Finger prick readings , new to this

[Taffyboyslim]

Diagnosed July 2022 , nurse has recently provided me with a finger prick monitor

She's pleased with hbac1 at 51 and reducing

Took first home test today , before breakfast , 10.4 ?

I was surprised and thought it would be a lot less than that

How does a high but not really high hbac1 match in with my finger prick level of 10.4 ?

And what can I do about it , apart from the obvious dietary changes I am doing ?

A change of medication ?

 

[rayray119]

Had you been moving about before testing sometimes when we get up and start moving first things our liver goes "oh we they need glucose for the day" which to us is rather unhealthy. It can also happen in early hours of morning while sleeping.

Your hba1c and one finger prick reading isn't really compare and hb1ac shows your average blood sugar over the last 3 months.

 

[RBZ5416]

Ideally the first (fasting) test of the day should be immediately on waking, while still in bed, for the reasons above..

 

[Taffyboyslim]

I might make an appointment with my nurse , a bit worried about this

 

[rayray119]

I might make an appointment with my nurse , a bit worried about this

I wouldn't worry about one reading(easy to do sometimes) the trick would be to see if any can identify trends pattens and then think about what chance. I noticed you haven't answered when you took the reading weather you were still in bed(as said this will give you more of idea of what your true fasting level was for example I woke up at 8mmol at around 6am todat today but a couple of hours latter it had risen to around 10). But as I said don't worry too much about one reading

 

[Taffyboyslim]

I wouldn't worry about one reading(easy to do sometimes) the trick would be to see if any can identify trends pattens and then think about what chance. I noticed you haven't answered when you took the reading weather you were still in bed(as said this will give you more of idea of what your true fasting level was for example I woke up at 8mmol at around 6am todat today but a couple of hours latter it had risen to around 10). But as I said don't worry too much about one reading

I was in my easy chair before I had breakfast

 

[rayray119]

I was in my easy chair before I had breakfast

Ah so you had gotten out of bed then so your real fasting level could have actually been lower in future if you can I would try and test before getting out of bed if you want to no what you woke up at.

 

[trophywench]

HbA1c is a test of how much unused glucose has stuck itself to your red corpuscles in the blood whilst circulating round your whole body for the last 3 months - ish.

The 3 months is not definitive - it is simply that the average life of a red corpuscle is between 90 ish and 120 ish days, so that's where the 'about 3 months' terminology comes from.

None of us whoever we are, knows how old any of our corpuscles might be when that half teaspoonful of blood they tested was pulled out of our vein because them dying and new ones being formed is a continual process so some would have been formed an hour ago and some be in their dying moments right now - but could be 89 days old or 121 days. The older ones have had more time to get more glucose stuck to them, those born this morning won't have got much so far.

Unless you want to fingerprick test on your meter every second of the day and night for 3 months , add them all up and work out the average then you could get a rough comparison with HbA1c. Otherwise - you can't.

 

[Deb_l]

I might make an appointment with my nurse , a bit worried about this

I wouldn't get worried from one result. The glucose monitors are an amazing tool to have but you need to use it with a purpose, i.e. before and after meals to see what foods are making your BG spike (or not).

Do a test before lunch or dinner and record it (I use an app called Glucose). Then take a further sample 90 mins to 2 hours later. Your BG should not have risen more than 2 points above the starting number. If it has, then maybe that food isn't for you

I stopped taking my BG first thing in the morning because it was all over the place. Just for context, I had a HbA1c of 96 but never had a finger prick reading over 12 so that didn't really figure either. I should (by rights) have been way up there in the 20's.

 

[Martin.A]

Do a test before lunch or dinner and record it (I use an app called Glucose). Then take a further sample 90 mins to 2 hours later. Your BG should not have risen more than 2 points above the starting number. If it has, then maybe that food isn't for you

Maybe, but it might also just be a case of reducing portion sizes? That's how I worked out that I can manage one Weetabix for breakfast but not two.

 

[Taffyboyslim]

HbA1c is a test of how much unused glucose has stuck itself to your red corpuscles in the blood whilst circulating round your whole body for the last 3 months - ish.

The 3 months is not definitive - it is simply that the average life of a red corpuscle is between 90 ish and 120 ish days, so that's where the 'about 3 months' terminology comes from.

None of us whoever we are, knows how old any of our corpuscles might be when that half teaspoonful of blood they tested was pulled out of our vein because them dying and new ones being formed is a continual process so some would have been formed an hour ago and some be in their dying moments right now - but could be 89 days old or 121 days. The older ones have had more time to get more glucose stuck to them, those born this morning won't have got much so far.

Unless you want to fingerprick test on your meter every second of the day and night for 3 months , add them all up and work out the average then you could get a rough comparison with HbA1c. Otherwise - you can't.

Don't understand that

 

[Leadinglights]

Don't understand that

The HbA1C is a test which measures the average blood glucose over the previous 3 months as it is looks at how much glucose is stuck to your red blood cells, the more excess glucose in your system the more sticks to the red blood cells.
When you take a finger prick reading it is the amount of glucose in your blood stream at THAT moment in time. You could get an estimate of your HbA1C if all the moments in time readings were averaged and converted using a fudge factor, as they are actually measuring something different which is why the units are different, finger prick readings mmol/l and HbA1C mmol/mol.

Is that any clearer?
What specifically don't you understand.

 

[Taffyboyslim]

The HbA1C is a test which measures the average blood glucose over the previous 3 months as it is looks at how much glucose is stuck to your red blood cells, the more excess glucose in your system the more sticks to the red blood cells.
When you take a finger prick reading it is the amount of glucose in your blood stream at THAT moment in time. You could get an estimate of your HbA1C if all the moments in time readings were averaged and converted using a fudge factor, as they are actually measuring something different which is why the units are different, finger prick readings mmol/l and HbA1C mmol/mol.

Is that any clearer?
What specifically don't you understand.

The technical talk

I know that my blood reading the six monthly one was 87 now it's down to 51

I want to get it as low as I can

The nurse told me that the finger prick test is not that important compared to the six monthly bloods and she's happy for me to do it once a week or even not use it at all

 

[rayray119]

The nurse told me that the finger prick test is not that important compared to the six monthly bloods and she's happy for me to do it once a week or even not use it at all

I would argue that figer prick testing would actually give more of idea of what effects you and what doesn't then a hb1ac test does however doing it once a week isn't really going to give you any useful information. But that's gone reduction

 

[Leadinglights]

The technical talk

I know that my blood reading the six monthly one was 87 now it's down to 51

I want to get it as low as I can

The nurse told me that the finger prick test is not that important compared to the six monthly bloods and she's happy for me to do it once a week or even not use it at all

You have made brilliant progress. The first result of 87 would have been your HbA1C and yes it was pretty high, the threshold for diagnosis is anything over 47mmol/mol so as a result of your hard work you have now brought your level down to 51 mmol/mol.

The value of finger prick tests is that you can get an idea of what is going on between those infrequent HbA1C tests and pick up if what you have been doing is not working.
Generally if finger prick reading are consistently between 4-7mmol/l fasting and before meals and no more than 8mmol/l 2 hours after eating then that will be more likely to give you an HbA1C result which is at a normal level of below 42 mmol/mol.

 

[Sally71]

Once a week is a bit pointless, that won’t tell you anything useful at all. As someone said, the best way is to test just before you start eating, then again 2 hours later and see how much you’ve gone up by. If not much (less than 2-3) then that was a good meal for you. If more than that, there’s too much carbohydrate in it for your body to tolerate, so you need to think about swapping things or reducing portion size. Once you’ve found out what meals work best for you then you don’t need to test so much.
Also make sure your fingers are clean and dry before you prick them, so that there’s nothing on your skin that could skew the result.

 

[everydayupsanddowns]

Try not to worry too much about that one result @Taffyboyslim

Blood glucose goes up and down the whole time. Mostly it is food (carbohydrates and sugars) that pushes it upwards, but it can be other things too, like stress and hormones.

Plus the strips and checks themselves can sometimes be a bit ‘wobbly’ (eg if you have something on your fingers that changes the reading, or if it happens to be a duff strip).

The best bet is to decide on how you want to use the information from your spot-checks to improve your diabetes management, and then establish a routine that supports that. 🙂

 

[Taffyboyslim]

Once a week is a bit pointless, that won’t tell you anything useful at all. As someone said, the best way is to test just before you start eating, then again 2 hours later and see how much you’ve gone up by. If not much (less than 2-3) then that was a good meal for you. If more than that, there’s too much carbohydrate in it for your body to tolerate, so you need to think about swapping things or reducing portion size. Once you’ve found out what meals work best for you then you don’t need to test so much.
Also make sure your fingers are clean and dry before you prick them, so that there’s nothing on your skin that could skew the result.

Thank you

 

[Taffyboyslim]

Well I am getting very stressed about this

My finger prick tests are consistently 10 and above , up to 13

I have completely stopped potatoes , rice , chips , crisps , pasta , bread , chocolate , sweets and have basically been on the straight healthy path for two months

I am taking my medication

Yet my sugars are 10 and above , consistently ?

I really don't know what else I can do

I want to see my healthcare team but the receptionists just fobb me off with utter nonsense

This is driving me into depression

Has anyone got some constructive advice ?

Thank you

 

[Proud to be erratic]

Hello @Taffyboyslim,

My advice is to pat yourself firmly on your back for the great progress you've made so far. You've reduced your HbA1c to 51, as posted by you on the 17th Dec and that alone is really terrific. That puts you just into the official Diabetes diagnosis of 48 and only a little above. You have not been doing "something right" but rather doing "everything right".

Finger prick tests consistently 10 and above are not ideal, but they are far from dreadful. A slow and steady recovery back into an even lower HbA1c is a great deal kinder on your body than a dramatic fall AND whatever you are doing now HAS to be sustainable by you into the future.

Reading back a little bit, one thing that you could consider doing is to be a bit more systematic with your FP testing routine: test immediately before eating and as close to 2 hrs after with the intention of getting a steady series of results showing that your post meal readings are no more than 2-3 mmol/L above your starting level. If they are repeatedly not so then you have found a meal choice that your body does not manage well. Then either change a higher carb item for a lesser one, or try a reduced meal size.

There will always be the odd rogue pair of readings. Our bodies are extraordinarily complex and susceptible to contrary results just because our bodies are managing so many other hidden or just unnoticed bits of business keeping us alive. Perfect metabolism does not exist - in anyone still alive!

If this is too much hassle and interference into your daily life for every meal, just do this for breakfasts until you've got the measure of those. Then stop testing for breakfasts and take the paired readings for your lunches and once you've got those sorted move on to your evening meals.

Lastly be kind to yourself. You getting stressed about this IS NOT HELPING. Stress invariably , just on its own raises blood glucose. I do understand this next observation is easy said and much, much harder to do - I've been here. Somehow you need to find a way of coming to terms with your situation, somehow relax into accepting you have T2 diabetes, somehow stay calm / chilled / or whatever word you choose and somehow work with yourself to monitor (repeatable test routine) and adjust without getting angry about yesterday's results not being perfect.

Try and see all of this in a positive light: your T2 was spotted and diagnosed before really bad problems arose [my late brother lost both legs to his diabetes; arguably his own neglect caused his first amputation, but the 2nd leg was steadily deteriorating for 12 months, despite everyone trying to prevent that] [ he was T2 and didn't succeed in managing his BG until permanently confined to a wheelchair and needing a hoist to get himself in and out of bed, forced him to eat better and test more - but then too late!] . Your latest HbA1c confirms what great progress you've already made and far from you finding this all depressing you are making a difference and try to be upbeat about this.

Apologies if I'm preaching - but you asked for advice! Good luck for 2024.