Hi another newly diagnosed type 2

[RyPingu]

Hi there.

for some reason my body has decided to save things up and then hit me with them all at once. from someone with generally low BP and normal bloods the last month has seen some significant changes.

my normally low BP is now high - managed by meds (losartin 75 mgs per day) (day 25 of these)
my colesterol is high so hello statins (day 25 of these)
and my blood sugar has decided that being diabetic looks like fun so joined in - managed by 1 tablet of Metformin per day. (on day 8 of taking these)

so, and i fully understand that diabetes is serious, trying to keep a positive outlook on this and learn what lifestyle changes i need to make - lets just say that up to now my lifestyle could be described as sub optimal. Therefore exercise has reappeared in my schedule for the first time in years and i am looking at what i eat much more carefully. the words fruit and salad have also mysteriously made their way into my vocabulary (and shopping list).

my first question though is about the accuracy of the home glucose monitoring devices. I got one as I am a data nerd (its my job to design systems that analyse data) so naturally i want data points to log and monitor. - the system i have is giving readings in the 6.0 -6.4 MM0L/L for the past 5 days (not a lot of data points but a start) which the nice chart that came with it says is in the normal range. Obviously I am happy with this provided its accurate but if these devices are not really that accurate then the data is meaningless.

so hi and let see where this journey leads to

 

[Drummer]

Most type twos use their meter to compare their readings before and after eating to see how well they are coping with the amount of carbohydrate in their foods - accuracy is not really an issue, as it is a comparison - what are you testing?

 

[ianf0ster]

Hi RyPingu, Since you mention that fruit has got into your vocabulary and shopping list, I assume that you are not eating healthily for a Type 2 Diabetic.
It is carbohydrates (starches and Sugars) which make our Blood Glucose spike. The problem is that we all handle carbs (even exactly the same carbs) differently depending upon our Insulin production, Insulin Resistance, Gut Biome, genes etc.
So some Type 2's can get away with eating apples, while I can't eat anything more than a few berries (and even then I have to add Cinnamon and eat them with a full fat Greek Yogurt to slow down the absorption of the glucose). Some can get away with eating brown rice, or whole grain pasta or sweet potatoes, while I can't even eat a raw carrot!

I agree with @Drummer about testing to see how your body reacts to different meals/foods. I take a reading just before eating and then another one 2hrs after 'first bite'. If I get a spike of more than 2 mmol then I either cut that food out, or restrict the portion size. Or with some food I find I spike less if I eat it at another time of day.

 

[Toucan]

Hello @RyPingu
Welcome to the forum, and sorry to hear that you now have some health issues to deal with, but good that you are already taking some positive steps.
To answer your question about meters, they do all have some in-built inaccuracy which is non-linear and usually stated in the meter's handbook. It is however still a very useful aid for getting comparative results.

The causes of Type 2 diabetes, are still not fully understood and are a mix of genetic and other factors – different for all of us, so not surprisingly the solutions also vary and there is no ‘one size fits all’. It helps if you can find a solution that is right for you and sustainable.

It will help if you can find out which foods cause your blood sugars to rise, and eventually arrive at a lists that lets you maintain good blood sugar levels, that you enjoy eating, and fits your lifestyle in terms of how much preparation and cooking you like and have time to do.

The glucose monitor is a way to find this out, by testing before and 2 hours after eating. (The aim is to have a rise of 2 or less) Also if you can keep a tally of the total number of carbs eaten in a day, your morning reading will guide you on working out how much you need to adjust your daily total.
It is all trial and error, so try to be patient, you are aiming for the long term, and a diet that you can sustain.

There is a great deal of information and knowledge on the forum, and a useful place to start is useful-links-for-people-new-to-diabetes which includes some links regarding testing.
I hope you find the forum useful, and please keep posting, asking questions and letting us know how it goes.

 

[everydayupsanddowns]

Welcome to the forum @RyPingu

Diabetes loves a data nerd! Collecting information about your food intake, activity levels and resulting BGs, then looking for patterns and attempting to make adjustments towards better outcomes is an extremely successful management strategy!

You might find this post by Aussie AlanS (also an engineer) a useful framework for how to structure self monitoring with a ‘test, review, adjust’ approach: https://loraldiabetes.blogspot.com/2006/10/test-review-adjust.html

As for the data integrity... it is true that BG meters have a margin of error, so while they give the illusion of decimal point accuracy, they are really a bit more ‘ish’ than that. ISO requires that BG meters provide results that fall within +/-15% of a lab test 95% of the time. And most meters achieve rather better accuracy that that, especially at lower ranges.

This table shows the possible variability within the ISO standard.

It looks horrendous - especially at higher levels. But at the end of the day... that’s the data feed we have to work with, and it’s a heck of a lot better than nothing

One thing meter leaflets always say, is to recheck if you get a result that doesn’t match how you are feeling. So if you get an unusual or unexpected result, it‘s often worth checking with another strip just in case it’s a rogue reading.

 

[Tee G]

Hi & welcome. I have just started self testing this past month to see what suits me....would do 1 test upon rising, 1 pre meal and 1 two hour post meal. However it was pointed out to me that by missing out that 1 hour post meal jab i could miss any 'spikes' because levels returned to just above pre meal within 2 hours. And indeed this was the case on a couple of occasions (with a baked potato and some weetabix, both of which have been struck from my diet, no hardship though as I found a much better alternative)....So my advice would be, until you 'know the foods' you're eating, then keep the self testing more frequent, especially in these early learning days! Good luck and please let us know how you are getting on.

 

[grovesy]

I would test before you get up if you can. I find that once I get up it starts to rise.

 

[Tee G]

Hi @Anitram - Yes, im testing far less now as I have learned mostly these days what foods suit me - I really only test now after a meal (1 & 2hr) if im eating something i haven't tried against my meter before. Haven't been hit by too many other surprises, yet!....But I dont have a 'real' diagnosis yet as im being long term monitored and using just dietand im pretty much left to my own devises. Hopefully i will get a favourable result with HB1Ac level in April...heres hoping i got it right! 😱

 

[RyPingu]

thanks for the replies. Have found that the fruits so far has not induced a spike but am adopting the "trial -test - review approach that others have mentioned. This will hopefully identify the food that i need to avoid (crosses fingers that pizza is a "good" food - knowing that the odds of this are lower than low). Its really a process of elimination for me and i am only just setting off on that journey.

for the geeks here i will be loading my dataset into Clickview and SAS once i have enough data points which will allow me to slice it all sorts of ways - 90 % of which will be totally meaningless outside of teh "being a nerd" angle but never know. My main aim atm is just to stabilize things whilst i work on the longer term activities of losing weight and other general lifestyle changes

 

[Tee G]

Never fear - if your pizza turns out to be not so good - there are alternatives! It never ceases to amaze me how inventive people can be around sugar free/low or nil carb foodstuffs. e.g. I made (for the 1st time ever) a chocolate cake filled with blueberry 'jam' & cream cake...even hubby loved it. No sugar, no flour - no spikes, no guilt.....no worries.....delish!!

 

[Eddy Edson]

thanks for the replies. Have found that the fruits so far has not induced a spike but am adopting the "trial -test - review approach that others have mentioned. This will hopefully identify the food that i need to avoid (crosses fingers that pizza is a "good" food - knowing that the odds of this are lower than low). Its really a process of elimination for me and i am only just setting off on that journey.

for the geeks here i will be loading my dataset into Clickview and SAS once i have enough data points which will allow me to slice it all sorts of ways - 90 % of which will be totally meaningless outside of teh "being a nerd" angle but never know. My main aim atm is just to stabilize things whilst i work on the longer term activities of losing weight and other general lifestyle changes

Another nerd here! During my first year I started to test very frequently, looking for peaks & troughs & how these correspnded to what I ate & how much I exercised.

I found it really useful. Better sense of control; good motivation for driving BG levels down with fast feedback. Particularly while you're bringing levels down, the day to day signal can be very noisy, so plotting and looking at MA's can really help you focus on the trend.

But if you want to go full-nerd, think about self-funding Libre sensors from time to time. They have accuracy and consistency issues, but generally 15 min data is going to give you a *much* clearer picture, and it's really the only way to see what you're doing overnight.

 

[rebrascora]

If you are testing pizza, it might be best to do a 3 and 4 hour after eating test as the high fat content usually delays the spike from the carbs, so at 2 hours you might get a perfectly respectable reading but go higher later...... of course you may just want to obliviously accept the 2 hour reading if it is OK and continue eating pizza in blissful ignorance of any subsequent spike and who could blame you.

 

[RyPingu]

Another nerd here! During my first year I started to test very frequently, looking for peaks & troughs & how these correspnded to what I ate & how much I exercised.

I found it really useful. Better sense of control; good motivation for driving BG levels down with fast feedback. Particularly while you're bringing levels down, the day to day signal can be very noisy, so plotting and looking at MA's can really help you focus on the trend.

But if you want to go full-nerd, think about self-funding Libre sensors from time to time. They have accuracy and consistency issues, but generally 15 min data is going to give you a *much* clearer picture, and it's really the only way to see what you're doing overnight.

*googles libre sensor*.... *does little geek dance*. not cheap but if it helps get things on track may be worth looking at short term.

going back to see the Dr as my BG levels have been consistently low over the past week (7 day average 3.9 sometimes showing as LO on the reader - resulting in rapid consumption of half bananas) since starting on the glucophage. it might be me doing stuff wrong (have had no guidance so far - still awaiting first appointment with diabetes nurse but to be on safe side have booked a GP appt.

not had a pizza yet btw...

 

[Drummer]

Ouch - that isn't good - can you contact anyone so late in the day and get advice?
It really isn't good to be fighting hypos with carbs.

 

[Bruce Stephens]

not cheap but if it helps get things on track may be worth looking at short term.

Back when I first started using it my DSN suggested that some people found value in using a sensor just once in a while. (Obviously you're stuck choosing continuous blocks of 14 days since sensors can't be reattached, but there's nothing saying you need to apply the next one immediately. I guess a few things would then not work: if you do keep wearing one it'll give HbA1c estimates and things, but those really aren't nearly as useful as the profiles and things which you get during use of a single sensor.)

 

[RyPingu]

sorry by short term i mean buy a coupe of sensors use them then review if things settle down go back to mr stabby if not buy a couple more. I am very fortunate in that i have a good job so self funding is an option.

drs appt is on saturday so will live with the low bg until then. I dont have any symptoms of a hypo so it could even be a dodgy monitor.

 

[Bruce Stephens]

sorry by short term i mean buy a coupe of sensors use them then review if things settle down go back to mr stabby if not buy a couple more. I am very fortunate in that i have a good job so self funding is an option.

That was the kind of thing I was thinking of. (Really anything that's not continuous use, where you're using Libre to get an idea of patterns and to adjust something, then once things seem better you go back to extracting blood.)

I'm also fortunate in that I can afford to self fund, and I decided that using it makes such a big difference to my quality of life that it's worth it. (Having said that, my latest repeat prescription form suggests I can order 5 more lots of 2 sensors so maybe I'll get some more on prescription. I'm guessing they've decided now isn't a great time to perform the trial review.)

 

[grovesy]

Yes that is what is known as short term. The HBA1C it estimates has been out for me. Though it does show trends and how much time you are spending in range.

 

[Bruce Stephens]

The HBA1C it estimates has been out for me.

It's been accurate for me. Just not very useful.

Time in range is much more practically useful.

 

[grovesy]

I did not mean the Glucose levels I meant the HBA1C estimates. The glucose levels can vary from sensor to sensor and different times, I usall do a finger prick twice day, they can between 1-2mmols differnt.