Should Type 2s Test Their Blood Sugar?

It will be a great leap forward when continuous meters are affordable and reliable. In the meantime, IF you think someone else is responsible for controlling your diabetes you don't need SMBG. Otherwise I think SMBG (2-3 times daily) is essential towards meeting that goal.

I agree with you both. Unfortunately, the sensors for the CGM are still pretty expensive. I was paying for my own, and so although it was wonderful to have, I decided it was not accurate enough to warrant the cost full time. I found I was spending almost as much time calibrating the Dex as I was getting useful information from it.

I'm not interested in transmitting my BGs to my doctors, as most of them wouldn't bother to look at it. All they care about is the A1c. When I showed my endo the printout from the CGM, she didn't really understand it!

I am using the Navigator CGM.  It reads about 20 points lower than the Aviva single meter.  I know that is not accurate.  I use it to show me when a BG rise starts,  when it levels of, when it starts to drop, and what is the delta spread between the various readings.  I use it to test foods and insulins.  Does it make sense? Can you comment on this? Any additional ideas?

What do you use to calibrate the Navigator? If you're using the Aviva to calibrate, it doesn't make sense that it would be 20 points lower. Or is the Navigator one that has the built-in FreeStyle meter? If that's the case, how do you know which meter is more accurate?

I agree with you that the main purpose of a CGM is to show trends, so you'll know when to test with your regular meter. I used it that way when I was experimenting with bolus insulins. I would inject the insulin and watch the CGM until the BG started going down just a little, and then I'd test with the Ultra and quickly eat, knowing that the CGM lags about 15 minutes behind the regular meters.

My biggest problem with regular meters is planning to do some testing and then getting involved with something else (like this) and forgetting to retest when I'd planned to. The CGM covered my brain lapses.

Dave, Again I agree (how boring!). It would be interesting to find out what percentage of type 2s are given enough information to take control of their disease.

Hi Gretchen, well I was not given enough, but I am of an engineering background and being of that persuasion, I dug for info.  I had numbers to use to make work, now there was and still are some unknown variables that I am unable to compensate for but my last HbA1c was 5.6 so not too shabby.   hey we need spell check here I am not much on spelling.

Oh my GOSH, i just had to reply to this. When i was diagnosed with type II 2 years ago, i was devastated. Sent home with prescriptions , and told to eat more salads !! I'm serious. Bless my computer. Over the past couple of years, i have joined "groups" for support and done my own research online.  For example, i had no idea exercising would bring down my numbers like they did. I had no clue what to eat, when to eat it, and a friend helped me figure out the meter. In the beginning dr was testing my blood every three mnths at least, but again, when she didnt get the result she wanted, it was just EAT BETTER ! What a nightmare. ON MY OWN, i gradually found out enough to bring all my numbers down to a healthy range, and my next goal is to get off such a high dose of these "metformin" pills. 2000 mg a day. When i ask her to take me off them or at least cut back, she tells me she wants my weight down more before we can do that. hmm.

sorry for rambling, i had to vent on that remark about patients not knowing , or not being told or educated enough.

thanks,

julie

I AGREE WITH YOU  THERE NOT ENOUGH DIABETES PROGRAMS FOR DIABETIC TO JOIN

IN. YRS. AGO THERE WAS.  NOW MY DR. OFFICE DOESN'T HAVE OUR LAB GIRL OR

DIETICAN ANYMORE.  I DO HAVE A DIABETES EDUCATOR SHE GREAT. 

I was fortunate enough to have an insurance company that offered me two consulatations with a dietician as well as one with a nurse.  Between that and the internet I learned what I needed to know.  After 2 years, I was experiencing too many hypoglycemic attacks and made a decision to cut my medication in half, without my doctor's knowledge or suggestion.  On my last visit, as she congratulated me on my great numbers I informed her that 3 months prior I had cut my medication in half.  This may not have been the wisest thing to do, but it did work for me.  While she was a bit surprised, she encouraged me to continue with the decreased amount and agreed with me that my diabetes is in my hands she is only there to help.  So far another 3 months have gone by and my numbers are still great.  Obviously once I changed my diet, which got my diabetes under control 2000 mg of metformin a day and the glyburide was too much.  I suggest anyone who is experiencing hypoglycemic attacks take this into consideration and speak to their doctor.

I totally agree with you about testing.  How would you control you blood sugar if you don't know the number?  When i was diagnosed with pre-diabetes, on my first visit to my doctor, he prescribed Metformin and tell me to eat "LESS".  I did not have a clue about "eat LESS".  Less what? and how much is Less?  Through a friend and thanks to the computer, I learned what Carbs foods do to my BS. I make sure to test my blood sugar 4 times a day and exercise every day.  3 months after the visit, I went back to see him with an average BS between 100 and 110 and 13 pounds lighter, my doctor ask me How did I do? In the long run, I think test strips are much cheaper than any prescriptions and complications.

"Test test test" is good, but CGM can catch highs and low that occur at times you didn't think to test.

My A1c always seems higher than it should be according to my BG levels, even when I'm using a CGM. But seeing that I wasn't going high overnight was very useful, as I knew that wasn't the explanation. The only thing I can come up with is that my red blood cells live longer than normal.

I agree with you 100%.  I even had an arguement with my doctor, that I needed to test three times a day.  (Medicare only pays for one strip a day).  With the testing, I am now down to 5.9 in my A1c and I would also, like to get it down even further.  Pat

Gracie, what you and other determined patients have shown is that it is possible to get close to normal BG levels when one makes some effort to do so. The sad thing is that so many patients aren't willing to do this. They want a pill so they can eat the same way they've always eaten.

So the blame is not just on the shoulders of the doctors.

What we need is a massive education campaign so the uninformed know what they need to do, so at least some of them will demand proper care.

Gretchen,

Yes, sadly many take exactly that approach ( which is probably why many doc's don't bother to try to offer it "no one's going to work that hard" ) And my hubby has a co worker who actually says " I'll eat what I want, there's a pill for that" . I just hope she changes her mind before she starts to lose body parts! Have a gal from work, who did not take good care of herself, ate anything she wanted, wasn't good about testing & now has 1 leg off at mid calf, the other at the hip. Makes me so mad, she could have prevented it, but chose not too.

Hugs,

Gracie

Monica, you're fortunate to have such an endo.

Ann, thanks for your supportive comments. I think each type of diabetes has its problems and its benefits. Type 2s are more apt to get complications even with good control because they've probably had it for 10 years or so before diagnosis and often get blamed for "bringing it on themselves." But type 1s can't take "vacations."

I think we need to support each other. Too many people think the other type has it easy. Not so! It's difficult for us all in ways that people without the disease can't understand.

I'm sorry you've had difficulty find a supportive health care "team." I've never really expected to have a team. I have different doctors and it's up to me to coordinating their findings. Maybe we really need to get our support from each other, by sharing strange BG patterns and using many minds to try to interpret them.

Have you used diabetes software to try to find patterns in your BG results?

Kathy, are you type 1 or type 2? Are you using insulin? What would your BGs be on days when you didn't go up to 200?

I'm a Type 2  Been on Insulln pump over 6 yrs. now.  Used to injected 4 - 5 times day.

My last Ac1 was 6.9  before that was 6.3 also is using REGULAR INSULIN  500mg. which is a CONCENTRATED INSULIN, also take SYMLIN 120 mcg. injections 3 x day.

before meals and last take   Glimerpride  diabetes pill  4mg.  2 x day. 

  Blood sugar sometime 8am  70-150  lunch  167-225  5pm  120-180   9pm  130-200

I'm  obesity all my life hard to lose weight cause of 500 unit of concentrated insulin.

I'm please when I switch over a year ago it has help me alot.  Before on 100 units

a day never out of 200 all day.  I hope I answer your question ok. Let me know.

Rainbow Kathy

Kathy, I agree it's difficult to lose weight when you're on insulin and a sulf. You're taking symlin. Have you asked your doctor about Byetta? If you're taking a sulf, your doctor seems to think you're able to produce some insulin yourself, so the Byetta might work for you.

Regardless, controlling BG is more important than losing weight. I know you're doing what you can to control it. Are you on a low-carb diet? If not, you might want to look into that as it would reduce the amount of insulin you need.

Yes I've been on Low Carb Diet for long time now.  8am  26-30  12pm  30-40

                                                                     5pm  30-48    9pm snack  15-20

yesterday my blood sugar was  8am 70  noon  118   5pm  162   9pm  276  WHY

I used a low carb recipe for oven bakes catfish, does catfish high in carb i don't know

couldn't find an info. on that  1 piece  instant potatoes 18g and aspargarus  4  Ice Tea  I cant eat any kind of ceral cause it always go over 200 by noon here again no

sense.  My body doesn't always work good on low carb body is weird.  Talk soon.

If those numbers (26-30, etc.) are carb counts, for some of us, that wouldn't be considered low carb. Instant potatoes would make my BG go over 200, I'm sure. Try mashed cauliflower with some butter or cream cheese instead.

Richard K. Bernstein (author of The Diabetes Solution) says don't eat more than 12 g of carb per meal, except breakfast, when you aim for 6. That's what many of us consider really low carb. But not everyone is that extreme. It depends on how many carbs you can deal with. If your BGs are too high after meals, that means you can't deal with that many carbs.

You could try even fewer carbs, but you say your body doesn't work well on less carb. It does take several days for the body to adapt.

Kathy, I forgot to add what I'm sure you know: If you do decide to reduce carbs, of course you should check with your health care people to reduce your mealtime insulin as well.

Hello,

   Someone has to show me how you can eat carb.  Everything you pick up has carbs,

I've been trying to yrs.  You're telling me to eat 12 per milk there no way my 1% low fat milk is alread has 12 carbs. I pick instant potato caused that only has 18 carbs

where regular potatoes has 27,  If there a way could you tell me or name of book i

could buy I probably has it already in my cllection.  Thank you for your help with this

matter.  I really appreciated so much. You have aa wonderful day.

Rainbow Kathy

If milk has too many carbs, then you don't drink milk. Or you substitute a low-carb milk called Calorie Countdown. If potatoes have too many carbs, you don't eat potatoes; you eat mashed cauliflower instead.

If you're using insulin, the best book is Richard Bernstein's Diabetes Solution,  as it has a lot of information about using insulin as well as diet advice. I've helped to write another low-carb diet book called The Four Corners Diet. The book bombed, so you can get a used copy for less than $1.

Today there are lots of low-carb recipe sites on the Internet.

Anyone living in a retirement or nursing home and not preparing their own meals might have more difficulty following a low-carb diet.

Hi,

   I'll check into these books. Thank you for your info.  I drink milk cause I don't drink

coffee and it  Iced Tea, I drink at lunch and suppetime. ok.  Talk soon.

Frank I agree that if your BG has been 85 every morning for the past month, there's no point in continuing to test every day. But it's good to do spot checks, just to make sure the fasting numbers haven't been drifting up without you knowing it.

For a type 2 not on insulin or only on basal insulin who is getting consistent results, I think not testing for a while, stockpiling the strips, and then using those strips to  test every hour or every couple of hours for a day or so makes more sense.

Alice, do you do that one test a day at different times? That will give you more information than just testing fasting every day.

yes I test at differnt times each day. I also go and get my eyes tested once a year.

I agree with self-testing as a denial buster. Sometimes I try to guess my sugar and then test it . I am usually wrong. Another reason to test and keep your A1c at a good level is when you may be having surgery. I have a hysterectomy coming up and thank God , my levels are great. However I have a friend with high levels and they cancelled her surgery until she is under better control. It isn't worth the wait when you need the surgery as soon as possible like my friend and I do.

I hope that you keep your sugars in the safe range before, during and after your hospital visit. Self-testing will help you stay in-range. The better your control, the faster you will heal and the less likely you'll get a wound infection (there are no guarantees, but still, good control greatly improves your chances.)

I recently discovered (much to my dismay) the dangers of any wound when blood glucose is too high. I had a biopsy to a lesion on my chest (skin only -- I have a history of melanoma) when my control was poor and it took FOREVER for the biopsy site to heal. Wounds that should take a week or less to pretty-much heal take many weeks to heal when blood glucose is chronically elevated.

Take care and best wishes for a full and fast recovery.

Intense checking of blood is silly.  According to my doc in the long run it wont prove nothing different.

Just ignore it and lead a Godly life and everything is okya.

No, it is certainly not silly. But everyone has their own opinion.  Ignoring it will only make matters worse. Leading a godly life has no effect on whether your blood sugars are high, low, or normal. What would that have to do with it?

Thanks anyway for the comment.

Oh my, please tell me you are being sarcastic!  I can handle sick humor, really.  I am on an intense insulin regimen (type II) and I test to make sure I don't under/over shoot my insulin dose!  Get a new doctor.  My doc knows her stuff when it comes to diabetes and from what I read, I am one of the lucky ones.

A Godly life has nothing to do with it.  God gave us free will and I suppose burying one's head in the sand is free will, but I shall use the brain that the good Lord gave me and test!  Get your head out of the sand sister and let the holy spirit inside you lead you to your glucometer.

Hi Helen, Nice to "see you" here. I'm sorry you're getting such poor care from your health care people. It's very discouraging when they know less than we do about the disease. The NP who said your A1c was too low had obviously read that veteran's study in which they found that mortality was higher in older vets with lower A1cs. But the patients in the study had already had poor control for years, and their A1cs were lowered with lots of drugs. Other studies contradicted that one, but some people persist in believing it.

Like physicians, some NPs are great, but others are mediocre.  I know one who refused to give insulin to a woman who turned out to have LADA and whose A1cs kept going up and up on oral drugs.

So it's sad that we have to take charge of our own health, but unfortunately, that's currently true. Internet communication like this site and e-mail lists can be a big help with that, as you know.

I agree that the CGMs will come down in price eventually. Have you had a C-peptide test recently? If your C-peptide is low, Medicare would pay for a CGM if you're on Medicare.

Your A1C of 6.0 was too low?!? Mine is 6.0 and my medical advisors are quite pleased. They say these numbers are actually within the normal ranges.

Just goes to show you another problem: conflicting advice.

As near as I can tell, once you hit 70+, fear of lows, possibly leading to a coma, become the leading factor in how much to control.  What?  Did my ability to read my meter, suddenly disappear?  Obviously I disagree.  As I am new to you, you don't know about all my cancers over the last year and a half, and the difficulty in getting treatment for the kidney ones, without losing kidney function.  My A1c about a year ago was 5.7, my personal best 5.5.  My goal is simply to get back to where I was.

Keep on testing, if nothing else, our meters are a reminder to take care of ourselves.

Helen Mueller

I am registered here, and the other day I ran across the information, right where I had filed it!  Imagine that.  So I think I will begin signing in and not have to sign e-mails.

I agree that seeing lower numbers when a person is careful about what they eat should encourage them to continue and also to try to get the numbers even lower.

Right you are that seeing an improvement in your BG numbers is uplifting and makes explicit the fact that you can make a big difference in controlling your diabetes AND makes you try harder to reach that goal. In other words- IF you know you can make a difference you will try much harder to do so!

I think testing one's BG several hours after dinner, ie. just before going to bed is important, since it tells you what impact your main meal (ie dinner) has on your BG AND also that BG level will

very likely be with you the whole night...til morn breakfast.

I agree with you.