Confusion over blood sugar testing

[Momo2021]

Hi I was wondering if someone could help with some understanding of blood sugar testing, I will try to speak to my diabetic nurse but wondered if someone can help me now.
I have been testing my blood sugars regularly morning, Before/after lunch and dinner (don’t eat breakfast) and at bedtime. My results have been coming down and using the musugr app my estimated Hba1c is 6.7% it was 10% (also does anyone know how accurate this app estimate is?) I was only diagnosed 2 weeks so not sure that % is accurate.
But I have been reading about spikes after eating, if my blood sugar reading is within the acceptable range at 2 hours does that mean I could still be having spikes at say 1hr?
if I am having spikes at 1hr is that a worry?
should I be testing at 1hr for spikes? and then at 2hr?
i don’t think I’ll be able to test much more as fingers are already sore and it’s costing me a lot in testing strips aswell.

thanks

 

[Ditto]

Hello and welcome to the forum @Momo2021 🙂

I'd test at 1hr and then 2hr till you see what's what.

 

[trophywench]

HbA1c results are not reported as a percentage now - it's a number, eg my latest one last week was 53.

The HbA1c measures how much glucose has 'stuck' to our red blood cells over the last approx 3 months.

It does not confine itself to only those few split seconds out of any day when we each actually test our BG with a glucometer - it measures the result of what happened all the split seconds during the 3 months.

 

[Ljc]

Hi, welcome to the forum.
The spike is normally over and our BGs levels are on the way back down within that 2hrs. Non diabetics spike too, it’s normal lol, it’s just that their pancreas and liver work well together and can handle it well whereas ours .......

At this early stage in your diabetes journey please don’t worry about doing in depth testing , you have enough to cope with and to learn without adding to your worries and having sore fingers too.

The Hb1ac blood test is the gold star test for the resons @trophywench has given , the ones apps and some glucose meters give can only ever be a very basic estimation.

Personally I never bothered testing at one hour .

 

[grovesy]

For me the estimate for HBA1C on the mySugr app is always lower than the laboratory one.

 

[everydayupsanddowns]

Welcome to the forum @Momo2021 🙂

I have been testing my blood sugars regularly morning, Before/after lunch and dinner (don’t eat breakfast) and at bedtime. My results have been coming down and using the musugr app my estimated Hba1c is 6.7% it was 10% (also does anyone know how accurate this app estimate is?) I was only diagnosed 2 weeks so not sure that % is accurate.

As you will discover with diabetes, the answer to almost all questions is ‘it depends’ 🙄 Which is a bit frustrating...but just all part of the joy and fickle individuality that is diabetes!

There is no way to directly convert spot-check fingersticks to Hba1c, but various formulae have been developed, often from pairs of datasets with fingerstick BGs and HbA1c, and then finding the ‘best fit’ conversion. But of course it will hugely depend on the number and distribution of the spot-checks, and whether they accurately reflect the ups and downs of BG over the 3-4 month period that an HbA1c covers. You will probably get a feel for how good a prediction they are for you in time, but like @grovesy I usually find them to be on the low side. And yes... I have no idea why the things I have hat offer an estimated A1c insist on providing it in the old, outdated % numbers, rather than the current IFCC mmol/mol?!

But I have been reading about spikes after eating, if my blood sugar reading is within the acceptable range at 2 hours does that mean I could still be having spikes at say 1hr?

Yes that’s quite possible.

if I am having spikes at 1hr is that a worry?
should I be testing at 1hr for spikes? and then at 2hr?

There’s no concrete answer for that. It’s very much a personal choice I think. Some people use post meal checks to try to limit the rise in BG to as little as possible, and are looking to see the highest spike that the meal gives in order to reduce that. Others are more inclined to favour aiming for no higher than 8.5mmol/L by 2 hrs after eating, and are happy that any short term blips above that for an hour are not going to concern them. I guess it might depend on how spiky the 1hr spike was... but that again would be individual, and depend on your first phase and second phase insulin responses. So there’s no one right or wrong answer, just what you feel comfortable with and what works for you.

i don’t think I’ll be able to test much more as fingers are already sore and it’s costing me a lot in testing strips aswell.

Which BG meter are you using? The strip cost can vary widely. The most affordable meters members here have found are the SD Gluco Navii or the Spirit Tee2 - which both have test strips at around £8 for 50

 

[trophywench]

That's true about meters etc and their estimate of HbA1c - my consultant was laughing with me last Friday when I mentioned how much lower the Libre reported than my BG meter. Yes he said - it estimates 40! - having just told me the lab result is 53.

(Blimey, a miracle! - a non diabetic blood test ....... NOT!!)

 

[Momo2021]

Which BG meter are you using? The strip cost can vary widely. The most affordable meters members here have found are the SD Gluco Navii or the Spirit Tee2 - which both have test strips at around £8 for 50

Thankyou for the reply, I’m using the glucorx nexus it was supplied by the gp practice but they said they would only give me one box of strips a month and they lasted me 6 days! Maybe I will speak to them about getting some more put the argument across that it’s helping me gain control etc. See what they say

And yes... I have no idea why the things I have hat offer an estimated A1c insist on providing it in the old, outdated % numbers, rather than the current IFCC mmol/mol?!

I was given the 10% my diabetic nurse she must still be doing the old way but I’ll ask her for my IFCC when I speak to her.

I guess it might depend on how spiky the 1hr spike was... but that again would be individual, and depend on your first phase and second phase insulin responses.

So I did a 1hr and 2hr check experiment today I had one slice of toast pre meal 6.7 at 1hr my blood sugar was 11.0! So obviously not a good spike but at the 2hr check it was back to 8.2 so within the 2hr acceptable range, would you say that suggests I have bad first phase response but good second phase responses? As I was surprised it came down to the reading of 8.2 so quickly.
Looks like bread is definitely off limits!
Thanks

 

[ianf0ster]

If you eat something that you know is a fast acting carb (refined flour or sugar) then it may be worth testing after 1 hour just to scare yourself into giving it up!
Personally I only once tested after 1hr - even non-diabetics get BG spikes, they are just last much shorter than for diabetics! I almost always just use the 2hr test, but have used 3hr ones (in addition to 2hrs) when I eat carbs with fat in order to account for the delay in the spike caused by the simultaneous digestion of fat.

 

[trophywench]

Well in Type 2, it is the 'first response' production of insulin that's a lot of the problem to start off with, before any insulin resistance can come into play.

 

[Deleted member 25429]

Thankyou for the reply, I’m using the glucorx nexus it was supplied by the gp practice but they said they would only give me one box of strips a month and they lasted me 6 days! Maybe I will speak to them about getting some more put the argument across that it’s helping me gain control etc. See what they say


I was given the 10% my diabetic nurse she must still be doing the old way but I’ll ask her for my IFCC when I speak to her.


So I did a 1hr and 2hr check experiment today I had one slice of toast pre meal 6.7 at 1hr my blood sugar was 11.0! So obviously not a good spike but at the 2hr check it was back to 8.2 so within the 2hr acceptable range, would you say that suggests I have bad first phase response but good second phase responses? As I was surprised it came down to the reading of 8.2 so quickly.
Looks like bread is definitely off limits!
Thanks

You could try another sort of bread . I have a superseeded one , but I always have it with cheese with me it slows down the release