[Diabetes] Testing Bloods

tbh

Hi Guys -

just wondering how often other diabetics test their bloods and what actions you take based on results. I'll be going to my docs in Jan, and I have a feeling my insulin regime will be changed significantly (I'm on mixtard 30/70 twice daily, but thats just because I haven't been to the docs in ages). I don't test regularly, certainly not to a regular schedule, so I'll be asking the doc for help with that. I was just wondering how people test - e.g. do you test before lunch or after? If before, do you eat less or more based on results? I have a pretty good idea what my levels are at any given moment, but am interested in how people tweak their diet/medication based on results. I'll have a go at doing a spreadsheet to record levels/min/max values and averages, I 'll post it up here when I get it done if anyone wants it.

thanks,
tbh.

CathyMoran

As you know me I test all the time but then again I am still on the steroids from the chemo at the moment. I am on Lantus once daily with bolus of Novorapid depending on activity/food/blood sugar levels. You should test first thing in the morning, before lunch, dinner, supper and before you go to bed AT THE VERY MINIMUM. You should use a sliding scale of insuln dosage depending on what you are eating, what type of carbohydrate you are eating, if you are feeling well/sick, how much exercise you are doing at the time/afterwards and what time of day it is.

There is a very good course called DAFNE which you can apply to be evaluated for to see if it is suitable for you (Dose adjustment for normal eating), the waiting list is quite long but I am trying to get on it at the moment. Will also send you a PM on this.

If nothing else I hope that this gets the ball rolling.

robinph

Nowhere near often enough for me usually.

Although it does range from the scarily infrequent that I'm currently going through where the frequency of testing can be measured in days and often weeks to the more advisable timing similar to the 'CathyMoran Minimum Standard'. I can't say that I've ever tested more often than that though and my fingers would certainly not appreciate it.

I tend to just go through a phase of testing regularly for a while and then I get bored and just seem to not bother at all for a bit. I do find that I need something to keep me interested in doing the testing though and due to my fetish for gadgetry I have a PDA that I keep my numbers in using SiDiary which can then generate some fancy charts indicating your levels over time and that goes some way to keeping me motivated to regularly squeeze some blood out of my finger.

I'd best run off now and start sharpen up my finger pricker again before I get told off for my lack of testing recently though.

mike65

I'm on NovoRapid (meals) and Levemir (basal). I test erm when I remember, nah I'm a bit better then that. I do it before a meal and last thing at night. I will do extra tests if my day is "messy" in nature. As for record keeping - don't ask!

I have a habit of adjusting my intake rather than dropping or raising insulin levels.

BC

I'm on novorapid for meals and lantus for basal.

I test before every meal but i rarely change my insulin based on the result. Testing before a meal really tells you if you took the right amount at the previous meal. E.g If you test before lunch and you are high then you didn't take enough insulin at breakfast so its the breakfast insulin the next day you need to change rather than the lunch dose.

I also test before i go to sleep, if i'm about to do any exercise, if i'm about to drive or as mike said, if my day is 'messy'.

As far as record keeping goes, i haven't been good at tracking, i usually just have whats in the memory of my meter. However, I have bought a cable for my meter that i can use to download the results to my laptop so i'm planning on getting better at that eventually

mike65

Thats what I need! A proper meter with a 500/1000 reading memory and a usb port.

Mike.

tbh

I've tried a number of things, like spreadsheets and pop-up reminders, but once the novelty wears off, I just ignore them, and then switch them off. I'm sure between us tho we can motivate each other - not to get to raa-raa-raa about it. I think for me, I see it as a chore that doesn't have any real value - simply because I don't really do anything about the results - I know myself when I'm high or low and react accordingly, which I know is the wrong approach. I think if I knew more about how to react to the reading - more long term than short term - I'd be more proactive. I suppose at the moment it's telling me what I already know (I ate too much or too little), it's not really giving me signs of a trend. And that's maybe because for me, every day is different as to what time I eat, how much, what kind - so maybe I need to cop on in that respect. Sorry, I'm rambling, just thinking out loud really. But does any of that strike a chord? rob - yourself and myself sound very similar, it's a relief

mike65

Well trends can only be established by testing! Good diabetic managment is about removing as many of the peaks and troughs as possible and thats down to disipline. I should proberly do as I say. Have you can real idea of your mean blood sugar level? The long-term ideal used to be 7 then it was 6 and the latest is 5 that is considered achievable.

Mike.

mike65

A general query - if you test and are say, 12 mmol/l rather than 6 do you put in a small amount of short acting and let it fall back slowly or whack in 7/8 units and try to get it down ASAP and risk overshooting into a hypo?

Mike.

europerson

I'm on Mixtard 30 twice a day. I usually test four times a day, but, now that I'm back at college, I'm kind of forgetting about the lunch-time test. My doctor thinks a four-a-day injection regime might be an option for me. Has anyone any thoughts on the four-a-day system? Is it a pain or is it manageable? How do you manage to spread your injections around different sites to prevent lypohypertrophy?

robinph

I've often tried coming up with more interesting methods of staying motivated for testing more regularly. I kept on forgetting to take one of my two daily lantus shots at one point as it was not at a meal time that I was taking it so would forget easily, so I then came up with a way of getting my PC in work to send text messages to my phone at the appropriate times to remind me and that kept me more 'interested' for a while.

My hba1c's have always tended to be around 7, I think it was 6 point something the last one though. They didn't say anything about needing to be down as far as 5 to me yet though, that sounds like I would have to be paying a lot more attention to what I was doing. :eek:

mike65

europerson

I'm on 4 a day (assuming no extras!) its not a problem and injecting prior to each meal allows greater flexibility. As for lipohypertrophy just vary the sites left/right leg, upper thigh/lower thigh etc.

Mike.

robinph

europerson wrote:

My doctor thinks a four-a-day injection regime might be an option for me. Has anyone any thoughts on the four-a-day system? Is it a pain or is it manageable? How do you manage to spread your injections around different sites to prevent lypohypertrophy?

I'm on 5 a day at the moment as only taking 1 shot of Lantus a day wasn't giving a good enough basal level over 24hrs so had to split that into two shots a day along with the 3 Humulog a day. It did make a huge improvement for me though once my dosage of Lantus was more spread out over time as I had been getting some very odd readings in the mornings previously.

Using the Mixtard might give you less options as to how to spread the dosage about to when you need it though as that is a combined fast acting and slow acting insulin isn't it?

LegacyUser

Hi i'm a student nurse you should be recording blood sugar levels before each meal and before bed esp as you can go hypo any type 1 are some times recommened getting the new pump that is out now to prevent hypos during the night and this is used all the time i dont really know much about the pump yet because havent met a patient with one. but if sugars are high in the morning for example should inject the corrrect amount of short fast acting insulin as the other insulin or tablets you are taking are long acting. if you are experiencing frequent highs and lows you really need to get a review esp if a type 2. also if you are sick, have an infection or pregnant this can cause flucuating levels however do not stop taking medication. long term problems with high blood sugar readings can cause complications so you should really get a review if this is constantly happening. hope i helped

graflynn

europerson wrote: »

I'm on Mixtard 30 twice a day. I usually test four times a day, but, now that I'm back at college, I'm kind of forgetting about the lunch-time test. My doctor thinks a four-a-day injection regime might be an option for me. Has anyone any thoughts on the four-a-day system? Is it a pain or is it manageable? How do you manage to spread your injections around different sites to prevent lypohypertrophy?

I was on the mix for about 7 years and it was more of a pain for me - I had to have snacks all the time and always eat the same amount at the same time every day.

I was resistant of the the rapid & long acting insulin regieme at first but now after 9 years, it's so much easier to handle. Having said that I do find it hard to work out the maths. But sometimes I feel like a bag of crisps with my lunchtime sandwich and I can take a couple of extra units to cover it. Or if I eat out and I have no idea what's in the food - I can correct my dose later if I need to.

In short, there are probably benefits to both regiemes. Change is always difficult, so read up some more on it and make an informed decision to change or not to change.

Good luck.

graflynn

tbh wrote: »

Hi Guys -

just wondering how often other diabetics test their bloods and what actions you take based on results. I'll be going to my docs in Jan, and I have a feeling my insulin regime will be changed significantly (I'm on mixtard 30/70 twice daily, but thats just because I haven't been to the docs in ages). I don't test regularly, certainly not to a regular schedule, so I'll be asking the doc for help with that. I was just wondering how people test - e.g. do you test before lunch or after? If before, do you eat less or more based on results? I have a pretty good idea what my levels are at any given moment, but am interested in how people tweak their diet/medication based on results. I'll have a go at doing a spreadsheet to record levels/min/max values and averages, I 'll post it up here when I get it done if anyone wants it.

thanks,
tbh.

I test 7 times a day.

I test before each meal so that I can adjust my rapid acting insulin accordingly.

I test 2 hours after each meal to tell me if I took the correct dose for the meal. Or if I feel like extra carbs to tell me if I took enough for it and so I know for next time.

And I test before bed - to make sure I'm on target.

I never forget to test before meals because I never inject without knowing the number. I do need help remembering to test after meals - so I set my mobile to alarm after breakfast (I've got kids going to school so breakfast is always the same time). In the afternoon, my motive is if I'm on the low side I could have a little something (never works!), and I'm usually gagging for the caffiene at that point. After dinner, I've just put the kids to bed so I test.

My trick is that every time I test is associated with some other aspect of my routine. The mobile alarm is great though.

PS my fingers don't give me any hurts after 16 years of testing - are you guys with the sore fingers testing on the side of the finger or the finger-tip? The general nurses usually try to test you on the fingertip and it definately hurts. Plus (not trying to be negative) but if your sight ever goes you'll need sensitivity in your fingertips to "see".

lucernarian

I probably test on average 2-3 times a day. I find it easy enough to tell if it's too high or too low, so I just take corrective action to deal with it. I always measure before going to bed however. I like having bs of around 10, so that there's a safety cushion from having hypos at night or early in the morning.

Waking up as per usual at half 7 becomes a pain when you feel the hypo a minute later.

HbA1cs go from 6.4 to 7.8 since I was diagnosed. How often I test seems to have little correlation with this. My diet and environment influences it much more strongly.

Also, the finger-pricks usually hurt slightly. Once they're not within 5mm or so of the fingernail, they all feel similar.