1. This site uses cookies. By continuing to use this site, you are agreeing to our use of cookies. Learn More.
  2. Get the Diabetes Forum App for your phone - available on iOS and Android.
    Dismiss Notice
  3. Guest, we'd love to know what you think about the forum! Take the Diabetes Forum Survey 2019 »
    Dismiss Notice
  4. Diabetes Forum should not be used in an emergency and does not replace your healthcare professional relationship. Posts can be seen by the public.
    Dismiss Notice
Dismiss Notice
Find support, ask questions and share your experiences. Join the community »

Newbie, feeling bit baffled

Discussion in 'Blood Glucose Monitoring' started by Andy J-R, Apr 21, 2019.

  1. Andy J-R

    Andy J-R Type 2 · Newbie

    Messages:
    3
    Likes Received:
    1
    Trophy Points:
    23
    I've just joined the "club" as a type 2 diabetic, with lots of info from my GP's practice but some advice would be welcome.
    I've invested in self test meter but the readings it gives me are typically 50% higher than the diagnostic test results from the clinic. Is this normal?
    Also when is the best time to take a reading - I'm not looking to stab myself too often and for the moment I'm doing it daily after I've walked the dog but before I eat any breakfast. Should I choose a different time?
    Finally, I've been prescribed Metformin, how quickly would this start to have an effect on my blood sugar?

    Cheers

    Andy
     
    • Hug Hug x 1
  2. KookieMunchster

    KookieMunchster Type 2 (in remission!) · Well-Known Member

    Messages:
    58
    Likes Received:
    73
    Trophy Points:
    38
    • Like Like x 1
    • Hug Hug x 1
  3. Rachox

    Rachox Type 2 (in remission!) · Moderator
    Staff Member

    Messages:
    7,744
    Likes Received:
    9,441
    Trophy Points:
    198
    Hi Andy and welcome! First let me tag in @daisy1 for her useful info post.
    Can you give us the numbers you have had for your various tests to help us explain the numbers please? The diagnostic test is usually an HbA1c which is a clever test which measures your average blood sugar over the previous three months, it’s usually quoted as mmols/mol but the older unit used is a percentage. The finger prick tests, which are a snapshot of current blood sugar are measured in mmols/litre.
    Metformin takes a while to build up in your system but will only help a tiny bit, you need to adapt your diet too. This is where your testing is useful, you need to test before eating and two hours afterwards to see which foods your body can tolerate.
    You obviously need to cut out or reduce hugely sugars but also carbohydrates as they all turn into sugar once eaten.
     
    • Agree Agree x 3
    • Like Like x 1
    • Friendly Friendly x 1
  4. Andy J-R

    Andy J-R Type 2 · Newbie

    Messages:
    3
    Likes Received:
    1
    Trophy Points:
    23
    Thanks for the comprehensive answer, appreciated . Well spotted , the clinic's results were mmol/mol, the meter is mmol/L. Easy conversion now I know. :)
     
    • Like Like x 1
  5. jjraak

    jjraak Type 2 · Well-Known Member

    Messages:
    1,252
    Likes Received:
    3,140
    Trophy Points:
    178
    Hi @Andy J-R

    cheers...:D..;)

    for me it's on wake up as i wait for kettle to boil.

    once up and about the liver can dump glucose into the blood to help us manage our day before intaking foods,
    so i think scores a bit more 'natural' early on.

    i also test pre meal..and 1 to 2 hours after..( i normally test at 2 hours, but have tested earlier if foods an unknown or one to be wary of )

    so i end up with minimum of 5 most days..but once tested many meals do not require the test as you will know the effect it has on your bloods.so you could be down to just one or two a day..FBG is the one i'd skip if testing was a real burden.

    the foods IF they spike you would be more of a danger, imho, if you didn't spot them early and stop having them.

    Good luck on your road back to better health.

    it may not be paved with gold, but for me it certainly is tarmacked with LCHF .
     
    • Like Like x 2
    • Informative Informative x 1
    #5 jjraak, Apr 21, 2019 at 3:16 PM
    Last edited: Apr 26, 2019
  6. daisy1

    daisy1 Type 2 · Legend
    Staff Member Retired Moderator

    Messages:
    26,441
    Likes Received:
    4,864
    Trophy Points:
    248
    @Andy J-R
    Hello Andy and welcome to the Forum :) Here is the Basic Information we give to new members and I hope you will find it both interesting and helpful.

    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 300,000 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 free 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.
     
  7. Derbysocks

    Derbysocks Type 2 · Active Member

    Messages:
    38
    Likes Received:
    23
    Trophy Points:
    28
    My DN recommends testing before meals & before bed.
    As I am on insulin I also have to test every 2 hours when driving. I test 4timrsca day when not driving.
     
    • Like Like x 1
  8. HSSS

    HSSS Type 2 · Well-Known Member

    Messages:
    1,650
    Likes Received:
    942
    Trophy Points:
    133
    As a newly diagnosed type 2 I’d agree test before and 2 hrs after a meal. See what it does to the levels.

    The goal is for it to not rise more than 2mmol, hopefully even less. If it rises by more then there were too many carbs for you. Try it again without the carbs or at least fewer of them. Once you’ve had the same meal a couple of times with acceptable results then it’s probably ok. There are other factors like time of day, amount of fat and preceding meals and others but for now I’d stick to that. Also you want the after food reading to be under 7.8 if possible.

    As you drop carbs I’d also ditch the low fat foods (full of sugars and chemicals often) for full fat ones and if you’re still hungry then add a few more fats, butter, cream, nuts, olive oil - just not vegetable and seed oils. You still need fuel and energy and if you look at carbs and fats as a seesaw as you decrease one the other increases. Fats don’t affect blood sugars and keep you full for longer than carbs do and don’t create cravings the way carbs do.
     
    • Like Like x 1
    • Agree Agree x 1
  9. Andy J-R

    Andy J-R Type 2 · Newbie

    Messages:
    3
    Likes Received:
    1
    Trophy Points:
    23
    Thanks to all for taking trouble to respond. Very much appreciated.
     
    • Friendly Friendly x 2
  10. BigBOBBEE

    BigBOBBEE Type 2 · Newbie

    Messages:
    1
    Likes Received:
    0
    Trophy Points:
    21
    In my 70's I definitely understand how serious this disease is and how it can affect us all. I was diagnosed in 2009 after completing a 15 mile charity walk to raise money for the Iain Rennie Hospice. Although not a race, I finished among the first 10 on a truly blisteringly hot day. When I got home I took off my trainers and noticed that the insides were soaked in blood. My physician sent me for tests and I was immediately diagnosed with T2 and peripheral neuropathy in my feet. My toes were numb and consequently I never felt any blisters develop or indeed, burst. Like you I was rather anxious and started taking my own readings. I then began developing debilitating foot ulcers and had to undergo long term treatment. These ulcers recurred quite regularly and the thought of losing a limb was a major concern. But, thanks to the wonderful treatment by dedicated NHS podiatry staff along with their advice, I have really taken care of my feet and now some 10 years later, my feet are in perfect condition and thankfully ulcers are a thing of the past AND although I am reviewed annually, Metformin and I are in control and I am confident enough not to take my own readings. I hope this gives you hope as the word CONTROL is paramount. All good wishes to you and all fellow diabetics.
     
    • Agree Agree x 1
  11. Stephen Lewis

    Stephen Lewis Type 2 · Well-Known Member

    Messages:
    97
    Likes Received:
    59
    Trophy Points:
    38
    You are in the right place to get good well informed information. Do all the research including about the several types (continuum?) of our condition. My early morning glucose levels are always on the rise even (especially?) without food. This appears to be the body's built in response to waking and/or getting up. I cannot recommend too highly some form of constant glucose monitoring (CGM). I do a sensor reading just before eating and afterwards at 1 hour and 2 hours - all without sticking needles in my fingers; a process that I consider medieval and barbaric. My chosen sensor does an under skin measurement every 15 minutes and when these results are downloaded when I choose to measure I get a daily graph of all the other measurements. As my recently Dublin trained MD said, "finger pricking is a complete waste of time." It does not show how high or when the spikes occur and it does not show the latest trend in your glucose levels. I have received advice from dietitians about the different glycemic indices of different carbs. In many cases what I have been told does not come even close to matching my CGM results and I have cut supposedly OK low glycemic carbs from my diet. BUT we are all different. You need to work out what foods work best for you. I strongly suggest a low carb diet. This and going to the gym 5 times a week have enabled me to stop insulin, lose 25 lbs in weight, cut my Metformin from 2,000 mg to 1,000 mg per day and I am now showing a definite improvement in my severe and supposedly irreversible neuropathy.
     
    • Informative Informative x 1
  12. Shaul Dror

    Shaul Dror Type 2 · Member

    Messages:
    10
    Likes Received:
    1
    Trophy Points:
    43
    Hi Andy
    I would recommend that if you intend to measure yourself only once a day you should do this before taking your dog for a walk AND before breakfast. The reason for this is that even moderate exercise requires your muscles to have Glucose and your body will generate this and your levels will be raised.
    This is different to your doing an hour of more vigorous exercise when your Glucose levels can drop as your muscles start to use up stored Glucose.
    As you are new to T2 I'd recommend that you also monitor yourself at dinner time...your levels will probably be higher because you have been using muscles steadily during your day to day activities.
    What I recommend even more is that you also monitor yourself 2 hours after meals and at other times so that you can observe and learn what effect different meal sizes and their content has on your Glucose levels.
    T2 is not a death sentence but is a lifelong disease that you can learn to live with and to control.
    A recent talk I attended given by a leading endocrinologist also made the point that if you are recently diagnosed and therefore only at the beginning stages of this disease it is actually possible to reverse your condition completely if you give everything your absolute diligence concerning monitoring frequently, diet, exercise and of course your meds.
    If you are averse to the pain of pricking often then I can personally recommend the Genteel lancing device as its virtually painless and you wont be discouraged from monitoring your levels frequently.
     
    • Informative Informative x 1
  13. jjraak

    jjraak Type 2 · Well-Known Member

    Messages:
    1,252
    Likes Received:
    3,140
    Trophy Points:
    178
    i would agree with most all you say there, @Stephen Lewis
    congratulations on your journey so far.

    but wouldn't, agree regarding this.

    while the cgm may give a clearer trend view of the bg over many hours, the units are a serious expense in themselves..(unit and sensors)
    not so bad if you can afford, ( most T2D's uk, rarely get any assistance from doctors, even getting a limited supply of test strips for meters as per nice protocol seems to be a real hassle.)
    but to say finger testing is of no use, goes against all the logic i have seen on here from others and personally.

    i hear that it's the view of a doctor, but it's not clear if that is also your personal view,
    perhaps you wouldn't mind clarifying that for us ?

    i think to offer that statement, unqualified as it stands, to any t2d on here could mean at best confusion as it's the first thing many suggest newbies do,
    and at worst risks deterring them from testing at all.

    i may have misread that statement, apologies if i have.
    health care in canada may be more user friendly regarding testing kits

    we all come on here, being pro active and looking for a way to improve our health,
    advise not to test as it's useless, is not in there best interests, i believe.
     
    • Like Like x 1
  14. Stephen Lewis

    Stephen Lewis Type 2 · Well-Known Member

    Messages:
    97
    Likes Received:
    59
    Trophy Points:
    38
    I agree that the CGM sensor units are expensive. About $200 per month here in Canada but certainly in my case the benefits have been significant. Earlier this year I was able to buy the sensors for a few 2 week periods. There was a big difference in my bg levels between the CGM and finger pricking. The latter was done 10 to 12 times a day and it was still impossible to tell when spikes were occurring. This information is essential because we each have a different reaction to the same foods and we need to find out what items should not be eaten, which should have reduced amounts and those that are OK. I have been lucky since my health benefit provider (through my pension plan) have just approved the Freestyle Libre paying 70% of up to $90 per sensor.
    It was definitely a fully qualified (UK) MD, my family doctor, who said that finger pricking was a waste of time because unless this is done before and then every half hour after eating it is virtually impossible to know when spikes occur and how high they go. The test strips and/or the meters are not very accurate, with a variance of up to 15%. This is potentially a significant difference. In the range that we usually aim for 6.9 could really be 7.9 which is 0.9 or 11% above a maximum pre-meal target of 7.0. At the other end someone could have reading too high when they are actually becoming dangerously low. The Freestyle Libre, if I remember correctly, averages 97% accuracy in a range from about 4.0 to 13.0. If a reading is getting close to these, the meter advises that a blood test should be done.
    A couple of month back I did comparative tests with finger pricking for my old meter and strips and the Freestyle Libre test strips and 10 minutes later a reading from the FL sensor. The old meter averaged about 0.5 higher than the FL using blood from the same finger prick. The Bayer test was higher by over 1.0 a few times during the week of comparisons 10 times a day. The sensor reading never varied by much more than + or - 0.2 from the FL blood test 10 minutes before. Using the sides of each finger at least once a day caused some bad soreness after a few days. Several months ago I tested the Bayer system with consecutive tests from the same site. The difference between the tests with a relatively new meter was 1.5.
    Sorry to give so much detail but I think you can see what is behind my opinion. I have not been able to find any independent research into the various testing methods. The only thing that seems certain is that doctors rely only on the A1c and it is up to us to each find out what works best in helping us control our condition.
     
    • Informative Informative x 1
  15. Stephen Lewis

    Stephen Lewis Type 2 · Well-Known Member

    Messages:
    97
    Likes Received:
    59
    Trophy Points:
    38
    Also looks like you are having success with a low carb diet? Well done.
     
    • Like Like x 1
  16. KeithT 2

    KeithT 2 Type 2 · Active Member

    Messages:
    33
    Likes Received:
    39
    Trophy Points:
    58
    Hi Andy
    The T2 club is one club that I never welcome people to, but I will welcome you to the forum. Diabetes is an insidious disease but being diagnosed with it does make us sit up and think that perhaps our lifestyle needs overhauling. Being diagnosed with this disease is not the end of the road however, but you will need to think of ways to keep on top of it, without it encroaching too much on your life. I was diagnosed 12 years ago and the journey has been a rocky road simply because at the outset I took it for granted and relied totally on the pills. Anyway, that's another story. Your random prick tests will not be as reliable as your HbA1c test and serve only to give you a rough idea of what is going on and warn you of any adjustments you may need to make with your medication or diet. You will find that sometimes these random prick tests can be erratic and at other times stable. So yes, the differences you are seeing is quite normal. In the main, every diabetic is different and what works for one person with type 2 may not work for another. However, it is true to say that for all diabetics, that cutting way back on your carbohydrate intake will at the very least keep you BG numbers within the target range. Here's a link to an informative site article on this subject. https://www.diabetes.co.uk/diabetes_care/blood-sugar-level-ranges.html Some diabetics test before a meal "preprandial" and 2 hours after a meal "postprandial". see site link below on this subject. I only test twice a day - before bed and on waking and before my first cup of tea of the day passes my lips. Through the day I am able to eat some carbs for breakfast (shredded wheat with fruit and plain yoghurt) and home made bread sandwich most days for lunch. After that I eat no more carbs for the day. This method has helped me shed 2.5 stone in weight over 18 months and I now weigh a few pounds heavier than the day I got married 50 years ago. My suggestion is to keep a strict record of you numbers and analyze what makes your BG higher or lower against the food you have eaten. Doing this will give you a good idea what is okay and what is poison to you in your diet and you can adjust to suit. It may take a year or so to get on top of it, but the struggle is definitely worth the pain. Good luck with it all and have a good day. Here's that other link. https://www.diabetes.co.uk/features/pre-and-post-meal-testing.html
     
    • Like Like x 1
    #16 KeithT 2, Apr 26, 2019 at 9:07 AM
    Last edited: Apr 26, 2019
  17. HSSS

    HSSS Type 2 · Well-Known Member

    Messages:
    1,650
    Likes Received:
    942
    Trophy Points:
    133

    Whilst broadly you are right that the libre tells you more than fingerpricking and fingerpricks aren’t totally accurate I think you’re overstating the case somewhat here.

    Yes fingerpicking meters are a bit inaccurate, but not so much as they’ll show dangerously low numbers as high ones.

    You don’t have to know exact numbers or exact peaks for them to be useful. The majority of us in here have used them to to identify which foods take us significantly higher than others. This is extremely useful and positive and has been the prime tool in our box for information and motivation and reassurance. A specific testing routine gets the most from them. Before and after meals being the main one to get usable actionable information. Fasting is nice to see progress but less you can take less direct immediate action on that one

    Not everyone can afford the sensors and a meter is a pretty damn good second option.
     
    • Agree Agree x 2
  18. jjraak

    jjraak Type 2 · Well-Known Member

    Messages:
    1,252
    Likes Received:
    3,140
    Trophy Points:
    178
    Thanks @Stephen Lewis

    a great deal of info as you say, and blessed that the majority of costs are being met..(good planning by you perhaps, but still blessed it's to hand for such a disease.).

    while you make good claims and justified i believe for the cgm..the truth about meter accuracy i can't dispute, the manufacturers suggest a variance is in each meter. and it's dicussed in many posts re meters.

    However i'd still suggest that the premise of don't test is wrong on a few levels.
    least of which is as i mentioned previous.

    i am all for differences of opinion, but here i find myself clashing into your assumption (i couldn't see it refuted ? )
    that testing is a waste of time..if not done on a cgm..at i think we agree, prohibitive cost to the many.

    i appreciate we are all different in our means, needs & reactions to food because of our very own health and other medical issues we may have..but that idea still appalls me, sorry to say.

    i COULD pay for the CGM for a few months..
    BUT i couldn't really justify the cost ongoing, if i'm honest , when the meter is a much more cost effective method AND as you 2nd post says, i am having decent success..(thank you :) )

    I wish all T2D had the luxury here of test meters and strips..and the holy grail of CGM's for everybody..
    but the T1D's needs here are greater, imho..once they all have one gratis..happy days
    then on to us T2's, please doctors..(sound very TERMINATOR, doesn't it..LoL)

    if i could liken it to some other OLD tech.
    i am on a ship, throwing out a weight to test how deep the waters are in any given harbour or bay i do NOT know.
    CGM users are more lucky to have full on sonar probing the depths, so are much more secure in their direction.

    But surely ANY measure that stops or aids a ship from running aground is better then just blind faith, until that moment the ship IS lost or damage incurred.

    and we certainly shouldn't be dissuading those who know so little, when asking for guidance by giving the impression that only the wealthy or those lucky enough COULD save/improve their health

    When clearly despite it's drawbacks, another method IS much more easily accessible, AND is achieving great things in regards to helping SO many reduce their A1c, (HBA1C here in UK ) and in many cases placing their T2D into remission.

    For me i have a corridor in my mind of where i want my BG to be..it's between 4 and 8
    i can reasonably test to find the foods that bash my BG into the walls of that corridor
    OR
    i could hope i eat the better foods that stop my bg's rising,

    but as i have found out, the rises are very rarely noticeable when they are happening, the only way i could possibly have known/learned what foods DO that and avoid them in future... WAS by testing.

    i wish you well in your ongoing journey
    i shall watch your name when i see any of the shiny CGM fleet hove into view and hope your doing well.

    Do please wave at any fleet of trawlermen, chugging along, i maybe be amongst them....and wish us well too.

    we might be using old methods, but are on the same mission.

    after all no one likes looking at the wrecks of those that failed to test the waters, before setting sail,
    without a small judder in there bones and a silent prayer of.. 'RiP...Thank god that wasn't me '

    Tl;Dr.
    Testing by ANY means is good.
    if not by CGM... then TEST using a meter.
    Far better to know a little and avoid health issues
    then to blissfully know nothing and leave yourself open to the progressive nature of the
    disease and it's full compliment of complications and issues.
    /
     
    #18 jjraak, Apr 26, 2019 at 9:26 AM
    Last edited: Apr 26, 2019
  19. KeithT 2

    KeithT 2 Type 2 · Active Member

    Messages:
    33
    Likes Received:
    39
    Trophy Points:
    58
    This is true. I have tried finger pricking two different target areas one after the other and there is always a slight difference in the readings up or down. Finger pricking gives a rough idea of what is going on at any one time and should only serve as a warning to adjust meds or diet. The Hba1c is as accurate as it gets, but even that isn't perfect.
     
    • Like Like x 1
    #19 KeithT 2, Apr 26, 2019 at 9:29 AM
    Last edited: Apr 26, 2019
  20. HSSS

    HSSS Type 2 · Well-Known Member

    Messages:
    1,650
    Likes Received:
    942
    Trophy Points:
    133
    Not if you have anaemia or some other condition affecting red blood cells possibly.
    Also it shows only an average. Not if that’s a nice smooth line or a potentially very damaging spikey graph full of highs and lows.

    So no not perfect either. We do the best with what we have
     
    • Agree Agree x 1
  • Meet the Community

    Find support, connect with others, ask questions and share your experiences with people with diabetes, their carers and family.

    Did you know: 7 out of 10 people improve their understanding of diabetes within 6 months of being a Diabetes Forum member. Get the Diabetes Forum App and stay connected on iOS and Android

    Grab the app!
  • Tweet with us

  • Like us on Facebook