Opinions, please.

[Phil Aypee]

Hi,

My diabetes specialists recommend that I take my blood sugar levels (and blood pressure) once a day in the following pattern.

Day 1 - before breakfast, Day 2 - after breakfast, Day 3 - before lunch, Day 4 - after lunch, Day 5 - before supper and Day 6 - after supper - and then repeat. (After meals means 2 hours after food.)

This seems reasonable as it should produce a valid sampling and any apparent spikes will be smoothed out. The [b:91e9285391]average[/b:91e9285391] should be about or below 7 mmol/L but no reading should be below 4 mmol/L (if it is I should eat immediately). If any reading is above 11 mmol/L I should test again - if it’s still above 11 I should see a diabetes specialist immediately.

I think this approach is good as it should guide people to good changes in lifestyle generally rather than reacting to specific readings. This kind of sampling, spread over days rather than hours, is good science and mathematically robust according to the methods I’ve learnt over the years.

[Phil Aypee]

But I do know others have different opinions and I’d like to read them [b:fab85ff67b]with[/b:fab85ff67b] an assessment of the [i:fab85ff67b]rationale[/i:fab85ff67b] behind them. My only request is that those with different opinions express them [b:fab85ff67b]as[/b:fab85ff67b] opinions, not absolute fact (well, it’s been known).

[Gemstone]

Hi Phil,

My personnal opinion is to test more often than that. Your body doesn't react the same to each food so if your lunch on day 1 isn't the same as on day 2, the results you get aren't giving you any hints as what you should take care or remove in your diet.

Let's take, as an example, a slice of white bread, a slice of rye bread, a portion of cereal or a portion of rice which are all calculated as 15 grams of carbohydrates in a regular diabetes diet. I know, for having tested each one, that if I eat the cereal, my blood sugar goes up to 15 mmol while the rye bread keep me under 10mmol.

On the other hand, if you are always under 7mmol just by watching your diet, I would do less testings until the evolution of the illness ask for more....as I used to do for the first 2 years. My A1c were always at 4.9.

The low limit of 4mmol is reasonnable as a limit to eat something though for experiencing lows quite often I know that at 4 I feel really good. Hypos for me are at 3mmol. Above 11mmol happen too and my guess is that your GP gave you that limit so he can prescribe medication to help control your numbers if you go that high.

I hope someone else will jump in and let us know what their testing habits and recommendations are.

Gemstone

[Anita]

Hi Phil,
Since you're newly diabetic, I believe your doctor is trying to check the severity of your case. In this case it is best to check in the most varried way and see what your sugar level in any condition. Later on, he'll probably will refine the test.

[sistersandy]

i mentioned my opinion of how to test in another thread, i also do mine mostly before meals, and then 1 or 2 hours after, to see how I am doing with certain foods. My fasting levels are usually above optimum, with them running around 110-120. So I dont worry about them, as I know it is difficult to get them down much lower.

I do have to worry about going very low in the afternoon, (after my main meal at noon) as I have been down as low as the 50's ! Had to stop taking Prandin because of this.

I am trying to practice strict portion control, mostly because I need to lose weight, as well as keep my numbers down.

I would do what your doctor suggests, and then discuss the numbers. See if he wants you to continue doing it this way. My doctor seemed only interested in my fasting numbers, says the others arent important! I dont happen to agree with him, and since it is my body, I will do things my way.

I also have chronic asthma, and other health problems to deal with. This one is a lot easier to keep under control than the asthma actually!

well so far anyway.

[Phil Aypee]

Hi.

Anita, what you say makes sense.

I think in [b:daf225040e]some[/b:daf225040e] cases (please, not mine) more frequent testing is virtually necessary for good control. But I also think that testing once a day is quite adequate for others. My neighbour, a Type 1 of some years standing, only tests twice a day and I know several Type 2s whose testing patterns vary - and we all use the same diabetes clinic.

Sandy, I’ll take your advice and follow “doctor’s orders”.

It is also relevant that I’m a recovering stroke victim. Just over 5 years ago I had a fairly major [b:daf225040e]Transient Ischaemic Attack[/b:daf225040e] and, although I’m recovering, I am comparatively inactive now. I actually used to walk over 5 miles most days and as many as 15 sometimes (well, I enjoy it).

Fortunately I don’t have any other chronic problems (except one neighbour!).

Sandy, not being funny, could you translate your figures to mmol/L in future and post both? It would make life so much easier for most of us as we’re more familiar with those units than mg/dL.

[sistersandy]

Will try to remember to translate, are most of you from countries where they use ...mmo/l ?

[Gemstone]

Will try to remember to translate, are most of you from countries where they use ...mmo/l ?

In fact, I think only USA don't use mmol. My old meter used to read in both, but Lifescan changed all the meters a few months ago as it could cause problems so now, canadian meters read only in mmol.

Gemstone

[Anita]

[quote:c1b88850a7="Phil Aypee"]Sandy, I’ll take your advice and follow “doctor’s orders”.[/quote:c1b88850a7]

Hi Phil,
Forgive me for being such an old aunty, but following the doctors orders is a must.
Yes, it is important to read and learn both online and offline and to understand what the doctor is doing and why, but deciding by yourself not to follow his orders is VERY dengerous and something you must NOT do.
If after reading, something in your doctor's orders looks weird to you, talk to him and ask him.

[Gemstone]

Phil,

High blood pressure is another chronic problem which can lead to cardiovascular events. Teamed with diabetes, it's even more risky. If you have also high cholesterol, then it's the jackpot. If the Dr. asked for testing your blood pressure daily, it is serious.

Paul,

Does that mean that the doctor is prescribing a perticular number of strips for a month? What if you feel hypos symptoms and need to test?

You know, the UKPDS research is still used as a bible, at least here, and since in it it's said that 90% of the patients taking oral medication couldn't obtain optimal control of their blood sugar, that's probably why they think testing is useless. Optimal means under 7mmol fasting and under 11mmol 2 hours after meals as well as A1c under 7.

Gemstone