Questions. I have questions.

[swimmingalong]

BACKSTORY I’m brand new. Diagnosed this week. HBA1C 51/49 (3 weeks apart). They measured it as I was hospital with an infection/ abscess (I’m early 40s female). ANYWAY I’m keen to address this, learn, make life style changes and not let it slow me down. (although there’s been a good few tears shed and plenty of naval gazing)! I’ve not got my head around my diagnosis yet for my mother in law (who lives in half our house) to know so my daughter can’t know right now which means I’m secretly doing testing.

Found out Wednesday. Bought a GlucoNavii. Started monitoring Blood Glucose on Fri evening.

Have learned some valuable nuggets - Alan’s testing tips (warm water/shake hands etc). I’ve got some readings (though we shouldn’t talk about how many test strips/lancets have gone in the bin to get the 17 levels I’ve measured to date.

However I have a load of newbie questions!

Q: SNACKS I am testing at meals (Just before eating) and 2hrs after and at bedtime - but what about snacks? I ate a snickers an hour before dinner on Saturday expecting to see a huge spike and there wasn’t one (don’t worry I know this isn’t a licence to eat snickers).

2.30pm (pre lunch) 7.3
Lunch: ham/salad/new potatoes/mochi ice cream
4.30pm (post lunch) 9.1

5.30pm snickers
7.10pm (pre dinner) 7.2
Dinner: pasta with beetroot sauce & courgettes
9.15pm 10.3
11.30pm 9.8
I’ve added my two days of complete graphs into images

Q: NIBBLES how pre-meal should pre-meal be? What if I nibble whilst cooking? What about my cup of tea 30 mins/1hr after dinner? Does that mess with everything?

Q: STARVING the twice I’ve had a result under 7 mmo/l (6/6.7 both Sunday) I’ve been ravenous, like “feed me NOW or I’ll eat you” hungry/grumpy. Both times I KNEW my blood sugar was “low” (but obviously it was literally just in range)… so my question is, am I to be permanently hangry/in starvation mode to have low BG? Or will I adjust once I get on top of things better?

Q: MY FINGERS… can I only use middle & ring finger on non dominant hand (instructions on meter)? What happens if I use my dominant hand fingers? What about thumb/index & littlest? With 7 measurements a day (and some early misfires) poor fingers are feeling it.

Q:FINGER ROTA Also does anyone have a sequence/rota for which finger they test each time to give all fingers chance to recover.

Q: LANCETS: do lancets come in different lengths/thickness? I got 10 dark blue free with my meter then bought the Amazon recommendation “buy with” and these are turquoise. They are stubbier, need a higher setting and feel chunkier (hurt more).

THANK YOU IN ADVANCE

 

[ColinUK]

Hi,
And well done for taking a proactive approach to your diabetes!

To answer your lancet question first, they come in different thicknesses but I’d advise buying an Fast-Clic lancet as it’s pretty much painless.
I used to use those plastic ones which came bundled with the BG meter and even the thinnest needles hurt. The Fast-Clix one was a revelation quite frankly!

I don’t have a finger rota and generally use middle or ring finger of the left hand. Use the sides of the finger not the pad.

As you get used to a lower carb way of eating your body will adjust and those hunger pains will pretty much vanish.

I’d advise cutting carbs by 1/3rd and holding it at that level for a well or so and cutting by a third again. Hold that for a week or so and repeat. That way you give your body time to adjust. Also there’s a potential to damage eyesight if you cut too fast.

The pre/post meal timings are ok but I’d question whether there would have been less of a spike without the new spuds, the moochie and the pasta.

All in all you’re off to a good start though!

 

[helli]

I have a "finger rota" but it sounds as if it may shock because I use all eight fingers. I have been doing so for nearly 20 years, my fingers have not fallen off, I do not have fingers covered in bruises and it doesn't hurt to type.
This is not because blood flows easily - I have Reynaud so my blood is often reluctant to flow. I just make sure my hands have been warmed (I usually cuddle a cuppa before pricking) and adjust my pricker to the depth that gets blood without going too deep.

And my rota? Left hand for odd dates (1st, 3rd, 5th, ... of the month) and right hand for even dates. Little finger for breakfast to lunch. Ring finger for lunch to dinner, index finger for dinner to bed, pointing finger for bed and any overnight pricks.

I was pricking more than 10 times a day without any ill effects. I now have a CGM to tell me what is happening between pricks so not pricking as often.


But in my experience, no harm has ever been caused using my dominant hand or other fingers.

 

[swimmingalong]

I’d advise buying an Fast-Clic lancet as it’s pretty much painless.

Thanks for replying Colin Is it this? Accu Chek Fastclix Finger Pricked Lancing Device + 6 Lancets https://amzn.eu/d/7ANJ8Rr

Also I’m really just working out carbs etc! Significantly less being consumed already… but also tied by not telling people about my diagnosis! I will get there.

 

[swimmingalong]

And my rota? Left hand for odd dates (1st, 3rd, 5th, ... of the month) and right hand for even dates. Little finger for breakfast to lunch. Ring finger for lunch to dinner, index finger for dinner to bed, pointing finger for bed and any overnight pricks.

oh my goodness I LOVE THIS! This was exactly the sort of thing I was looking for! Thanks!

 

[Felinia]

Hi and welcome
First, the encouraging news - you are only just into the diabetic range, so with a few tweaks you should be able to reduce your glucose substantially, into the pre-diabetic range or even into the normal range, within a few months.
You've had plenty of advice about pricking - all I would say is that after a few weeks of pricking I worked out what foods did and did not affect me, so now I only test when I try a new food.
As ColinUK says, the best thing you can do for yourself is slowly reduce your carb intake. That not just the usual suspects of cakes, sweets, biscuits, sugary drinks, but bread, potato, pasta, rice, processed foods, most fruit. Sounds dreadful, I know, but you simply fill up with lots more veggies and protein, and find substitutes, like cauliflower for rice and mash, roasted squash for potatoes, soy bean pasta. I had a lot of fun trying out new foods and recipes.
Two tips for carb measurement - get an app like MyFitBit or NutraCheck, and weigh your portions of carbs and proteins. I keep digital scales and a clear weighing bowl on my kitchen surface and weigh before cooking. It's surprising how small a portion is, and "guesstimating" means you invariably eat too many carbs.
I had a look at your meals. ColinUK has already pointed out that potato, rice and ice cream can cause spikes. I picked up that you seems to feel the need to snack and nibble. So if you can't stop, then you should look to make sensible choices, like a few nuts, 80gm berries like strawberries, veggie crudities, or do what I do - have a glass of water. I find sparkling or soda water does the trick for me.
There is nothing shameful in being diabetic, particularly as you are so motivated to manage it. I never had any problem telling everyone. There was an initial period of people trying to tell me you can't eat that - but all I would tell them is that I'm doing exactly what the doctor / DiabetesUK advised. I was helped by knowing a few diabetic people who told me what I have written here. Now I just make sensible choices.
You haven't mentioned exercise, but I was advised to up my exercise level, so now go to the swimming pool 3 times a week. But walking is fine and I know others who cycle or do classes. If you could do with losing weight, that will also help. But ask away with all your questions, and best wishes

 

[swimmingalong]

You haven't mentioned exercise, but I was advised to up my exercise level, so now go to the swimming pool 3 times a week. But walking is fine and I know others who cycle or do classes. If you could do with losing weight, that will also help. But ask away with all your questions, and best wishes

Thank you for the info. I actually usually swim 3-4 times a week and have completed Diabetes 22 challenge twice in the last year. I also Nordic walk and do Pilates weekly. Sadly for last 6 weeks I haven’t been able to swim due to the abscess that brought about my diagnosis and walking had been less easy. Abscess nearly healed now I should be back in the pool & lake (I mainly open water swim) within 10-14 days all things being well).

 

[Felinia]

Just a thought. I was doing well managing my diabetes, then was ill for 5 months with a very severe infection, and on antibiotics. During that time my glucose shot up, but is coming down slowly but steadily now. Perhaps now you (super fit you) are recovering, your glucose will also start to come down naturally. Illness does do funny things to diabetes.

 

[swimmingalong]

Just a thought. I was doing well managing my diabetes, then was ill for 5 months with a very severe infection, and on antibiotics. During that time my glucose shot up, but is coming down slowly but steadily now. Perhaps now you (super fit you) are recovering, your glucose will also start to come down naturally. Illness does do funny things to diabetes.

Oh gosh I’m not super fit (far from it) but I do like to move my body a lot usually! Here’s hoping. Though HBA1C at time of hospitalisation is 3 months before that and I’d only been ill for a week and on abx for 48hrs… I am hopeful though!

Just working out how to replace my beloved carbs!

 

[everydayupsanddowns]

Q: SNACKS I am testing at meals (Just before eating) and 2hrs after and at bedtime - but what about snacks? I ate a snickers an hour before dinner on Saturday expecting to see a huge spike and there wasn’t one (don’t worry I know this isn’t a licence to eat snickers).

Great discovery! The fat in the chocolate can slow down the absorption of the carbs/sugars. While you won’t want to go overboard, this could suggest that an occasional sweet treat (especially if you are planning to be active eg alongside your Nordic Walking) could help you to resist temptation other times.

2.30pm (pre lunch) 7.3
Lunch: ham/salad/new potatoes/mochi ice cream
4.30pm (post lunch) 9.1

5.30pm snickers
7.10pm (pre dinner) 7.2
Dinner: pasta with beetroot sauce & courgettes
9.15pm 10.3
11.30pm 9.8

These look great for so early in your diabetes career. Notice that slow and stubborn high level after the pasta though. That’s quite common. There are lower carb pasta alternatives (eg konjak), or a smaller portion with more sauce might be gentler on BGs?

Q: NIBBLES how pre-meal should pre-meal be? What if I nibble whilst cooking? What about my cup of tea 30 mins/1hr after dinner? Does that mess with everything?

I’d not expect any hiccups from a cuppa. Anything around 5g of carbs seems to pretty much pass my system by on the whole - so it would depend on what you were nibbling and how much!

Q: STARVING the twice I’ve had a result under 7 mmo/l (6/6.7 both Sunday) I’ve been ravenous, like “feed me NOW or I’ll eat you” hungry/grumpy. Both times I KNEW my blood sugar was “low” (but obviously it was literally just in range)…

Hehe! Again, yes, not uncommon. If your body has been used to running at high levels for a while it can see levels in the normal range as being ‘on the edge’ and trigger warning signs of extreme hunger etc to get you to act. Your glucose thermostat should reset in a few weeks.

Q: MY FINGERS… can I only use middle & ring finger on non dominant hand (instructions on meter)? What happens if I use my dominant hand fingers? What about thumb/index & littlest? With 7 measurements a day (and some early misfires) poor fingers are feeling it.

+1 for the fastclix / multiclix. And I use both sides of all 4 fingers at random. I must be getting on for well over 65,000 fingerstick checks now after 30 years, and though the skin’s a bit tough in places my well-bodged fingers don’t hurt at all.

Q:FINGER ROTA Also does anyone have a sequence/rota for which finger they test each time to give all fingers chance to recover.

Not a formal pattern. I just chop and change

Q: LANCETS: do lancets come in different lengths/thickness?

A famous forum saying is that people with diabetes change their lancets once a year, on St Swithin’s day. Whether they need to or not!

Many forum folks will happily reuse the same lancet until it becomes blunt enough to be felt. They are nothing like so delicate as needles, and forum experience suggests there are few potential problems observed through a degree of reuse (whatever you are happy with).

Welcome to the forum, and well done for your pro-active approach!

 

[ColinUK]

The FastClix is the one!
And I only move it on to a new one when it starts to hurt whether it’s St Swithin’s Day or not!

 

[Lucyr]

Looks like most of your questions have been answered though I think some of your questions are overthinking things a bit. I only change lancet a couple of times a year and generally use a favourite finger though I do occasionally try to vary the finger to give some variety

 

[Felinia]

Oh gosh I’m not super fit (far from it) but I do like to move my body a lot usually! Here’s hoping. Though HBA1C at time of hospitalisation is 3 months before that and I’d only been ill for a week and on abx for 48hrs… I am hopeful though!

Just working out how to replace my beloved carbs!

I use soy bean noodles - a bit firmer with a slightly nutty taste. I tried a few different ones before settling on these but it's a matter of taste. I also tried all the low carb breads, but settled on Warburtons wholemeal medium and Kingsmill crustless, both at 9 carbs a slice. At least they taste like real bread! Just one slice for me without a spike, but fine for open sandwiches piled high with protein and salad. I was using squash sheets for lasagne but can't seem to find them now. I think others use deconstructed leeks. I cut butternut squash into wedges, spray light them and sprinkle a little paprika on them before roasting. And I love cauliflower cheese! Like I said - I have great fun experimenting!
One thing I would suggest you request is another HbA1c 3 months after diagnosis. That's the only way you can tell whether or not your measures are working. No way could I have waited a year after my initial diagnosis. Also you should be given other tests - feet, eyes, weight, BP, cholesterol at least annually.
You didn't mention whether or not you have been given diabetes medication. At your level I sincerely hope not. I was offered 3 months of healthy eating and exercise (yours is fine!!!) and reduced from 57 to 48. But some surgeries go thundering in without giving marginal diabetics (or sadly even pre-diabetics) the chance to help themselves.
Many people find this is just the nudge they needed to follow a healthier lifestyle - me included.

 

[swimmingalong]

One thing I would suggest you request is another HbA1c 3 months after diagnosis. That's the only way you can tell whether or not your measures are working. No way could I have waited a year after my initial diagnosis. Also you should be given other tests - feet, eyes, weight, BP, cholesterol at least annually.
You didn't mention whether or not you have been given diabetes medication.

Thank you. Yes. I intend to ask for another HBA1C after 3 months. Will my blood glucose that I’m measuring 7 x / day not give an indication of measures working too?
I know it’s super early days but I do seem to be bringing my average daily BG level down. Does this not necessarily = lowered HBA1C if I continue to improve/maintain?

I love cauliflower cheese too, and I am super excited to make it soon. I made aubergine parmigiana yesterday and that was a hit. We grow lots of squash here so hopefully can enjoy that come the autumn.

Thanks so much for responding

 

[swimmingalong]

Also you should be given other tests - feet, eyes, weight, BP, cholesterol at least annually.
You didn't mention whether or not you have been given diabetes medication. At your level I sincerely hope not. I was offered 3 months of healthy eating and exercise (yours is fine!!!) and reduced from 57 to 48. But some surgeries go thundering in without giving marginal diabetics (or sadly even pre-diabetics) the chance to help themselves.
Many people find this is just the nudge they needed to follow a healthier lifestyle - me included.

Oh and I am hoping I will get the checks as my feet aren’t great. I found out my HBAIC result by asking a nurse changing my dressing to tell me it. She’d seen I was diabetic on my record and had no idea I hadn’t been given my diagnosis. Reception has just called and said “issue with bloods/book GP phone appt. This appointment is in mid Sept. So this BG monitoring and food intake change all off my own back. Hopeful I can have a good understanding of the situation before I speak to GP with a hope of not needing medication.

 

[Felinia]

Thank you. Yes. I intend to ask for another HBA1C after 3 months. Will my blood glucose that I’m measuring 7 x / day not give an indication of measures working too? View attachment 21807
I know it’s super early days but I do seem to be bringing my average daily BG level down. Does this not necessarily = lowered HBA1C if I continue to improve/maintain?

I love cauliflower cheese too, and I am super excited to make it soon. I made aubergine parmigiana yesterday and that was a hit. We grow lots of squash here so hopefully can enjoy that come the autumn.

Thanks so much for responding

Yes, if your daily prick levels fall, it will indicate progress, although the prick levels are spot measurements, and the HbA1c is a 3 month average. I think your before eating measurements should aim to be 4.5 - 7 and your after eating less than 8.5, but if I'm wrong no doubt someone will tell you.

 

[Felinia]

Oh and I am hoping I will get the checks as my feet aren’t great. I found out my HBAIC result by asking a nurse changing my dressing to tell me it. She’d seen I was diabetic on my record and had no idea I hadn’t been given my diagnosis. Reception has just called and said “issue with bloods/book GP phone appt. This appointment is in mid Sept. So this BG monitoring and food intake change all off my own back. Hopeful I can have a good understanding of the situation before I speak to GP with a hope of not needing medication.

Suggest you build up a list of questions ready for your phone appointment. It's easy to forget something. And if you are concerned about your feet ask for a face to face appointment - they can't be checked over the phone!!

 

[Leadinglights]

You may find this link helpful to see a way of modifying your diet. Although you seem to have some good ideas already. https://lowcarbfreshwell.co.uk/
Squash is a good substitute for potatoes in many recipes and much lower carb.

 

[everydayupsanddowns]

Thank you. Yes. I intend to ask for another HBA1C after 3 months. Will my blood glucose that I’m measuring 7 x / day not give an indication of measures working too?

If you’d like a very (very!) vague indication of your direction of travel, you could try one of the old fashioned formulae - derived from matched pairs of HbA1c and estimated average glucose levels. They are far from perfect, and are likely to be a bit out from a lab test - partly because HbA1c and fingersticks measure completely different things, but some find them helpful as long as their shortcomings are taken into account.

The one I used to use was

HbA1c % = (Average BG+2.52) / 1.583

And to convert from % to mmol/mol

(HbA1c % - 2.15) x 10.929

Hope these help 🙂

 

[swimmingalong]

@ColinUK @Leadinglights any idea how long I should expect before a change in fasting BG /overall BG with a low carb diet? I’ve been eating significantly fewer carbs. It’s been a week. I have ironed out a lot of peaks but my fasting glucose/baseline is still stuck around 7.5-8. Will that eventually drop or do I need to be more aggressive with my carb evasion (I’ve had petit pois and beetroot and the odd half portion of potato)

Also Colin thanks the fastclix is a game changer. No more pain!