[onga]

Hello!

Since docs seem to use the A1c as the "gold standard" to decide how well T2 diabetes is being managed, and that's only every 3 months, is our daily poking to measure blood glucose mostly helpful for us to know what foods might spike us?

I have an extreme aversion to needles so poking is anxiety-producing for me. My doc tells me to do it 2x/day but I'm not sure why except to get fasting BG, and know if I can eat that flatbread pizza or potato or whatever.

What is your experience and opinion? Thanks!

 

[itissteve]

is our daily poking to measure blood glucose mostly helpful for us to know what foods might spike us?

Absolutely!

A1c is a good measure of long-term blood glucose management. But there's a difference between getting an A1c of, say, 6.0 by always keeping your BG in the range 116-136 or by your BG ranging between 76 and 176. The average is 126 in both cases. But the 76 is hypoglycemia territory and the 176 has been shown to damage human organs. Tighter control is better. And you don't know your level unless you test.

One thing you'll discover is that every diabetic responds to foods differently. I've learned I can eat a couple of chunks of watermelon and not see my BG spike. Other people can't even eat one piece. The only way we know is by testing.

If you're eating a food that's new to you, we recommend testing before you eat that food and then one and two hours afterward; in some cases even three hours afterward if your BG has not returned to "normal". I know that sounds like a lot of testing and ... it is. I didn't look forward to it. But it's not forever.

I tend to eat the same foods for breakfast and lunch. I've learned that I get about the same reading each time I eat the same foods. So I don't test after my two eggs and two sausage links for breakfast unless the sausage had an ingredient that concerned me.

I'm not sure what testing only twice a day tells you at this point in your journey. Fasting BG is a good number to know but one more reading? Without the baseline of where you are before you eat, how do you know how high is too high? Personally, I would test as often as I needed to (at the beginning I was testing ten times a day) or just stick to the once for all the information two pokes would give me.

There are techniques to make the poke less painful, too. If that's an issue, say so and we'll give you our tips for that.

 

[itissteve]

I'll also put in a word for "alternate-site testing". Some meters will let you test some other place on your body (like your thigh) that doesn't have the concentration of nerve endings that our fingers have. There are some adjustments you have to make when you measure that way, but if less pain will make it easier for you to test often, it might be worth making those adjustments.

 

[onga]

Absolutely!

A1c is a good measure of long-term blood glucose management. But there's a difference between getting an A1c of, say, 6.0 by always keeping your BG in the range 116-136 or by your BG ranging between 76 and 176. The average is 126 in both cases. But the 76 is hypoglycemia territory and the 176 has been shown to damage human organs. Tighter control is better. And you don't know your level unless you test.

One thing you'll discover is that every diabetic responds to foods differently. I've learned I can eat a couple of chunks of watermelon and not see my BG spike. Other people can't even eat one piece. The only way we know is by testing.

If you're eating a food that's new to you, we recommend testing before you eat that food and then one and two hours afterward; in some cases even three hours afterward if your BG has not returned to "normal". I know that sounds like a lot of testing and ... it is. I didn't look forward to it. But it's not forever.

I tend to eat the same foods for breakfast and lunch. I've learned that I get about the same reading each time I eat the same foods. So I don't test after my two eggs and two sausage links for breakfast unless the sausage had an ingredient that concerned me.

I'm not sure what testing only twice a day tells you at this point in your journey. Fasting BG is a good number to know but one more reading? Without the baseline of where you are before you eat, how do you know how high is too high? Personally, I would test as often as I needed to (at the beginning I was testing ten times a day) or just stick to the once for all the information two pokes would give me.

There are techniques to make the poke less painful, too. If that's an issue, say so and we'll give you our tips for that.

Thank you so much, itissteve. For me, it's not so much as the poking is "painful," because, really, it's just a quick poke. It's more about the stress of holding that lancet on my finger and the anticipation of a needle intruding on my body. I shake while I'm doing it, even though it's only a short prick.

I'm getting the hang of testing before eating something that might spike, and then poking 2 hours after. I don't know what my "normal" BG is. Doc told me <180 is right, but I've read other that says <140, which is what mine usually is after a meal.

I am also getting frustrated that the diabetes docs and dietitians seem to only go by ADA standards and numbers without taking into account each individual. I learned a lot about that when I was first diagnosed with hypothyroidism many years ago: It took a couple of years before I was treated properly and felt good again, and I had to "fire" a doctor because of it. It seems the same is happening with this diabetes diagnosis.

Grateful for you feedback.

 

[onga]

I'll also put in a word for "alternate-site testing". Some meters will let you test some other place on your body (like your thigh) that doesn't have the concentration of nerve endings that our fingers have. There are some adjustments you have to make when you measure that way, but if less pain will make it easier for you to test often, it might be worth making those adjustments.

Thanks again, itissteve. It's not so much pain with my pokes, but the invasive nature of the needle going into my body that makes it uncomfortable. I can easily handle the finger pokes, I guess because it seems less "personal" than other points in my body might be. But sometimes I have to poke and poke again because I'm not getting a big enough sample for the test strip, and I have great anxiety each time I have to put the lancet to my finger. I am soooo grateful that I don't have to inject insulin: I don't think I could so that.

Yeesh! You should see me when I have a blood draw! Or have to get a vaccine!

 

[mbuster]

The A1c is a average over a period of time. Just because 2 people have the same A1c does not mean they are both equally controlled. An A1c of 6.0 is an average 126 mg/dL blood glucose reading. As an oversimplified way of creating an example, say one person runs between a 112 and a 140 everyday for 3 months they would expect and A1c of 6.0. Another persons runs between 70 and 182 everyday for 3 months and they would expect an A1c of 6.0. Which one has better control?

Studies show that running over a 140 BG can allow damage to occur, If I was worried about diabetes complications, I would rather be the first person and not the second one. Only way to know is testing. Like itissteve said, once or twice a day is not telling you much.

I too used to be poke phobic too. i had to be chased, caught, and held down as a kid to get shots. Checking for blood sugar (I guess thats what they were doing back then) they used a little razor blade looking thing and literally cut your finger. I feared shots until I had my first kidney stone as an adult. I dreaded the shot, but the pain was overwhelming. That one didn't help a lot, and I was begging for the second shot. That ended the fear of shots. When I started testing my own BG I was trigger shy at mashing the button, it hurt, and I often had to do a repeat, so I used alternate testing on my forearm. I eventually changed back to finger poking after reading advice about washing with warm water and using a lower setting on the lancing device, Warm water helped with blood flow closer to the skin surface. The poke didn't have to go as deep and didn't hurt as much. It also helped getting a meter that could test smaller samples, reduced the re-pokes.

 

[itissteve]

It's more about the stress of holding that lancet on my finger and the anticipation of a needle intruding on my body. I shake while I'm doing it, even though it's only a short prick.

I am convinced that not wanting to poke to test my BG postponed seriously managing my diabetes for months. Needles don't bother me much. But my experience with lancets was those huge square-cut things they use to test before you donate blood, and darned if I was going to do that to myself every day (never mind multiple times a day)! Fortunately, the lancets diabetics use are much smaller and more comfortable to use. It still helps me, though, to kind of distract myself before I push the lancet button. Not one of the better parts of being diabetic.

I am also getting frustrated that the diabetes docs and dietitians seem to only go by ADA standards and numbers without taking into account each individual.

You have learned what took many of us some time to learn: when you have a chronic condition, you have to be your own advocate. That includes expressing what works for you as a patient. This is particularly true when you don't want to follow the ADA standard of care (as many of us don't). I've found what quiets the chorus is results. My primary care provider was dubious when I told her I wanted to go low-carb to manage my BG. She's convinced now after years of A1cs in the 5.x range and with all my other numbers where they should be. But if I hadn't stuck to my guns...

You do you. As well-meaning as medical providers may be, they're not the ones who experience the symptoms, you do. If you've got a way that works for you and doesn't harm you or anyone else, go for it -- and prove them wrong.

 

[onga]

The A1c is a average over a period of time. Just because 2 people have the same A1c does not mean they are both equally controlled. An A1c of 6.0 is an average 126 mg/dL blood glucose reading. As an oversimplified way of creating an example, say one person runs between a 112 and a 140 everyday for 3 months they would expect and A1c of 6.0. Another persons runs between 70 and 182 everyday for 3 months and they would expect an A1c of 6.0. Which one has better control?

Studies show that running over a 140 BG can allow damage to occur, If I was worried about diabetes complications, I would rather be the first person and not the second one. Only way to know is testing. Like itissteve said, once or twice a day is not telling you much.

I too used to be poke phobic too. i had to be chased, caught, and held down as a kid to get shots. Checking for blood sugar (I guess thats what they were doing back then) they used a little razor blade looking thing and literally cut your finger. I feared shots until I had my first kidney stone as an adult. I dreaded the shot, but the pain was overwhelming. That one didn't help a lot, and I was begging for the second shot. That ended the fear of shots. When I started testing my own BG I was trigger shy at mashing the button, it hurt, and I often had to do a repeat, so I used alternate testing on my forearm. I eventually changed back to finger poking after reading advice about washing with warm water and using a lower setting on the lancing device, Warm water helped with blood flow closer to the skin surface. The poke didn't have to go as deep and didn't hurt as much. It also helped getting a meter that could test smaller samples, reduced the re-pokes.

Thanks for that perspective, mbuster. I always try to keep my BG 140 or less, not the 180 that the specialist told me. I always test after I've eaten carbs, testing to see if they spiked me. If, after eating something, my BG is more than 140, I will avoid that in the future. It's not difficult for me because I'm not a fan of pasta or bread. I was afraid that I could never eat pizza again, but I found a couple of super-thin-crust pizzas that don't put me over 140. I would also rather be the first person.

What is ironic is that I am on Medicare and they only allow you to refill test strips so often. So I had to go buy a ReliOn meter and strips at Wal-Mart to keep testing the way I do.

My next A1c is not until early May so I guess I have to wait and see.

 

[onga]

I am convinced that not wanting to poke to test my BG postponed seriously managing my diabetes for months. Needles don't bother me much. But my experience with lancets was those huge square-cut things they use to test before you donate blood, and darned if I was going to do that to myself every day (never mind multiple times a day)! Fortunately, the lancets diabetics use are much smaller and more comfortable to use. It still helps me, though, to kind of distract myself before I push the lancet button. Not one of the better parts of being diabetic.


You have learned what took many of us some time to learn: when you have a chronic condition, you have to be your own advocate. That includes expressing what works for you as a patient. This is particularly true when you don't want to follow the ADA standard of care (as many of us don't). I've found what quiets the chorus is results. My primary care provider was dubious when I told her I wanted to go low-carb to manage my BG. She's convinced now after years of A1cs in the 5.x range and with all my other numbers where they should be. But if I hadn't stuck to my guns...

You do you. As well-meaning as medical providers may be, they're not the ones who experience the symptoms, you do. If you've got a way that works for you and doesn't harm you or anyone else, go for it -- and prove them wrong.

I learned, itissteve, when I was first diagnosed with hypothyroidism several years ago, that I absolutely needed to be my own advocate to feel well again. In doing so, I fired two doctors because they only treated "by the book" and told me that my numbers were "normal." When I was finally treated as I should have been, all of my symptoms went away and I have been well in that department ever since. A painful but good lesson to learn that is guiding me as I learn about diabetes.

 

[robertprice]

I have an extreme aversion to needles so poking is anxiety-producing for me.

I would not mind a finger poke, if it was really "a" poke. Single. No, I have to poke 3, 5, 5 6, times to get a drop big enough to activate the test strip. I've watched a dozen videos how to do it, but I guess I'm the opposite of a bleeder. EXTREMELY frustrating...!

 

[onga]

I would not mind a finger poke, if it was really "a" poke. Single. No, I have to poke 3, 5, 5 6, times to get a drop big enough to activate the test strip. I've watched a dozen videos how to do it, but I guess I'm the opposite of a bleeder. EXTREMELY frustrating...!

That happens to me a lot, robertprice. Poke. Oops, not a big enough blood droplet and I can't squeeze anymore out. Poke again. Not enough blood, again. Poke again. Not this time either. Okay, which fingers did I poke or not poke? Poke again. Ah, this time it worked. Each time the poke is traumatic to me. I hear your frustration.

 

[robertprice]

That happens to me a lot, robertprice. Poke. Oops, not a big enough blood droplet and I can't squeeze anymore out. Poke again. Not enough blood, again. Poke again. Not this time either. Okay, which fingers did I poke or not poke? Poke again. Ah, this time it worked. Each time the poke is traumatic to me. I hear your frustration.

Sorry you also have this same problem, but at least good to know I'm not the only one.

 

[onga]

I am convinced that not wanting to poke to test my BG postponed seriously managing my diabetes for months. Needles don't bother me much. But my experience with lancets was those huge square-cut things they use to test before you donate blood, and darned if I was going to do that to myself every day (never mind multiple times a day)! Fortunately, the lancets diabetics use are much smaller and more comfortable to use. It still helps me, though, to kind of distract myself before I push the lancet button. Not one of the better parts of being diabetic.


You have learned what took many of us some time to learn: when you have a chronic condition, you have to be your own advocate. That includes expressing what works for you as a patient. This is particularly true when you don't want to follow the ADA standard of care (as many of us don't). I've found what quiets the chorus is results. My primary care provider was dubious when I told her I wanted to go low-carb to manage my BG. She's convinced now after years of A1cs in the 5.x range and with all my other numbers where they should be. But if I hadn't stuck to my guns...

You do you. As well-meaning as medical providers may be, they're not the ones who experience the symptoms, you do. If you've got a way that works for you and doesn't harm you or anyone else, go for it -- and prove them wrong.

I haven't done the research on the science of 140 being the point when the glucose can start damaging body, cells, and nerves. But if it's true, why-the-heck is the goal for people with diabetes <180, not <140??? Why does the ADA recommend the higher number?

I am always suspicious of our medical system in the U.S., with its profit-driven pharma and insurance, and therefore I am suspicious of the ADA's recommendations. "Let's keep them with a high A1c so we can keep having them on drugs and maybe increase their drugs." I especially feel bad for people who must take insulin, when the cost of that pharma keeps climbing and climbing to beyond being affordable.

For heaven's sake, I bought a meal planner/cook book published by the ADA and it recommends Stouffer's Mac-n-Cheese and McDonald's Quarter Pounder!?!?!?

I decided to just keep my carb counts to what I feel comfortable, instead of going with what the dietitian and specialist say. While I don't trust any blood test or the A1c number to be the be-all-end-all to how I'm doing, I figure it's just part of the map for me.

I really like, itissteve, that you stuck with your guns on lowering BG with eating only. And that finally your PCP accepted the wisdom of your ways. It might not work with everyone, but it's worth putting out there so people with T2 don't have to think that taking a pill is the only way.

 

[HappyJack]

My friend is type 1 and has a deal he has on and can just scan it anytime for a BS reading. Says it has really helped him use insulin to keep his BS in range and stopped some very bad trouble with his eyes. Don't know what it costs but folks might want to look into it. I have the opposite problem and need to be careful or I bleed all over the place. My Relion Prime meter uses very small amounts of blood also. I have to be careful not to over do it.

 

[JagTac]

When I first started they taught me to use the lancet at the tips of my fingers. That was painful and I found out that I could use the sides of my fingers instead. That way I’m not further irritating my poke sites with using my fingers like typing on a device etc. I alternate on 6 fingers as well.

 

[itissteve]

I have to poke 3, 5, 5 6, times to get a drop big enough to activate the test strip.

There are days I have to do that and they're not my favorite days. For a while I was convinced the fingers in my left hand had no blood in them!

There are tips to help with that. One big one is warming your hands (with warm water or whatever you like) before poking. Other options include changing the depth setting on your lancet (sometimes it just doesn't go deep enough on thicker or callused skin) and -- if you have a really old meter -- updating it. Newer meters use considerably smaller drops of blood.

JagTac's advice is good, too. Sometimes it's helpful to go over the basics because sometimes people just don't get all the information they need when they start out. Spreading out the pokes really helps, too.

 

[gailfillia]

Absolutely!

A1c is a good measure of long-term blood glucose management. But there's a difference between getting an A1c of, say, 6.0 by always keeping your BG in the range 116-136 or by your BG ranging between 76 and 176. The average is 126 in both cases. But the 76 is hypoglycemia territory and the 176 has been shown to damage human organs. Tighter control is better. And you don't know your level unless you test.

One thing you'll discover is that every diabetic responds to foods differently. I've learned I can eat a couple of chunks of watermelon and not see my BG spike. Other people can't even eat one piece. The only way we know is by testing.

If you're eating a food that's new to you, we recommend testing before you eat that food and then one and two hours afterward; in some cases even three hours afterward if your BG has not returned to "normal". I know that sounds like a lot of testing and ... it is. I didn't look forward to it. But it's not forever.

I tend to eat the same foods for breakfast and lunch. I've learned that I get about the same reading each time I eat the same foods. So I don't test after my two eggs and two sausage links for breakfast unless the sausage had an ingredient that concerned me.

I'm not sure what testing only twice a day tells you at this point in your journey. Fasting BG is a good number to know but one more reading? Without the baseline of where you are before you eat, how do you know how high is too high? Personally, I would test as often as I needed to (at the beginning I was testing ten times a day) or just stick to the once for all the information two pokes would give me.

There are techniques to make the poke less painful, too. If that's an issue, say so and we'll give you our tips for that.

Hello!

Since docs seem to use the A1c as the "gold standard" to decide how well T2 diabetes is being managed, and that's only every 3 months, is our daily poking to measure blood glucose mostly helpful for us to know what foods might spike us?

I have an extreme aversion to needles so poking is anxiety-producing for me. My doc tells me to do it 2x/day but I'm not sure why except to get fasting BG, and know if I can eat that flatbread pizza or potato or whatever.

What is your experience and opinion? Thanks!

There are days I have to do that and they're not my favorite days. For a while I was convinced the fingers in my left hand had no blood in them!

There are tips to help with that. One big one is warming your hands (with warm water or whatever you like) before poking. Other options include changing the depth setting on your lancet (sometimes it just doesn't go deep enough on thicker or callused skin) and -- if you have a really old meter -- updating it. Newer meters use considerably smaller drops of blood.

JagTac's advice is good, too. Sometimes it's helpful to go over the basics because sometimes people just don't get all the information they need when they start out. Spreading out the pokes really helps, too.

I have a few tricks too! One I hated the 'SURPRISE" lancet so use a fine point syringe (have left overs from before flexpen) or can use lancet needles by hand, and I have no issues gently pricking finger. Also new glucometer(Verio) needs very small blood sample, and finally I just ordered a DEXCOM - so won't have to prick finger - phone can read anytime (hope costs work out). And found like noted - test more when a newbee: 1st find your high peak time (mine is 2 1/2 hrs after eating); then test before you eat and again at your high peak time. When I did this I learned how much insulin to use for every type of food I eat, it's amazing how it wasn't hard to learn which foods jump me more and now only test just before I eat.

 

[NoniB]

Oh for sure we need to be our own advocates! Thankfully I have found an entire group of primary and specialists for my mixed-basket of chronic disorders, some congenital apparently. It only took me until I was 75 and I'm a retired nurse! I tried all of the ADA recommended eating information and slowly gained weight by eating their version of 'right' until I finally developed T2D in my long list of auto-immune disorders that began with Hashimoto's in my 20s and exacerbated after PPB exposure in early 30s. I learned to listen to my own instincts, finding that what was 'good' or 'bad' for me often was not the 'normal.'

I may never be normal weight again but so far, I'm getting better slowly in several ways, avoiding prescriptions as much as is reasonable and responsible (3). Now about finger-poking...I've waited two weeks for my most recent order of supplies to be sent --new provider via FedEx--and am getting ready to call my insurer and ask to be able to just purchase them locally, hoping insurance will still pay for them. And it's not FedEx's fault.

I've read this thread with great interest because I've subconsciously (or unconsciously) paid attention only to my a1C and see where I really should be doing a better job of monitoring ac and pc not just ac breakfast and hs. Thanks for this discussion of the two scenarios of the 'same' a1C actually being two very different levels of control.

 

[NoniB]

When I first started they taught me to use the lancet at the tips of my fingers. That was painful and I found out that I could use the sides of my fingers instead. That way I’m not further irritating my poke sites with using my fingers like typing on a device etc. I alternate on 6 fingers as well.

Whoever taught you to use the tip should be slapped! The most sensitive part of your entire hand is the fingertips. Glad you found the right places on the sides.

 

[mbuster]

Hi NoniB, yes we are our own best advocates. Glad you have found a good team for support though. My PCP is supportive of what I want to do, even though we really differ in opinions of what is important.

You sound like my wife's Aunt Noni, she was a NoniC. It would be great if you could go post on our new member introductions threads and tell us more about yourself. I'm sure you have lots of experience to share. Looking forward to getting to know NoniB and I'm sure others are too.