Feeling patronised

[HalfpipMarathon]

I have recently posted on a diabetes Facebook group that I wasn't enjoying food that I felt guilty whatever I ate whenever. I also said that my GP practice can't be that worried about my latest HbA1c (it had risen slightly by .5 or .6) otherwise they would be seeing me face to face wouldn't they. The commenter said almost that I was wanting to be told what I wanted to hear. I resisted saying I found that almost offensive and untrue.

I was just having a moment. I have stopped finger pricking for a day but will go back to it tomorrow.

I was told I should stop reading rubbish about type 2s especially not on insulin not needing to test but people have said they don't test for the same reason as me - anxiety, and a nurse told me it's not recommended. Excluding the cynical fact that money is the reason for saying the aforementioned, is medical information out of date regarding this?

I feel almost angry because I wanted some support and understanding of what I was feeling not a lecture which is what it felt like. It's just as well I was anonymous as feel sometimes this is easier.

I will return to finger pricking tomorrow. I know I have made the right decision regarding this. I know you don't get TIR but unless I am wrong this is more for type 1s. Sometimes too much information is not always good especially if it makes you feel anxious and uncomfortable.

 

[Dragonheart]

There is a strong financial aspect to the nhs not supporting self testing for type 2 unless on hypoglycaemic medication (there’s a lot of us). There was a study some time ago starting in some people it causes anxiety and that is widely quoted to justify the policy.

Also it’s not standard for the Hcp to be taught about testing in type 2. They are used to it being about dose adjustment and hypo avoidance, neither relevant to most non insulin type 2. Some are more enlightened.

We use it to ascertain and adjust food choices mostly, testing pre and 2hr post meal seeking less than a 2mmol rise (and in a perfect world under 7.8 at 2 hrs) to match a normal non diabetic profile as best possible.

Any testing should have a purpose and it should have a clear plan of what to do with the information gained. Random tests that you do nothing about tell you little and are a bit of a waste imo. Fasting morning readings are usually a longer term measure and only change slowly (as a trend) over time and not as useful as meal testing. Anxiety often comes from seeing numbers you either don’t understand or not knowing what to do about them or why they happened. And that is a lack of education and training not inappropriate testing.

TIR more typically relates to cgm rather than fingerpricks but I can’t see why it’s not useful for a type 2 to know this subject to the above about it being actually useful or reassuring.

I‘m a bit confused about your situation. Is testing stressing you? Have you been told on the FB group not to test? Do you want to? Do you understand what it means and what to do or is that the source of your anxiety?

Finally I wouldn’t be too confident about the surgery contacting you. Their goals and yours might not align (they generally aren’t very ambitious and often expect slow deterioration that I’d be a lot less happy about than they might). They are also under a lot of pressure and things get missed. if you have the nhs app you can ask your surgery to allow you access to the results on there or ask at the surgery for them. They are yours and you are entitled to them. Always check them for yourself and learn what they mean imo

 

[Leadinglights]

There is a strong financial aspect to the nhs not supporting self testing for type 2 unless on hypoglycaemic medication (there’s a lot of us). There was a study some time ago starting in some people it causes anxiety and that is widely quoted to justify the policy.

Also it’s not standard for the Hcp to be taught about testing in type 2. They are used to it being about dose adjustment and hypo avoidance, neither relevant to most non insulin type 2. Some are more enlightened.

We use it to ascertain and adjust food choices mostly, testing pre and 2hr post meal seeking less than a 2mmol rise (and in a perfect world under 7.8 at 2 hrs) to match a normal non diabetic profile as best possible.

Any testing should have a purpose and it should have a clear plan of what to do with the information gained. Random tests that you do nothing about tell you little and are a bit of a waste imo. Fasting morning readings are usually a longer term measure and only change slowly (as a trend) over time and not as useful as meal testing. Anxiety often comes from seeing numbers you either don’t understand or not knowing what to do about them or why they happened. And that is a lack of education and training not inappropriate testing.

TIR more typically relates to cgm rather than fingerpricks but I can’t see why it’s not useful for a type 2 to know this subject to the above about it being actually useful or reassuring.

I‘m a bit confused about your situation. Is testing stressing you? Have you been told on the FB group not to test? Do you want to? Do you understand what it means and what to do or is that the source of your anxiety?

Finally I wouldn’t be too confident about the surgery contacting you. Their goals and yours might not align (they generally aren’t very ambitious and often expect slow deterioration that I’d be a lot less happy about than they might). They are also under a lot of pressure and things get missed. if you have the nhs app you can ask your surgery to allow you access to the results on there or ask at the surgery for them. They are yours and you are entitled to them. Always check them for yourself and learn what they mean imo

The OP has gone back to finger prick testing after having had sometime trailing Libre and Dexcom but gave up on them as they were causing her anxiety.

 

[HalfpipMarathon]

There is a strong financial aspect to the nhs not supporting self testing for type 2 unless on hypoglycaemic medication (there’s a lot of us). There was a study some time ago starting in some people it causes anxiety and that is widely quoted to justify the policy.

Also it’s not standard for the Hcp to be taught about testing in type 2. They are used to it being about dose adjustment and hypo avoidance, neither relevant to most non insulin type 2. Some are more enlightened.

We use it to ascertain and adjust food choices mostly, testing pre and 2hr post meal seeking less than a 2mmol rise (and in a perfect world under 7.8 at 2 hrs) to match a normal non diabetic profile as best possible.

Any testing should have a purpose and it should have a clear plan of what to do with the information gained. Random tests that you do nothing about tell you little and are a bit of a waste imo. Fasting morning readings are usually a longer term measure and only change slowly (as a trend) over time and not as useful as meal testing. Anxiety often comes from seeing numbers you either don’t understand or not knowing what to do about them or why they happened. And that is a lack of education and training not inappropriate testing.

TIR more typically relates to cgm rather than fingerpricks but I can’t see why it’s not useful for a type 2 to know this subject to the above about it being actually useful or reassuring.

I‘m a bit confused about your situation. Is testing stressing you? Have you been told on the FB group not to test? Do you want to? Do you understand what it means and what to do or is that the source of your anxiety?

Finally I wouldn’t be too confident about the surgery contacting you. Their goals and yours might not align (they generally aren’t very ambitious and often expect slow deterioration that I’d be a lot less happy about than they might). They are also under a lot of pressure and things get missed. if you have the nhs app you can ask your surgery to allow you access to the results on there or ask at the surgery for them. They are yours and you are entitled to them. Always check them for yourself and learn what they mean imo

My GP practice said the Dr will call tomorrow. The Dr who I spoke to last time is very good and believes that if you don't know what is happening with bs then how can you make changes. I feel comfortable talking to her. I don't have an issue with testing per se just find it stressful when I get high readings sometimes.

The FB group members who responded to my anonymous post didn't say don't test quite the opposite. Some people on another FB group others said they didn't test as they found it caused anxiety. Sometimes I know why and sometimes I don't have any idea regarding the readings.

Someone said that the true figure in the morning is 2hrs after breakfast as the liver dumps glucose. Is this correct? If so may be I should eat when I wake then test 2hrs later. Also I feel I need a range that suits me not some arbitrary one size fits all this is just my opinion.

 

[Dragonheart]

Ok so anxiety is often from feeling helpless so the answer is to have a plan when you see those higher numbers at 2hrs. (Everyone rises after food even non diabetic, this difference is how high and for how long). Is it changing the meal next time, taking a walk etc or ask in here

The morning thing is about dawn phenomenon. The liver dumps glucose to get us up and going, in everyone. Again the difference is how much and for how long.

There’s no such thing as a true reading. Assuming they are done correctly they are all true readings. You just need to understand what they do and don’t represent. I’ve never heard the morning ones referred to that way.

 

[Leadinglights]

People will test their morning readings everyday and will get a variation depending on a large number of variables one of which will the the liver releasing glucose but others may be how many times you got up in the night to visit the bathroom or how hydrated you are even though they think they are having the same routine therefore looking at trends is for many more useful.
However if you want to find how you have tolerated whatever you had for breakfast then testing just before you eat not half an hour before and after 2 hours is what is suggested.
The more consistently you keep your meal increases to less than 2mmol/l the more likely your HbA1C will be in normal range

 

[HalfpipMarathon]

Ok so anxiety is often from feeling helpless so the answer is to have a plan when you see those higher numbers at 2hrs. (Everyone rises after food even non diabetic, this difference is how high and for how long). Is it changing the meal next time, taking a walk etc or ask in here

The morning thing is about dawn phenomenon. The liver dumps glucose to get us up and going, in everyone. Again the difference is how much and for how long.

There’s no such thing as a true reading. Assuming they are done correctly they are all true readings. You just need to understand what they do and don’t represent. I’ve never heard the morning ones referred to that way.

I think the person actually said real numbers same meaning as true numbers I suppose. I interpret this is saying that, as the liver dumps glucose to get everyone going hence high readings, it makes more sense to test 2hrs after food.

 

[Leadinglights]

I think the person actually said real numbers same meaning as true numbers I suppose. I interpret this is saying that, as the liver dumps glucose to get everyone going hence high readings, it makes more sense to test 2hrs after food.

That doesn't tell you much unless you have tested before as you would not know if the level was from the food you have eaten or what it is relating to. You may reject meals that are OK because an 2 hour post meal is over 8mmol/l when actually the meal is OK as you were 7mmol/l before you ate, so the increase was less than 2-3mmol/l so absolutely fine.
It depends on the reason for testing.

 

[HalfpipMarathon]

That doesn't tell you much unless you have tested before as you would not know if the level was from the food you have eaten or what it is relating to. You may reject meals that are OK because an 2 hour post meal is over 8mmol/l when actually the meal is OK as you were 7mmol/l before you ate, so the increase was less than 2-3mmol/l so absolutely fine.
It depends on the reason for testing.

I misunderstood the person 's comment. She said test before eating just not on waking so if I say get up at 6.30 I usually have breakfast and then shower (I have to be in and out of the shower before 7pm when my husband gets home from work) before getting ready for work so how long after getting up should I test before I eat?

 

[Leadinglights]

I misunderstood the person 's comment. She said test before eating just not on waking so if I say get up at 6.30 I usually have breakfast and then shower (I have to be in and out of the shower before 7pm when my husband gets home from work) before getting ready for work so how long after getting up should I test before I eat?

Just before eating generally means you test then put the food in your mouth, and after 2 hours is 2hrs after the first bite. It sounds as if you have a tight time schedule anyway.