Advice please

[Gwynn]

I eat little fat. Today it was same, very little.

8 was an abberation. It eorried because I am now doubting the validity of any of the readings.

 

[silentsquirrel]

I eat little fat. Today it was same, very little.

8 was an abberation. It eorried because I am now doubting the validity of any of the readings.

If you had eaten 2 hours before the 8, it was perfectly in range Guidelines for a T2 are 4 - 7 before meals, but up to 8.5 after a meal. I may be misremembering, but I think for T1s the post-meal target is up to 9. Not an aberration at all.
I agree with @Inka , perhaps give your fingers a bit of a rest while you are not on insulin.

 

[everydayupsanddowns]

Here's a helpful table that shows the permitted variation of home BG monitors from a lab test result at various BGs. The higher the BG the greater the permitted variation. But you can see that even mid-range there's quite a spread. As has been said, for all their illusion of decimal points home BG meters are showing 5ish, 6ish, 7ish readings

 

[Gwynn]

Thanks for that. Some variation!!

 

[Gwynn]

Forgive me for asking but, considering accuracy, wbich meters do you use?

I thought that all meters would be accurate as it is so important. But apparently I am wrong.

Any recommendations?

 

[silentsquirrel]

Better accuracy would be the ideal, but wishing for something does not make it happen. It isn't that long ago that there were no meters at all, and Type 1s had to go through elaborate routines to get the vaguest idea of what their glucose levels were some hours earlier. I'm sure @trophywench or another of our long term T1s can give you the detail!

 

[trophywench]

It wasn't that difficult TBH - just boiled 10 drops of water plus 5 drops of wee up in a miniature test tube every single morning when you went for your fist wee, by adding a Clinitest tablet to it, wait till it stopped boiling then shook the test tube (without touching the bottom of it where the liquid was, unsurprisingly it was boiling hot LOL) - and checking what colour that liquid was now. You wanted it to be Royal Blue, not green, khaki or Burnt Orange.

Ah well, Hey ho! - orange went far better with a primrose bathroom suite than dark blue, didn't it?

 

[Bruce Stephens]

It wasn't that difficult TBH - just boiled 10 drops of water plus 5 drops of wee up in a miniature test tube every single morning when you went for your fist wee, by adding a Clinitest tablet to it, wait till it stopped boiling then shook the test tube (without touching the bottom of it where the liquid was, unsurprisingly it was boiling hot LOL) - and checking what colour that liquid was now.

And that (or the rather simpler test tape that I used at first) could tell you whether your BG was above (and to some extent how far above) or below some individual threshold. So of marginal value for actual management. (On the other hand the insulins were also fairly iffy, so knowing precisely what your BG was probably wouldn't have been that valuable anyway.)

 

[everydayupsanddowns]

Forgive me for asking but, considering accuracy, wbich meters do you use?

I thought that all meters would be accurate as it is so important. But apparently I am wrong.

Any recommendations?

Ascensia Contour Next Link was a bit of a step-change for me. Previously if I didn’t ‘like’ a result I could recheck and pretty much guarantee a different result, but i find the Next strips to be very consistent and reliable from drop to drop and sample to sample.

Accu-Chek usually come out well in bench tests too.

 

[Gwynn]

This morning...
5:55am 4.5
5:57am 4.7 sounds consistent

+/-15% gives an accuracy range of 3.99 to 5.04

Retest at 5:58am 5.4 outside the boundary for error.

So what is going on. My body will surely not change so quickly. Is the machine inaccurate. Should I even care. I am well. All readings are ok. 4.5 is edging towards concern but a way off.

Do I just see if I am below 4 or above 10 and only take action if that is the case?

How do you ensure better accuracy?

 

[Docb]

Hi Gwynn, there is another factor which has yet to figure in this discussion and that is sampling error. The thing is that blood wanders around the body picking up glucose here and loosing it there and quite what reading you get from a tiny drop of blood at the end of your finger will depend on where it has been as it has been travelling around. General experience suggests that the sampling error is not too wild but it will be there.

Add the sampling error to the meter reproducibility and your 5.4 is best considered no different to the earlier readings.

I think you are trying to read far too much into your readings than is merited. In my mind, a better way of looking at things is to, as you suggest, have ranges in mind and be content if you are within them. I tend to have three ranges to keep an eye on.

There is the overall range which for me is 4 to 10. I would like to see any reading I take at any time during the day somewhere in that range. Anything much over 10 suggests I have eaten something which I should think about avoiding.

My waking and bedtime rangesI would like to see somewhere between 4 and 6. For me that means I am starting and ending the day in a good place. Interestingly this morning I got a 6.8. I'm not worrying about it but I will do a post breakfast check to see what that is. If that is in range, then I will put the 6.8 down to being one of those things. If it isn't, then I will do a bit more testing over a few days to see whether I am running higher than historical or not.

By way of background I spent most of my working life measuring things and then trying to make sense of the measurements and so I am quite comfortable with handling error. If you are not used to it, then it is all to easy to assume a precision in a measurement which is not justified and then worry about it. It is part of the reason why the NICE guidelines do not recommend providing meters to "run of the mill" T2's.

There is no answer to your final question, "How do you ensure better accuracy?" All you can do is stick to best practice, use a meter that meets a recognised standard with in date test strips and make sure your finger is clean before testing. The reproducibility (a better term than accuracy) you then get is what it is.

 

[Gwynn]

It all sounds like a game for two with one of the players using their own invisible rules.

Thanks for that reply. Helpful.

 

[Docb]

It all sounds like a game for two with one of the players using their own invisible rules.

Lol, a brilliant way of putting it. Most of science is like that!

By the way, one hour after my breakfast (when my BG usually peaks) I got an 8.9. That's within range so can forget about the 6.9 waking for the time being. See what happens over the next few days and think again if my waking reading does not return to the normal "somewhere between 4.5 and 6"

 

[Inka]

@Gwynn Did you see my reply and my post showing the glucose trace of someone without diabetes? (the last two posts on page 7 of this thread)

 

[rebrascora]

It all sounds like a game for two with one of the players using their own invisible rules.

Thanks for that reply. Helpful.

I see my BG levels as very much like a game. Not sure if you remember the early computer games that you played on the TV and involved a slow moving game of tennis where you had a player at each side of the screen and the cursor or paddle at each side stopped the ball going off screen if you got it in the right place and the ball bounced off it and back to your opponent. I see my diabetes like that.... the screen is my range and I am constantly trying to keep it on the screen by one cursor being my Jelly babies or glucose tabs and the other being my insulin. My range is 3.9-10 as these are roughly normal range for a Non diabetic person. So if I drop below 4 I have glucose and if I get up to 10 I have insulin and if I can do that the ball stays nicely on the screen bouncing back and forth and the game continues. If I misjudge it and the ball goes off screen I am disappointed but the game isn't over... It's just that we start a new service and hopefully I learn from the mistake I made in the previous point, but there will also be times when I get distracted or don't focus enough and the ball will go out of play as well as me actually making a mistake.... and that is OK too. We are all human and can't concentrate fully all the time, but the more we practice the less genuine errors we should make.... then it is just about life sometimes getting in the way of our focus on the game and finding a balance which is acceptable is important.

And yes, BG levels can certainly change that quickly even without food. For instance on a morning, if I didn't take insulin straight away, by BG levels could easily rise by 3mmols in half an hour before breakfast. Similarly, my levels dropped by over 6 mmols in an hour yesterday from 10 to 3.1 because I injected just 1 correction unit and then did some exercise. I knew it was a risk but exercising when my levels are at 10 is hard work and they had been stuck up at 10 for over an hour.... probably because I am stressed at the moment. Getting the balance right isn't always easy or within our ability.

This was why I was trying to warn you that you are being too rigid with your expectations of control.... it isn't natural to have control that tight even for a non diabetic person with a fully functioning pancreas....

Edited to add..... There are two different modes for my game. This is my "correction" game mode but there is also the "bolus" game mode for meals and sometimes there might be a little bit of overlap, when you are playing both modes at the same time.... which is trickier and more expert level.

 

[rebrascora]

@Gwynn Did you see my reply and my post showing the glucose trace of someone without diabetes? (the last two posts on page 7 of this thread)

@Inka... I have also posted that link earlier on this thread for Gwynn's consideration

 

[rebrascora]

Someone used an analogy of herding kittens for managing their BG levels the other day which I thought was really apt..... it is just not a precise science.

 

[Eddy Edson]

This morning...
5:55am 4.5
5:57am 4.7 sounds consistent

+/-15% gives an accuracy range of 3.99 to 5.04

Retest at 5:58am 5.4 outside the boundary for error.

So what is going on. My body will surely not change so quickly. Is the machine inaccurate. Should I even care. I am well. All readings are ok. 4.5 is edging towards concern but a way off.

Do I just see if I am below 4 or above 10 and only take action if that is the case?

How do you ensure better accuracy?

I'd echo all the "don't sweat the decimal points" comments, but I'd also point out that the ISO standards given by Mike upthread say "+/- 0.83 when the reading is below 5.6". So yr 4.7 then 5.4 readings are consistent with that standard.

 

[Inka]

Someone used an analogy of herding kittens for managing their BG levels the other day which I thought was really apt..... it is just not a precise science.

And it doesn’t need to be. To continue that analogy, we’re trying to ‘herd our kittens’ into a pen (ideal blood sugar range). We understand that our kittens will walk around a bit in that pen but that doesn’t matter. What we’re not trying to do is ensure our kittens stand in the same place all day because that’s not necessarily and simply doesn’t happen.

 

[adrian1der]

This morning...
5:55am 4.5
5:57am 4.7 sounds consistent

+/-15% gives an accuracy range of 3.99 to 5.04

Retest at 5:58am 5.4 outside the boundary for error.

So what is going on. My body will surely not change so quickly. Is the machine inaccurate. Should I even care. I am well. All readings are ok. 4.5 is edging towards concern but a way off.

But if the true reading was, say, 5.2 then +/- 15% gives a variation of 0.78 so all readings are identical