Newbie

Bogart99 said:

I duly ordered 100 more strips assuming incorrectly that they would come with 100
lancets, wrong so need to order a few more of those.

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I know the instructions say to change the lancet every time, and you're welcome to do so of course.
But in real life, most people change their lancets far less often. Once a day, once a week, or like myself, about 3 times a year, so I'm happy those lancets don't come with the teststrips. If they did, I would have to find room for about 15,000 unused lancets with my close to 8 years of diabetes...

There are even plenty of memes about (not) changing lancets!

You'll find plenty of similar people on this forum.

I also meant to reply to your lancet question. I've been blood testing for getting on five years now and I've used exactly three lancets.

They are changed every time in places like hospitals because of the obvious risks of cross-contamination. And I'd certainly change it if someone wanted or needed to use my meter for whatever reason.

I change mine when they get blunt.

Bogart99 said:

Am amazed they can be used for so long. So getting 10 with the kit would appear to be fine.

I really do appreciate you fine peple taking the time to answer my questions.

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Welcome to the wonderful world of diabetes.

Bogart99 said:

Right I have a few questions in relation to the following chart. My upon waking figure has varied between 4.7 and 5.7 mmol/L
Pre prandial between 5.0 and 5.5mmol/L, with one exception of 6.3mmol/L which I put down to a couple of beers an hour before eating
Post prandial between 4.5 and 6.1mmol/L usually taken around 2 hours after finishing eating.
Now my questions.

1. Why no target levels upon waking?
2. Unsure about the at least 90mins after meals. So does it matter 90 mins or 3 hours?
For example say after a meal ones reading for a type 2 was say 8.6mmol/L at 90 mins is outside the
recommended limit but wait another 30 mins and surely would be under 8.5mmol/L within the limits.
Or am I getting something wrong.
3. Basing my readings on this chart I have never had anything outside of the Non diabetic range
and nothing within the type 2 range. There appear to be no readings for pre people.

Hope this clear if you understand this let me know because am not sure I do.

View attachment 68337

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Your figures look good.

No targets for waking, because the waking/fasted level is generally controlled by your liver and isn't amenable directly to alteration by diet.

Alcohol will tend to lower your BG readings because the liver prioitises metabilising the alcohol and stops adjusting your BG, usually leading to a drop. If you have alcohol with a meal that you're testing for, you can get a skewed figure that is artificially lowered. The point of testing is not to fool the meter or yourself, but establish the true impact of carbs in the diet.

It does matter about 90 mins or 3 hours, because what you are testing for is how efficient and effective your system is at handing a glucose excess. It's not about "how high you go" - you'll see all that with a CGM, by the way - it's about getting the glucose squared away. High levels over time is what causes damage - so you want to limit glucose coming in - so low carb meals - and get it dealt with as soon as possible. I'm attaching a CGM graph from a non-diabetic person but it shows clearly glucose rises after meals and the fairly quick return to baseline.

You may not be getting any readings out of range, but if you've lowered carbs then that might be expected. You also don't see what happens when you're not testing - but the CGM will show you that . Pre-diabetes had to be invented as a concept to cover the gap between "normal range" ending at 42 and the automatic diagnosis level of 48. It doesn't mean that you won't have diabetic symptoms (which is diabetes in my book) with a BG below 48. I did, and many others do too.

Also remember that there is an allowable and accpetable inaccuracy in all glucometers so don't get fixated on small differences of 5% or less. A true BG value of 5.0 mmol/l could generate acceptable results of between 4.5 and 5.5, and around one in twenty of all results might be completely off.

Bogart99 said:

Good reply. I often thought of the figures that with HbA1c of 41 one was normal, 42 suddenly pre up to 47 then 48 tips one over the top.
Seems I had the beer thing all wrong I thought readings would go up because of it. Only thing I drink with my meals, now, is water or a coffee.
I will obviously have to keep a chart of my daily graph once I have started with the LIbra. Not sure how most people are expected to use this thing as cost over £50 a go and last supposedly 14 days.

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The 48 thing was intended to be a fallback, if no diagnosis was made earlier, so there was nothing stopping anyone with a problem being diagnosed at a lower BG level. However in the UK at least when a payment was attached (via the Quality and Outcomes Framework) to GPs making a diagnosis the payment was linked to diagnosis following an HbA1c reading...of 48. So 48 became the only point of diagnosis for many. I have no issue with 48 being used as a fallback as intended, but refusing to diagnose or intervene at lower levels is positively damaging.

Beer is carby - I would usually estimate 18-20g per pint. Drink enough and yes, you won't be doing low carb that day. It's the alcohol that has the immediate impact on the liver though. There are very low and zero carb beers around - there's a thread on the forum.

The Libre will do you its own records and graphs etc via an app through a smartphone. It is expensive, and I couldn't justify funding one full time myself. I took advantage of the free trial, but you have to have a T2 diagnosis to qualify. They are generally available (someone will correct me if this is wrong) to T1s on prescription, but not (most)T2s.

Hi @Bogart99 The excuse that the NHS use is that testing BG with a monitor (or using a CGM) for those who are not on insulin or serious glucose reducing medication will just make the user more anxious and thus may raise their BG.
Note that in addition to food there's a long list of things which can affect blood glucose.
At the top of the list come things like:
Illness, injury, stress, lack of sleep, strenuous exercise, medications such as statins and steroids.

You are correct that the official advice isn't the best in many/most cases. The thing about people testing their BG getting anxious, is only true if they see it getting worse (or getting no better despite medication). The real reason is cost.

The nutritional guidelines are still a one size fits all and still based on the largely discredited science done by Ancel Keys in the USA, rather than that by John Yudkin (the Brit who wrote the book 'Pure White and Deadly'). But things are slowly changing thanks to Dr David Unwin, the PHCUK and the international low carb community.

You might find some recent papers useful as background. They show that while the practical thinking in the research community has developed considerably, the official guidelines and recommendations are lagging far behind.



I have just finished Gary Taubes' new book "Rethinking Diabetes" - it might give you some more of the information you're asking about.