Meter confusion.

[Northernlad1965]

Hi everyone. A little backstory first methinks
I'm 52 and a triple stroke survivor, after the NHS gave me sepsis for my 40th Birthday following a gallbladder removal that didn't go quite as they hoped it would. Was diagnosed as T2 about 5 yrs ago but I believe I have a decent understanding doctor whom told me I wasn't really in desperate need of medical intervention, so he'd monitor me and leave me to see if I could control it with lifestyle and diet change. I immediately went out and bought a BG meter (SD Codefree) and over the course of 3 months got my number down to 43 which the doctor was delighted with, so sent me on my merry way.
I continued to use my meter and never really had any cause to question the results until recently when I not only got a result of 76 at my HBA1c check, but after a few tests was also diagnosed with Angina The 76 was despite my meter giving me the impression that I wasn't doing too badly. I knew it would be higher than the first 43 some 4 years earlier, but expected only a minor increase. That made me decide to purchase a new meter, so I could at least double check the Codefree, and go onto a STRICT keto diet. Bought the meter from here (Contour Next One) and it duly turned up. Bizarrely the check strips included went out of date 3 months ago, but they seemed to work fine and were giving me readings approx 1.0 Mmo/l lower than my previous Codefree, but this is where it gets a bit strange. I quickly used the 10 included out of date strips and bought some new from Amazon. They continued to give me readings similar, but slightly lower than the codefree, and I thought HAPPY DAYS , then yesterday before a meal I checked and had a reading of 4.2, then 60 minutes after my Keto fry up, it was still at 4.2, confused I checked at 90 mins and at 120 mins and each time 4.2 was the result. I'm pulling what's left of my hair out. Checking with the Codefree gave me a reading of 5.6 which I'm still ok with 2 hours after food, but I really need to know what other people would do in a similar circumstance? I find it hard to believe that 4 strips were ALL faulty, and this morning I get a reading of 4.9 on the Contour Next, but 5.7 on the Codefree. How on earth do I trust the results I'm getting? I'm actually considering buying a 3rd meter, but if I do how do I decide which one of the three is the closest to my actual true BG reading? I bought the Contour Next as it gave me the impression that the device is about as accurate as you can get, exceeding European accuracy tests but now I'm not so sure. What would you guys recommend?
Sorry it's such a long post, thanks for reading.

 

[EllieM]

I don't think that a difference of 10% is significant, most meters agree that they are only accurate to within that level. If the readings are the result of the strict keto diet, you don't have to worry, your next hba1c will be in non diabetic range. If you were getting those readings with the 76 hba1c then there's something weird going on - maybe hba1c is not accurate for your physiology, ask for a fructosamine test to double check.

 

[Alexandra100]

this morning I get a reading of 4.9 on the Contour Next, but 5.7 on the Codefree. How on earth do I trust the results I'm getting?

Yes, it's a minefield!!! Short reply: don't trust any one result, and that applies to the A1c teat too. All these tests are notoriously inaccurate. First suggestion: ask your GP for a repeat A1c.

I mainly use a Codefree, and also a TEE2 meter. When I get a Codefree reading I find odd (well, to be honest, high - I don't question low ones!) I retest with my TEE2 and then if I get a similar reading accept that the first one must be more or less right. If the 2 readings differ significantly, I do a third test with my Codefree. Then if I have got 2 low / normal I assume that is the true result and if I get all three very different I just, like you, tear out my hair and postpone judgment til the next reading.

Since all your readings are pretty acceptable, I don't see the need for further expense buying yet another meter, especially not before you have had a repeat A1c. Congratulations on your strict keto diet.

Just to cheer you up, here are the readings I got at 9.02 this morning, 1 hour after an almost carb-free breakfast: Codefree 6.7 TEE2 5.4 Codefree 5.3. Lucky I have thick hair!

 

[Northernlad1965]

I don't think that a difference of 10% is significant, most meters agree that they are only accurate to within that level. If the readings are the result of the strict keto diet, you don't have to worry, your next hba1c will be in non diabetic range. If you were getting those readings with the 76 hba1c then there's something weird going on - maybe hba1c is not accurate for your physiology, ask for a fructosamine test to double check.

Thanks for the reply, no I wasn't getting readings quite this low when I got my 76, they were a tad higher but nowhere near the 9.1 that 76 infers which is why I didn't expect a reading quite that high.
I think the issue I have isn't so much the 4.2 reading I saw, as I've dropped weight from 214lb's to 178, so closing in on 3 stones in pounds shillings and pence , but the fact that the Next meter didn't seem to change at all from 4.2 irrespective of eating a meal. That's my biggest concern. Surely the most basic meter should detect the change ?

 

[carol43]

My reading two hours after dinner last night was only 0.2 higher than my before dinner reading so it's possible that you didn't rise.

 

[EllieM]

Thanks for the reply, no I wasn't getting readings quite this low when I got my 76, they were a tad higher but nowhere near the 9.1 that 76 infers which is why I didn't expect a reading quite that high.
I think the issue I have isn't so much the 4.2 reading I saw, as I've dropped weight from 214lb's to 178, so closing in on 3 stones in pounds shillings and pence , but the fact that the Next meter didn't seem to change at all from 4.2 irrespective of eating a meal. That's my biggest concern. Surely the most basic meter should detect the change ?

I wouldn't worry too much about some one off readings, with a keto diet it's possible you didn't go up after the meal. look to see if the meter continues to give you suspect results over a longer period.

 

[Alexandra100]

the Next meter didn't seem to change at all from 4.2 irrespective of eating a meal. That's my biggest concern. Surely the most basic meter should detect the change ?

A fatty meal may take longer to digest and therefore to show up on your meter. There is also the possibility that, like me, you suffer from the common diabetic complication of delayed stomach emptying or gastroparesis. With this, I can sometimes see no rise or even a fall in bg for hours after a meal, but the rise does come finally. It is completely unpredictable and can be unfortunate if one's next meal piles up on top of one's last one and both are finally digested together. You can read about gastroparesis here: http://www.diabetes-book.com/gastroparesis-causes-effects/

 

[slip]

I can only wish for a steady 4.2 before and after a meal! (but then again I don't keto but also don't have my own insulin) - as EllieM has just said would you really expect a 'significant' rise? maybe a slight rise past the 2hr mark I guess.

But bear in mind meters have a 15% variance for your pre-meal test it could have been 3.6 and the 2hr one 4.8 so there's your rise if you really wanted one!

Also a man with 1 watch knows the time a man with 2 watches is never quite sure.........

What ever it is/was, you are doing fantastic.

 

[porl69]

Hi @Northernlad1965 and welcome to the forum. Will tag @daisy1 for her helpful info pack

I would stick to 1 meter else you will be totally confused.....dont get a third whatever you do. There is a 15% tolerance on meter readings, you could do 2 different test with the same drop of blood and get a 5.8 and a 4.8 while your BG could actually be 5 ...
I would have expected a rise a few hours after your meal depending on what the meal was. Your HBA1C is an average of 3 months BG as you are probably aware. You may be going a bit higher after you have done a BG test?? Only a CGM/FGM will let you now that for sure

 

[slip]

You may be going a bit higher after you have done a BG test??

As porl69 has alluded to maybe the hba1c of 76 may have come as a shock if you were only testing before meals, therefore you were only seeing the low points which is quite a common routine to get in to when you foot comes off the gas - but by the sounds of it you're fully on it and doing lots of post meal tests now.

 

[porl69]

As porl69 has alluded to maybe the hba1c of 76 may have come as a shock if you were only testing before meals, therefore you were only seeing the low points which is quite a common routine to get in to when you foot comes off the gas - but by the sounds of it you're fully on it and doing lots of post meal tests now.

Yep agreed

 

[daisy1]

@Northernlad1965

Hello Northernlad and welcome to the Forum Here is the Basic Information we give to new members and I hope you will find it useful. Ask as many questions as you want and someone will be able to help you.


BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 235,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.

There are two approaches to controlling your carbs:

• Reduce your carbohydrate intake
• Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes.

Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 8.5 mmol/l

Blood glucose ranges for type 1 diabetes (adults)

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 9 mmol/l

Blood glucose ranges for type 1 diabetes (children)

• Before meals: 4 to 8 mmol/l
• 2 hours after meals: under 10 mmol/l

However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

• structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
• self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic.

Note: This post has been edited from Sue/Ken's post to include up to date information.
Take part in Diabetes.co.uk digital education programs and improve your understanding. Most of these are free.

• Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why
  
  
• Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.
  

 

[briped]

(well, to be honest, high - I don't question low ones!

I'm like that too. Curiously enough I react the same way when I weigh myself.

 

[Alexandra100]

yesterday before a meal I checked and had a reading of 4.2, then 60 minutes after my Keto fry up, it was still at 4.2, confused I checked at 90 mins and at 120 mins and each time 4.2 was the result. I'm pulling what's left of my hair out.

I thought my lunch-time readings today might cheer you up.
Before lunch 4.9
Lunch: 2 egg omelette with Cheddar, 50g broccoli with Cheddar, chicken scratchings, 10cal jelly + double cream, 1 small 100% cocoa chocolate drop, cup of tea +1T double cream
1 hour after lunch 4.9
2 hours after lunch 4.9
3 hours after lunch 5.2
1 mile walk
4 hours after lunch 5.6
Cup of tea + 1T double cream
5 hours after lunch 4.8
I think this demonstrates the value of extended testing. And that your readings may have been more accurate than you thought.