Diabetes: Your Glucose Meter

Health Care & Carte Vitale
1

Diabetes is on the increase around the world. Living in a non_english speaking country like France, access to self management diabetes education may not be readily available. Australian Diabetes Educator and Health Change Practitioner David Mapletoft has recently fallen in love with France. His medium term plan is to move to live in France and become a 'Digital Nomad'


David is going to provide a brief article about diabetes self management for our subscribers to read each month.


Your Glucose Meter


Glucose meters test and record how much glucose is in your blood. They help you track your blood glucose level at different times during the day and night.


Meters can help you know how well your diabetes treatment plan including your medications, are working. They can also help you to understand how the food you eat, your physical activity, other medications and illness can change your blood glucose level.


There are different kinds of meters. Meters come in different sizes. They also come with different features. Some meters let you track and print out your test results. Others have audio and larger screens to help people who have problems seeing. The meter you choose should fit your lifestyle and your needs.


Most meters come with three parts:


Lancet - A needle that is used to get a drop of blood from your finger or another part of your body.


Test Strip - The strip where you put the blood you are testing.


Control Solutions - Liquid used to make sure your meter is working properly (Although more and more control solutions are being phased out)


Did you know?



  • The meter may give you the wrong results if you use the wrong test strip. Use the right test strip for your meter.

  • Glass cleaners, ammonia and other cleaning products may damage your meter. Follow the directions on how to clean your meter.

  • Your other medicines and dialysis solution may affect your blood glucose reading. Talk to your health care provider about how your medicines will affect your blood glucose


How to Throw Away Used Devices



  • You should throw away your used needles in a hard container like an empty laundry detergent bottle or a metal coffee can.

  • Make sure the needles cannot poke through the container.

  • Put a label on the container to warn people that it is dangerous.

  • Keep the container where children cannot get to it.

  • Always put a lid or top on the container.

  • Put the container into a sharps disposal bin at your local hospital, community health centre or the like. NOT in your rubbish bin.


Check Your Blood Glucose Levels


Checking your blood glucose levels helps you to know if your current treatment plan is working or needs some adjustment. Remember, these numbers are not your diabetes, they are simply a guide day to day, week to week, how your treatment plan is working.


Depending on you as an individual, the type of diabetes you have and the type of diabetes medication that you use, test when you wake up in the morning, before meals, 2 hours after meals, and at bedtime. You may need to test more often, for example, on days when you are sick, or participating in sporting events where your usual activity is higher than usual.


Also, determine what your BGL targets are. Do you want them in non-diabetic range most of the time, or are you satisfied for them to be slightly above the non-diabetic range (and understand ask your doctor what your blood glucose number should be. This number is your target blood glucose level.



My Blood Glucose Targets


Before Meals ______(acceptable targets are 4-6mmols)


2 Hours After Meals _______(acceptable targets are 4-8mmols)


Helpful Tips



  • Read the directions for the meter and the test strips before you start using them.

  • Wash your hands before you check your blood glucose. Food or juice on your fingers may affect your blood glucose result.

  • Write down your results and the date and time you tested. Do this even if your meter tracks your numbers. Take the results with you when you go to your doctor.

  • 3-4 days testing 4-6 times a day is often more useful than testing once or twice a day each week.

  • Take your meter and record chart of your BGL’s with you when you go to your diabetes educator, dietitian or doctor.

  • Show your diabetes educator, dietitian and doctor your diabetes self care plan, and discuss how it can be altered if you find a need.


Type 2 diabetes is progressive. Over time your pancreas will produce less insulin. This means that no matter how good your diabetes self care plan, you will need a regular assessment for your medication – which over time will need to be increased.


If you would like some affordable personal diabetes education submit an e-consultation request @ http://www.diabetescounselling.com.au Please be sure to ask for David.


(If you are an Australian citizen, this service is FREE - thanks to a grant to our charity from the Australian Government)


Safe travels.




2

As a Type 1 diabetic for over 40 years, I would love to have access to CGM, not yet available at anything like an affordable price. However, there are still available good blood testing kits which means we can do our best to maintain a reasonable level of control. However, I would like to point out that it never goes away, is sometimes inexplicably out of the healthy range and this can give rise to feelings of despair and frustration. It remains an on going condition to be lived with all the hours God sends us, good luck and best wishes to all those of you out there who continue to struggle with diabetes 1 or 2.

3

I have had Type 1 diabetes for 50 years & thought I would add a couple of PS's to the original 2 year old post.

I use an Accu-Chek Mobile that uses 50 test cassettes with an attached finger-pricker. Plus it is essential that Type 1 diabetics BS test prior to & when driving (having stopped first!).

I recommend Dr Bernstein's Diabetic Solution for diabetes-some good stuff therein although he seems to be on a mission somewhat. Today there are also CGMs (Continuing Blood Sugar Monitoring devices that can be coupled with Apples new iWatch), and insulin pumps for Type 1s.

All the best,

Roger

4

Perhaps to add to Norman's note of caution this. My ex-wife died in October 2012, she was 69 years old and had been Type 1 since she was 47. Her work meant she was forever in places where insulin was not immediately available over the counter, so as to speak, and her diet was not always as it should have been. After all, she lived in West Africa, then Thailand and finally Malaysia but working in the regions she was in mainly with other jobs elsewhere from the mid-1990s on. In fact, when she died she was two weeks short of going to Afghanistan for two months to work in communities, not be based in an office and plush hotel. What she did was seriously watch her health and react to changes in her condition, thus mainly breaking many of the rules her endocrinologists tried to impose on her. By reacting to herself she kept it steady. When she visited us just two months before she died she was using a cheaper insulin because she was running out of money and also apparently mainly living on beans and rice back in Penang. For someone who had such a strict self-control that was strange, but she told us how her nervous system was gradually going and how she would be blind in a couple of years. She did not want to be what she considered a vegetable, so we get the feeling (many of us who knew her well) that she let herself go.

My point is, by telling this story I hope that it shows how stigmatising diabetes can be, how medical regime can be as damaging as preserving and that a great deal of it is up to the sufferer, irrespective of their endocrinologist's diktats about the rights and wrongs. All people are individuals and different, from what I have learned that applies to diabetics too.

5

I am a bit lost here as there seem to be two debates on Diabetes happening now.

I have no intention of adding my own experiences again, NB Diabetes 2, other than to expand a little on the psychological aspects which I think get overlooked. Diabetes discussions in my view are awash with a) technicalities and/or b) horror stories.

Glucose meters may be of great use to Diabetes 1 sufferers, and I cannot comment on that, but in my considered view it is possible to become overwhelmed with being told how serious Diabetes IS, and getting people into a depressive mindset which is not at all helpful - been there, done that. I think the daily use of such tools is not useful as they can very not only day by day but hour by hour - as can bloodtests incidentally. I don't think they help with Type 2 in any way.

I was 70 when diagnosed and all the surrounding crap frightened the Hell out of me. Maybe it was necessary shock treatment to finally get me to control my weight, and exercise a bit more. I also became vegetarian, and still believe that was the major part of my new life. Yes I look at glucose content in products but by and large I don't buy packaged goods very often now following some amazing (to me) discoveries e.g. Tomato Sauce contains sugar - eh? Weetabix and non-available in France, Shredded Wheat have zero sugar but put Semi-écremé milk on them and forget the advantages of the cereals.

I find I don't trust meat (and disapprove mightily of Halal), find it very expensive and mostly tasteless and this was before I was diagnosed, so dropping that off the menu wasn't hard. Exercise? Well I won't be entering the Olympics at 75 years old but I stopped any medication at 71 and have never gone back.

Finally it is sometimes forgotten that even with Diabetes you NEED sugar and it is not a banned substance. In fact you find out very soon that having something sugary - cubes, boiled sweets, chocolate is essential when out and about as a sugar 'crisis' can strike without warning, but exceptionally rapidly fixed by taking something of this nature.

Above all, a balanced diet is essential even if you do eat meat. Fruit and vegetables are the main part of this. Bread is fine if wholemeal which tastes better anyway. As ever I note recently that cheese and eggs are returning to favour with regard even to cholesterol control - another condition most older people have to contend with.

Probably the psychological aspect is the most important. If you think you are ill, then you will be ill. Over-concentration on controls and control tools to me at least makes the condition of Diabetes central to your life and not peripheral. Again I refer to what I know - Diabetes 2 only. I have no knowledge of the complexities of Type 1.

6

Liz, I have heard that too, If that was the case would it not cause a spike in the blood sugar/insulin production level? Could you not test this effect for yourself using hubby as the guinea pig?

7

Useful post, for an increasing issue. Interestingly there is evidence emerging that suggests that some sweetened diet drinks even if they contain no sugar may cause issues as the body reacts as though they do contain sugar…hubby has type 2 diet controlled and we steer clear of all of these diet fizzy drinks as a precaution

8

I wish there was more support like this available. I am not diabetic but have COPD (emphysema) and would love someone to start a blog of encouragement about that. My dad lived to be 96 with diabetes so definitely not a death sentence these days with careful management…

9

David - I'm finding the information you post really useful - thank you.

I was diagnosed with type 2 diabetes 3 years ago and take 450mg of Metformin daily. On receiving confirmation of being diabetic (several members of my family are type 2), I worked hard to lose a significant amount of weight (over a long period of time - no crash dieting).

I am hoping you could help with a question I have on exercise please. I started running about 2 years ago and now achieve about 70kms per week, but about 30 minutes after completing my run, I sometimes feel light-headed and a little dizzy. I always ensure I eat (something like porridge) an hour before my run, and take water with me, but would appreciate advice on the best post-exercise/recovery food I should consume. I've read lots of information relating to this, but for non-diabetic runners - any advice would be gratefully received.

Thank you

10

Doreen, I have a One Touch Vita and I put the strip in first which automatically turns on the machine. You can turn in on first though and then insert the testing strip. You then apply the sample to the strip with it already in the meter. If you have a french meter the readings are in ml/dl and not mmols so you would have to divide the number by 18 if you wanted to arrive at the mmols referred to in David's post. I also have my finger pricker set to 4 (thick skinned?)

11

Very true Val. the amount of fruit required to make a smoothie or just to drink as a fruit juice is way above what we should have especially as a diabetic. People forget that fruit (fructose) is sugar and subscribe to the belief that juicing is healthy. In the summer, I did a test by having a fruit juice with no added extras just so that I could see the effect on my blood sugars - they doubled!

12

Using metformin Doreen indicates that your OH actually has diabetes. It is possible to be prescribed metformin for impaired glucose tolerance, but very infrequently.

I would advise against using the finger tips to test - it is more painful than using the side of the finger between the tip and first knuckle.

Having the HbA1c measured every 3 months is likely to be more than satisfactory for a 78 yr old gentleman. Home testing is of little value unless the HbA1c is over 9%, and then only to determine a change in medication for a few weeks. I almost never recommend home testing of the BGL for people over 75. This is of course a personal choice. BUT if a person is unable to change there level of physical activity, or don't use a healthy meal plan, home testing is of absolutely no value when only using metformin.

HbA1c less than 8% are most likely suitable for your OH

For more information you could go to http://www.diabetescounselling.com.au

Cheers,

David

13

Firstly Doreen, there is no such diagnosis as 'borderline diabetes'. You either have it or you don't. Sometimes glucose intolerance is labelled by mis-informed health professionals as 'borderline diabetes'.

I would be asked for some clarification on the diagnosis. If your OH does NOT have diabetes then monitoring the blood glucose is of NO VALUE.

If you are having trouble with your meter usually the best way to have a resolution is contact directly the meter company who usually have a free helpline.

If your OH has diabetes, suggest they see an experienced diabetes educator and a dietitian. GP's usually have a poor understanding of a diabetes self management plan and often believe that telling people what to do works in preventing the long term health problems associated with diabetes.

Our Australian charity http://www.diabetescounselling.com.au can help if you cannot find anyone local.

Safe travels,

David

14

Thanks James for your support here. I started reading the replies just now (after what seems to be a lot of posts already deleted) and almost gave up continuing to read.

It would be good to see some robust evidence based discussion about diabetes :)

15

Hi Doreen

I do not know this meter but I am sure most are very similar. Firstly I can only get blood easily if I use the tip of my little finger, give your hand a shake first. make sure you hold the needle tightly against the skin before you press the trigger. While in hospital recently a Portuguese nurse used my ear lope to draw blood, it hurt less and was very effective, so maybe try that. Some meters have a time limit after you put the strip in. Make sure you get the blood in the end of your finger before you put the strip in the machine.

I have been type two for about 8 years, first 3 controlled by diet and exercise, despite my Dr wanting to put me on metformin. So I did learn a lot in the first few years by testing different foods etc. However it is no that simple, don't eat and it goes up, have a cold and it goes up. Some carbs take longer to get in your system, so slow release carbs are better for you. I could go on, but have written a little basic help guide for type 2 for a friend of mine that was diagnosed and was totally confused.

16

To which bit? ;-)

17

See, I do have my uses. Two questions James.1) Can anybody go to the Kitchen? I always found a good spat to be great spectator sport, saddo that I am :-) & 2) have you got a direct connection to my computer. You seem to have copied my exact thoughts?

18

Oh Doreen, that sounds awful. Your poor husband. If no-one can advise you on the OneTouch before your appointment, would the doctor be able to show you exactly what needs to be done? You do not sound in the least bit stupid, I must say - the procedure itself sounds quite fiddly and the doctor may be able to advise why there's difficulty getting sufficient blood to run the test.

19

Thanks to Vic's suggestion we now have such a place, I'm sorry your previous efforts to bring this issue to the fore were unsuccessful. I would take your (or anyone else's) departure from this site for the reasons you have mentioned as a personal failure. So I invite you along with anyone else who has things they would like to get off their chest to get up from the table and step in to The Kitchen.

20

James.I don't know diddly squat about computers but my kitchen idea might have some legs. Surely someone like you, who can make things out of pallets could design a parallel kitchen sort of thingy for this place where people could sashay off to for a fag & slag session. Perhaps a "kitchen" sign on the main thread could lead people away & avoid any problems.

By the way, did you see what you have done. Your comment re. bickering has led us further away from the main subject. Easily done innit :-)

Edit. Bugger. Having disappeared to rescue my bread from the oven I see James has invented "the Kitchen"