerned about spikes after meals - many people (including me) find they can lower that by going for a brisk walk for about 20 minutes. I have even been known to walk briskly around the house and up and down stairs for 20 mins and it usually works as the muscles are being used and the glucose is taken up by them.
 
Thank you everyone for your help. I see that 2 hrs after eating a reading for a T2 should be no more than 7.8 mmol/m and the only times I have tested before and after meals I seem to get a reading of between 7.8 and 10.5. I wonder if I am testing incorrectly as these numbers are indicative of type 2 I think and I was told I was prediabetic. As seadragon says it is readings over 7.8 when damage starts to ocurr
Testing apart I do worry slightly that things might be getting worse as I seem to feel tired much of the time although that could be down to poor sleep. Also I increasingly have to get up twice most nights and often more, which does affect my sleep.
 
One more question: As my HbA1c was only 43 I don't think I really realised where it was all leading and did rather believe people who said I didn't look the diabetic type as I was slim and active. Mistake!
If you reduce the HbA1c to below 42 you are no longer officially classed as prediabetic I understand, in the same way that diabetics once diagnosed are always diabetic - but is this true or is it a case of once a pre diabetic then always one unless of course you progress to full blown type 2.
 

Rather than look at the actual levels, it is preferable to look at the amount of the actual rise from before to after a meal. This rise should be no more than 2mmol/l and preferably less. If it is more than 2mmol/l there were too many carbs on your plate!
The 7.8 is just a guide that it is best not to go over, but that only depends on the level before you ate - if you were 5 before and 7.8 after, your rise was 2.8, which is not very good. Try to concentrate on the actual rise.
 
Imo the important question is not whether one is diabetic or pre-diabetic or even, as in my case, pre-pre-diabetic (A1c 41). What matters is, whether one is living with a harmfully high level of glucose in one's blood, and also whether that blood glucose level rises and falls sharply, which is also harmful. The A1c test shows an average, which tells nothing about spikes. Two people could have the same A1c, but one be always at the same level while the other fluctuated between much higher and much lower.

Dr Bernstein http://www.diabetes-book.com and Jenny Ruhl http://www.phlaunt.com/diabetes/ who are my go-to diabetes gurus, believe that harm starts at a much lower level than the usual targets. That is, if I have understood correctly, instead of 21 to 41 being a normal A1c, problems actually start at 31. I believe this, as since making efforts to lower my bg from 41 I have realised that my digestion is hugely improved and my joints are less stiff. (My physio confirms the latter). This is not my imagination, as I had no idea these problems could be blood glucose related. Oh, and I used to feel tired much more of the time than I do now. Luckily, many, maybe most of the problems caused by high bg can be reversed if not neglected for too long.
 
As a pre diabetic person Alexandra do you feel that you are permanently going to have to watch what you eat or that you can relax sometimes? Will check out the links, thankyou.
Interesting what you say about your joints I'm wondering if that could be my problem. I do have OA in one knee which is why originally why I lost weight, bought a new dog and walked. I find both knees are incredibly stiff and I can't keep up the pace as I once did but then I am 75 - going on 21! My grandmother was seriously compromised because of OA, then she got diabetes and everything was downhill after that. She did live to be 90 though!
Incidently when they talk about genetic risks for diabetes do grandparents count? Neither my mother or her siblings were diabetic but I have a cousin who is. Just wondered.
 
Well, I am a perfectionist and passionate about having the very best health and fitness I can, (given the large number of health problems I have accumulated over the years). So I expect to follow a low carb diet for the foreseeable future, just as before my A1c I ate lots of fruit and vegetables and wholegrains and low fat yoghurt and milk believing I was doing the best for myself. When I see a nice low reading all that effort seems well worthwhile. It is when for some mysterious reason I think I have done everything right and the reading comes out higher than I would like that I get discouraged. But I have to acknowledge that as I have learned better how to manage my bg, my readings have gone down but my standards have gone up, so that numbers that would have seemed OK not long ago are now a big disappointment to me.

However I have seen lots of threads on this Forum where people are confessing their diet sins or discussing how far they are going to relax their standards on holiday. I remember one person said firmly that s/he was going to leave his/her meter at home! So not everyone is as puritanical as me!

OA runs in my family, so I have always been afraid of it, but so far I have escaped it, perhaps due to running. (There is research showing that runners suffer less from joint problems than non-runners as they age.) I run and even walk slowly, but then, like you, I am 75. I never heard of anyone in my family with diabetes, though we all die of heart / circulatory problems, so maybe some of us were just not diagnosed. IMO there are huge numbers of people walking around unaware who have high bg levels. They may never progress to being diagnosed as diabetic, but they are still at risk of heart attacks and other health problems.
 

Off topic, but last Christmas I locked my meter away on Christmas Day. A couple of hours after we had all eaten our gorgeous meal my 18 year old granddaughter clamored for me to test her. 3 other family members joined in. I was forced to produce the meter and test them all. It was an eye-opener. Of the 4 of us, I won!!! I was 5.6, son in law was 7.3, daughter was 5.7 and granddaughter was 6.5. None of them are anywhere near being diabetic. Was I chuffed? You bet.
 

Interesting, how do you account for it.? How come they had a worse result if you had all eaten the same thing - Christmas pudding too? I wonder how many carbs there are in a plate of that !!
 
 
OA was a serious problem for both my mother and grandmother and they were neither of them able to exercise much. I've always had a more active life than either of them but fell headlong over the dog landing badly on my knees. Then 2 years later did the same thing by falling over the hosepipe and landing on concrete. Shortly after that OA kicked in. It was after that I was diagnosed with hypertension [NHS health check] and later found the HbA1c at 41 was marginally dodgy as was my cholesterol. That was 5 years ago.
 
gardengnome42 said:
Interesting, how do you account for it.? How come they had a worse result if you had all eaten the same thing - Christmas pudding too? I wonder how many carbs there are in a plate of that !!
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It wasn't scientific at all. Daughter and I had similar results and we ate the same things and drank red wine. Son-in-law stuffed his face and was drinking beer, granddaughter is vegan and ate something totally different. No Christmas pud in our house, not one of us likes it!
 

Sadly I adore Christmas pud -wish I didn't but there you go!
 
gardengnome42 said:
Sadly I adore Christmas pud -wish I didn't but there you go!
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Me too, especially with brandy butter and cream. Well, I can still have the cream, and it is indeed delicious in coffee and tea. Before my A1c I would never have permitted myself cream, even full-fat milk was a rare treat. So it's not all loss.
 
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