Needing some advice on complication when glucose testing.

[AnnH 2]

I have recently been diagnosed with diabetes and have followed the advice here and got a testing kit to measure glucose levels. I have my first visit to the diabetic clinic tomorrow and would like to go armed with some solutions. I have a disease called Complex Regional Pain Syndrome (crpsor RSD), it affects my left side which means I can only test blood from my right hand and even this carries the risk of spreading the disease. Is there a way of testing my glucose levels without pricking my finger as my right hand is getting sore testing 4 to 5 times a day on one hand. It is also difficult to do because my left hand only has limited function on a good day.

Any ideas?

 

[NicoleC1971]

Hi Ann
The obvious but not cheap answer is to invest in a CGM (freestyle libre made by Abbott) or to prick your toes!
The libre is a patch worn on your arm for 2 weeks I think (you can spot one on our PM at the City dinner she attended last year). A sensor is waved across the patch and it tells you what your blood glucose is and gives you a great picture of trends through the night etc. It is a continuous glucose monitor. I believe it measures glucose within your cells rather than in your blood so I am not sure what risks of infection that would carry for you?
i am sure others will chip in with suggestions on this too.
The downside is the cost because under current guidelines us type 1s are struggling to get it on prescription but I do know of at least one person who has persuaded their GP to fund it. Maybe worth asking given your situation.
The other thing is that once you have established a good knowledge of how you react to foods/stress/exercise etc. through this testing then you may not need to test quite so often.

 

[Rachox]

I’ve seen people post about this Genteel device, I don’t understand the mechanics of how it works but here’s a link so you can do your own research:
https://smile.amazon.co.uk/Genteel-...pID=31P6dV028WL&preST=_SY300_QL70_&dpSrc=srch

 

[AnnH 2]

Hi Ann
The obvious but not cheap answer is to invest in a CGM (freestyle libre made by Abbott) or to prick your toes!
The libre is a patch worn on your arm for 2 weeks I think (you can spot one on our PM at the City dinner she attended last year). A sensor is waved across the patch and it tells you what your blood glucose is and gives you a great picture of trends through the night etc. It is a continuous glucose monitor. I believe it measures glucose within your cells rather than in your blood so I am not sure what risks of infection that would carry for you?
i am sure others will chip in with suggestions on this too.
The downside is the cost because under current guidelines us type 1s are struggling to get it on prescription but I do know of at least one person who has persuaded their GP to fund it. Maybe worth asking given your situation.
The other thing is that once you have established a good knowledge of how you react to foods/stress/exercise etc. through this testing then you may not need to test quite so often.

Thank you I was just reading about CGM but that looks invasive as well, it may have to be right hand fingers and toes then lol. I am in a wheelchair and non weight bearing so my toes very rarely touch the floor.

 

[JeremySE18]

I use the Genteel, I find one of the best sites to use it on is just about anywhere on the heel of the palm. It is certainly not painful there. Come to think of it the heel of the palm is a suggested alternate site for testing anyway, no reason you cannot use any standard lancing device there to be honest.

Just to add I also use fingers as well

 

[AnnH 2]

As an update I saw diabetic nurse for a review and she said I did not need to be testing my glucose levels as I was type 2 and they would do ny Hbac every 3 months. I argued that as diet and tracking blood glucose levels was the only way I could get control over my glucose and that all the evidence I have read has said I should be testing regularly. She said that was 'old fashioned' thinking and it was all about weight loss and exercise and I should concentrate on that. I am feeling really confused and depressed about it all, I am a full time wheelchair user who has limited use of left arm and no use of left leg there will be no paralympics for me I use electric chair outside the house and I scoot round the house with one arm and one leg in a manual chair so exercise needs some imagination. I think I need to research more.....

 

[dbr10]

As an update I saw diabetic nurse for a review and she said I did not need to be testing my glucose levels as I was type 2 and they would do ny Hbac every 3 months. I argued that as diet and tracking blood glucose levels was the only way I could get control over my glucose and that all the evidence I have read has said I should be testing regularly. She said that was 'old fashioned' thinking and it was all about weight loss and exercise and I should concentrate on that. I am feeling really confused and depressed about it all, I am a full time wheelchair user who has limited use of left arm and no use of left leg there will be no paralympics for me I use electric chair outside the house and I scoot round the house with one arm and one leg in a manual chair so exercise needs some imagination. I think I need to research more.....

You can only get proper control by testing. This is standard NHS BS I'm afraid. The HbA1c is the best measure there is, but the post meal glucose spikes which do most of the damage are obviously hidden in the average figure.

 

[Brunneria]

The advice that T2s don't need to test is pretty standard. Mainly because if it was approved, then the NHS would be obliged to fund the testing, and the money simply isn't there. The NHS would also have to provide training and support and have to explain why and how such testing can be used to tailor the individual diet to control blood glucose - and most health care professionals don't know how to do that.

Let me ask you - have YOU found self testing helpful and informative? Has it begun to show you which foods raise your blood glucose out of range? And have you started to adjust your food choices and portion sizes to improve your blood glucose levels after meals?

If you are finding it useful, then don't worrit about what the nurse says.
If you don't find it useful, then don't worrit about doing the testing.

When I first got a meter I tested about 7 times a day. But as soon as I worked out what my meals and snacks were doing to me, I dropped the ones that caused spikes, and eased off on the testing. No point in testing the same portion of scrambled eggs every day if they aren't a problem

Now, I only test if I am eating new foods, or every few months when I get a Libre sensor, to check what is happening at night and in the background.

You may find this article interesting
https://www.the-scientist.com/?arti...e-Glucose-Monitoring-Revolution-Ever-Arrive-/

 

[Mal37]

The advice that T2s don't need to test is pretty standard. Mainly because if it was approved, then the NHS would be obliged to fund the testing, and the money simply isn't there. The NHS would also have to provide training and support and have to explain why and how such testing can be used to tailor the individual diet to control blood glucose - and most health care professionals don't know how to do that.

Let me ask you - have YOU found self testing helpful and informative? Has it begun to show you which foods raise your blood glucose out of range? And have you started to adjust your food choices and portion sizes to improve your blood glucose levels after meals?

If you are finding it useful, then don't worrit about what the nurse says.
If you don't find it useful, then don't worrit about doing the testing.

When I first got a meter I tested about 7 times a day. But as soon as I worked out what my meals and snacks were doing to me, I dropped the ones that caused spikes, and eased off on the testing. No point in testing the same portion of scrambled eggs every day if they aren't a problem

Now, I only test if I am eating new foods, or every few months when I get a Libre sensor, to check what is happening at night and in the background.

You may find this article interesting
https://www.the-scientist.com/?arti...e-Glucose-Monitoring-Revolution-Ever-Arrive-/

I don't test as often as most appear to, but I do test early morning on most days and I try to test after at least one meal per day, just to see if my levels remain steady (which they do). I have days where I will test after each and every meal ... just as a precaution) but after two years I know what to avoid. I find that testing helps me to continue to stick to healthy eating

 

[Dark Horse]

For people with genuine type 2 diabetes who are overweight (or even in the middle to upper ranges of normal weight) at diagnosis, there is a good chance that they can put their diabetes into remission by sufficient weight loss.

Some people can achieve this through focusing on calorie restriction, e.g. the Newcastle diet https://www.ncl.ac.uk/media/wwwncla...ecentre/files/2017 Diabetes reversal info.pdf or the Blood Sugar diet https://thebloodsugardiet.com/ Some people can achieve this by focusing on eating a LCHF (low carbohydrate high fat) diet https://www.dietdoctor.com/

The contribution of exercise to weight loss is small compared to diet and, as willpower is a resource that can get depleted, it's generally better to focus on diet in the initial stages of a weight loss programme. Exercise is useful to help maintain weight loss and can be gradually introduced a later stage. There are some exercise programmes aimed at people who use a wheelchair on youtube, e.g.

or

and there is some evidence that exercising only one side of body may benefit the other side of the body https://www.livescience.com/25717-stroke-recovery-contralateral-training.html

If remission is possible by weight loss, this can occur within a few months. As complications due to raised glucose levels take years to develop, it is quite reasonable to keep things simple in the short term by concentrating on achieving weight loss rather than monitoring glucose levels.

For various reasons, some people do not achieve remission through weight loss, or only achieve partial remission. In this case, home blood glucose testing is important. By testing 'at first bite' and then 2 hours later, it is possible to see how big the blood glucose rise after particular meals is. Those meals which cause 'spikes' in blood glucose can be avoided or adjusted to reduce the glucose rise.