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Self testing is unreliable and unnecessary

MargJ

Well-Known Member
Messages
48
Type of diabetes
Type 2
Treatment type
Diet only
These were the words used by my doctor yesterday. I was diagnosed as type2 in March and had a whole lot of tests. Since then I have been sent for 2 blood tests but only found out last week that neither of these included HbA1c test. So I have been asked to change my diet etc radically but they haven't checked my blood sugar since. In shock, I asked for a monitor so I could check my own level. That was the response. Do I ignore this and buy the equipment myself?
 
Hi Marg and welcome to the forum. Unfortunately you may need to buy your own meter and test strips, as many T2s do.

Many of us use the SD Codefree meter, available here:
http://www.homehealth-uk.com/medical/blood_glucose_monitor_testing.htm

... because they have the cheapest test strips on the market, and you may need a lot initially.

There is a discount code if you buy 5 or 10 boxes, which brings the price down to about £5 for 50 strips.
5 packs 264086
10 packs 975833

If you feel the level of help from your doctor is not good enough, you might want to change doctors if possible for you. Some doctors do 3 monthly HbA1c tests for people newly diagnosed and this can be very helpful. Do you happen to know what your blood test results were?

I will also ask @daisy1 to come by and post some welcome info for you.
 
IMHO if the HCP won't provide the monitor, then ,yes purchase one and perform a structured regime of testing yourself to ascertain your levels and how they can be changed.
To the doc, the test may be unneccessary, as it does not matter to HIS/HER health, and as to inacuracy, it should be accurate to given levels, and done properly it should show trends.
 
Yes.
 
Hi and welcome,

This is what most of us Type 2s are told. It is an excuse for the NHS not to prescribe the meters and strips for financial reasons. It is, quite frankly, rubbish. Initially it is essential to test out the foods we are eating. Testing before a meal and 2 hours after first bite will tell you what that food has done to your levels. The aim is to keep any rise in levels down to as little as possible. Initially, no more than 2mmol/l. Any more than that and there is something in that meal that is causing your levels to rise unacceptably so needs reducing in portion size or cutting out completely. Without a meter there is no way you can do this. It is an essential tool.
 
Thank you all. CatLadyNZ my levels were apparently just over the threshold at 50 mmol. She gave this as one reason why testing was not needed more than every 6 months. However, as I am diet only I am concerned about what happens at times like Christmas where my diet control will not be so strict.
 
Yes, the threshold is 48, and pre-diabetes is 42-47, and normal is under 42. Even if someone is in the high 30s I say to them it's best to try to reduce their number so they don't end up getting pre-diabetes then diabetes. My level was about 54 I think, and I have got it down to 33 by eating a low carb diet and testing to find out which foods increase my blood sugar.

IMO one or two days every now and then where we loosen the control for a special occasion such as Christmas, don't do any major harm. It's important to still be able to relax and enjoy gatherings and seeing family and friends. I just try not to get too carried away and think I can keep on eating fruit mince pies for weeks on end, lol. (My absolute favourite!)
 
@MargJ

Hello Marg and welcome to the forum As other members said, I agree that testing is necessary to look after yourself properly. Here is the information we give to new members and I hope you find it useful. Ask as many questions as you want and someone will be able to help.


BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS

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 over 150,000 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

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes-and-whole-grains.html

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

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 bloodglucose 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.
 
Thanks daisy1. That's very helpful. I quoted NICE to my doctor yesterday but she would not move from her stance that I did not need to test. I will buy a monitor as I need to know what affect foods have. Her testing every 6 months is not enough. If I can control my levels through diet, I can postpone the need for medication as long as possible.
 
Hi. Yes, you must have a meter and I regret not buying one when I was first diagnosed. Many GPs will not do an HBa1C until 3 months after dieting. Do insist on an Hba1C after 3 months have elapsed and then every 3 to 6 months if the figure isn't good.
 
Meter and strips ordered. This may seem a silly question but how will I safely dispose of used lancets?
 
Hi @MargJ and welcome to the forum!

I totally disagree that self-testing is inaccurate. If that were the case, why would so many diabetics (both t1 and t2) rely on their meters and bg readings?! It does only give you your bg level at a certain moment in time, but as said above, keeping a diary of your readings can help identify any patterns.

With regards to necessity, I don't really know how else you would know whether you're on the right track, or the progress you're making outwith an hba1c test. And as you have said yourself, it is a great way to experiment with new foods and get an understanding of how your body reacts to different types of foods.

You might be able to get a sharps box on prescription (although I am t1 and have a sharps box provided with my needles and lancets). Alternatively, you can buy sharps boxes on amazon. There is a great one I buy, which is pretty small so can fit into my handbag I will have a look and post you the link.

On another note, I know a lot of t2's on this forum have done well on the Low carb, high fat diet and I think there is a separate forum on here dedicated to it. There are loads of people to help you. Good luck
 
It depends on the type of lancet, but if you have the one's with a plastic lid that you remove before use, then I usually keep it and stick it back on before binning it.
 
I totally disagree that self-testing is inaccurate.

Unfortunately it is. Meters are allowed quite a wide tolerance margin, and so a reading of say 7, could quite easily be a high 5 or low 8 in reality.

This morning I tested on my last strip with one meter, and also with a new meter on the same drop of blood and had a 5.7 and a 6.4.

It is important to remember this, but not to focus too intently on the absolute number, and not to get into a "game" of comparing youir results top other peoples, but to monitor the changes caused by different foods and different times of day and to focus on the trends.
 
Hi @britishpub ! You are right in that the meters are not 100% accurate in their readings (as your meters have shown), however, I think they are invaluable to knowing how bg levels are behaving and accurate enough to gauge patterns. eg. if I am reading at 13.3, I know that even considering the tolerance range, I am high.

Also, with regards to the disposal of lancets, even once the plastic top is back on, it can be removed again. It is still a used needle and so I always dispose of them as I would my injecting needles. I know that is coming from a t1 who doesn't HAVE to pay for a sharps box, but it gives me peace of mind that I know where my needles end up and don't end up in the wrong hands (I have a horrible vision of one falling out of the binbag and a child picking it up). I do know a fellow t1 who doesn't own a sharps box and flattens his needles against a table before binning. I don't necessarily agree with that either, but each to their own
 
Ps. @britishpub , well done on your hba1c results (I saw them in your signature), what a fantastic drop!!
 
Meter and strips ordered. This may seem a silly question but how will I safely dispose of used lancets?

"They" tell you to use a new lancet for every test. I don't - I change the lancet when I change the tub of test strips, & use the previous tub to keep the strips & lancet(s) till I bin them.

Note - if you test anyone else, change the lancet before & after - never share lancets.

I have good reason not to trust HbA1c as a guide to my control:
7-8 years diabetic T2 I was suffering crippling peripheral neuropathy, & various other problems.
HbA1c was 6.8 (50.8) which Dr did not consider the cause of the problems - basically diabetes is a progressive condition, & my diabetes was progressing.
That HbA1c corresponded to my finger prick tests.
He suggested hospital tests but first I came on this forum, & took the low carb advice - cutting out all the obvious carbs.
Immediately my readings improved, & soon my health, so that in 3 months I went from crippled to playing tennis again.
As an experiment, with high carb food, I found that testing an hour after a meal gave readings in the teens, so that it became apparent that HbA1c - an average of 2-3 months blood sugar gives NO indication of highs & lows during that period. It's the highs that do the damage. [I was never in the hypo region.]
On the low carb diet I rarely go above 9.
Now - diabetic for 15 years, at 76 y-o, I am fully fit & without diabetes problems.
The last HbA1c=49 (6.6).
I suspect that the HbA1c units were changed to make it more difficult for diabetics to relate HbA1c to their finger tests.

I think this point of the inadequacy of HbA1c needs a new thread?
 
Also, with regards to the disposal of lancets, even once the plastic top is back on, it can be removed again.

That is a good point, I should and will from now on take a bit more care when I dispose of them.
 
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