Inconsistent meter readings

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Gary PL

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Hello,

This is my first post here, so hello

I've been type 2 for a while and have only recently been asked to check my blood glucose at home. Having recently undone weight loss surgery (please don't judge!), the surgeon has asked that I maintain readings below 10, otherwise I'm to restart medications starting with Metformin.

This leads me onto my meter readings. Yesterday was 8.2, but on checking again immediately after the first time, even using the same prick site and essentially the same drop of blood (albeit more squeezed from the same site), it then jumped to 9.0.

This morning, the first test was 8.7 and testing again as above within 60 seconds led to it jumping to 10.7.

Is this normal? Which reading should I believe? Is my meter faulty? My technique?

I ensure that I wash my hands with soap and warm to hot water before doing the test and am careful not to touch the top of the test strip.

Any insights greatly appreciated.

Thanks,

Gary
 
We expect meter readings to have about a 15% margin of error so when calibrating a CGMs it’s common to have to do 2 readings and the sensor then takes the middle as being accurate. Your readings are showing the same thing. Essentially it’s not about any individual reading but building a picture of data over time. You’re not doing anything wrong it’s just the nature of the beast.
 
Hi @Gary PL and welcome to the forum.

I'm a sad ex-scientist who cannot help checking out what the numbers you get from test equipment might actually mean. So when I got a meter I tested all 10 digits one after the other to see what I got.

My conclusion was that to a decent approximation you might as well round the result to the nearest whole number - the machines cannot give a reading to decimal point accuracy. Do that and then expect a variability of at least one unit around any test. When comparing two tests then you want clear space between the ranges before you start to look for reasons other than random chance for the difference.

So your 8.7 becomes a 9 and the 10.7 becomes an 11. Add +/- one unit to each reading and you get somewhere between 8 and 10 for the first and somewhere between 10 and 12 for the second. Since the number ranges overlap, treat them as not being different.

You can do the statistics properly and get a probability of the numbers being different but you have to be a bit nerdy and not have better things to do to indulge in such practices.

So there is a high probability that your meter is not faulty and your technique is fine. My advice is always to write the numbers down and look for patterns and don't try and overthink individual readings.

Keeping readings below 10 is a good target. I would add to that a suggestion to do your testing first thing in the morning and then avoid testing in the two hours or so after eating. A meal will push your blood glucose up and it is not unusual for non-diabetics to get readings above 10 if they test within a couple of hours of eating.

PS...hand held blood glucose monitors are brilliant bits of kit and I am amazed they get a reading anywhere near a blood glucose level. They provide results you can work with, just recognise their limitations.
 
Hi all,

Thanks for the replies. I didn't know that meters had such a margin of error, so all good education for me.

@Docb I took the reading first thing this morning after having had some yogurt at about 10.00 or 11.00pm. Yesterday's was about 4 hours after food. I am having to spread out my meals in order to get the necessary protein and other liquids down because I can't take enough in at the moment. A pot of yoghurt does me in at the moment. Suppose that's the point of the surgery!

As a scientifically minded person, you may like the fact that I have created a spreadsheet
 
Love a good spreadsheet, and welcome to the forum
 
Gary PL said:
Hi all,

Thanks for the replies. I didn't know that meters had such a margin of error, so all good education for me.

@Docb I took the reading first thing this morning after having had some yogurt at about 10.00 or 11.00pm. Yesterday's was about 4 hours after food. I am having to spread out my meals in order to get the necessary protein and other liquids down because I can't take enough in at the moment. A pot of yoghurt does me in at the moment. Suppose that's the point of the surgery!

As a scientifically minded person, you may like the fact that I have created a spreadsheet
Click to expand...
I wrote a database. When you get over well over 1000 records, spreadsheets get a bit unwieldly!
 
Gary PL said:
Hi all,

Thanks for the replies. I didn't know that meters had such a margin of error, so all good education for me.

@Docb I took the reading first thing this morning after having had some yogurt at about 10.00 or 11.00pm. Yesterday's was about 4 hours after food. I am having to spread out my meals in order to get the necessary protein and other liquids down because I can't take enough in at the moment. A pot of yoghurt does me in at the moment. Suppose that's the point of the surgery!

As a scientifically minded person, you may like the fact that I have created a spreadsheet
Click to expand...
When you have to contend with dietary restrictions a monitor is a valuable tool. Pairs of reading are the most useful so just before you eat and after 2 hours, however if your digestion system does not comply with the norm then something different may be needed for you.
 
Hope you are able to find a BG friendly and enjoyable menu that suits you @Gary PL , and helps with your post-surgery capacity, while also keeping your levels and weight in the target ranges you have been given.

Are you recovered from the surgery now? Recovering from illness or injury can bump up your glucose levels as hormones are released.
 
everydayupsanddowns said:
Hope you are able to find a BG friendly and enjoyable menu that suits you @Gary PL , and helps with your post-surgery capacity, while also keeping your levels and weight in the target ranges you have been given.

Are you recovered from the surgery now? Recovering from illness or injury can bump up your glucose levels as hormones are released.
Click to expand...
This morning's results were 8.2 and 8.7, so maybe I'm doing okay. I'll be interested to see what my HbA1c does when that's next checked. I had managed to get it down from 82 in July (94 at its peak) to 56 just before the surgery.

I am basically living on natural and Greek yogurt and milk at the moment as the operation wasn't even 2 weeks ago and these foods have the necessary consistency and protein (which I supplement with milk powder and protein powder). I will be going from liquids to pureed food during the week, so I can add some fibre in the form of soggy Weetabix. I understand that fibre can help with blood glucose levels (as well your constitution)? I can also have a bit more variety in the form of hummus and anything I can blend. Baby food texture spag bol here I come! My Christmas dinner will consist of soft foods like scrambled egg, minced lean meat, mashed veg, etc, as I won't have progressed to normal texture food by then.

I was in considerable pain for about 4 or 5 days after (I'll politely describe it as due to changes in my digestive motility), but that has eased off and I have been able to ditch the opiates which make me itch all over! I am quite fatigued though, so will be asking the GP to consider signing me off for another week or two. And no lifting for 6-8 weeks. Hopefully it's worth it and I manage to improve my health - jury is out on both counts at the moment. I am acutely aware of the controversial nature of the surgery that I have had and how much of an opportunity it is to change things, but also accept that some people will hate me for it.

Probably too much information shared, although someone may find it useful if doing a Google search. Thanks for asking either way though 🙂
 
Gary PL said:
I am acutely aware of the controversial nature of the surgery that I have had and how much of an opportunity it is to change things, but also accept that some people will hate me for it.
Click to expand...

I would hope you don’t get a such sense of anything like that here. It is one option, that has positive clinical trial outcome data. There are many approaches and strategies for managing diabetes, but each person is unique and individual, and there is no one option that is ‘better’ or ‘worse’ than any other - different people just need to find the strategies, options, medications, technologies, and yes, including surgical procedures, that work for them and their unique position.

Hope the transition towards more solid foods goes well 🙂
 
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A couple of things to try may be the High protein yoghurts, Arla or the Aldi ones which are low carbs. Home made soups like broccoli and stilton, courgette and brie, butternut squash and red pepper are all tasty.
 
everydayupsanddowns said:
I would hope you don’t get any such sense here. It is one option, that has positive clinical trial outcome data. There are many approaches and strategies for managing diabetes, but each person is unique and individual, and there is no one option that is ‘better’ or ‘worse’ than any other - different people just need to find the strategies, options, medications, technologies, and yes, including surgical procedures, that work for them and their unique position.

Hope the transition towards more solid foods goes well 🙂
Click to expand...
I suspect Mike that, that first sentence should read, "I would hope your don't get any such nonsense here." Not that I am suggesting we always talk sense. 🙄

Anyway, @Gary PL , welcome from me too.

I appreciate that you are on a limited diet and I am not sure how much the surgery will ultimately improve your diabetes, but some of the foods you have mentioned already, like Weetabix and the pasta in liquidized spag bol are quite high carb and the sort of things that dietary controlled type 2s would limit or avoid. It may be that the smaller portion size that you can currently manage.... perhaps just one Weetabix and a half or quarter portion of spag bol will not cause you too much BG disruption though. Just something to bear in mind if your levels don't drop down into range as much as you would like. Diabetes is about all carbohydrates not just sugar. Sometimes that message gets lost within the NHS.
Wishing you lots of luck with your recovery and look forward to seeing you, hopefully posting some lower BG numbers once your body recovers from the trauma of the surgery.
 
everydayupsanddowns said:
I would hope you don’t get any such sense here. It is one option, that has positive clinical trial outcome data. There are many approaches and strategies for managing diabetes, but each person is unique and individual, and there is no one option that is ‘better’ or ‘worse’ than any other - different people just need to find the strategies, options, medications, technologies, and yes, including surgical procedures, that work for them and their unique position.

Hope the transition towards more solid foods goes well 🙂
Click to expand...
No sense here. Was more a remark on society in general and the fact that it is an opportunity many don't get, so I would hate to waste the chance I have been given.

Thanks 🙂
 
Leadinglights said:
A couple of things to try may be the High protein yoghurts, Arla or the Aldi ones which are low carbs. Home made soups like broccoli and stilton, courgette and brie, butternut squash and red pepper are all tasty.
Click to expand...
I've had a couple of the yogurt and quark pouches. They aren't something I would be able to have all the time though, as I have one and I am completely full. Hence the Greek/natural yogurt as I can add sugar free flavour and protein in the form of protein powder or skimmed milk powder. The target is 80g of protein a day, but also 1.5l of liquids. Essentially you can't eat and drink at the same time, at least in the early days, so it's a case of little and often.

Tomorrow is texture progression day (I started early with some hummus) and have some bits I can shove in a blender like casserole, etc. Probably still a place for yogurt though.
 
rebrascora said:
I suspect Mike that, that first sentence should read, "I would hope your don't get any such nonsense here." Not that I am suggesting we always talk sense. 🙄

Anyway, @Gary PL , welcome from me too.

I appreciate that you are on a limited diet and I am not sure how much the surgery will ultimately improve your diabetes, but some of the foods you have mentioned already, like Weetabix and the pasta in liquidized spag bol are quite high carb and the sort of things that dietary controlled type 2s would limit or avoid. It may be that the smaller portion size that you can currently manage.... perhaps just one Weetabix and a half or quarter portion of spag bol will not cause you too much BG disruption though. Just something to bear in mind if your levels don't drop down into range as much as you would like. Diabetes is about all carbohydrates not just sugar. Sometimes that message gets lost within the NHS.
Wishing you lots of luck with your recovery and look forward to seeing you, hopefully posting some lower BG numbers once your body recovers from the trauma of the surgery.
Click to expand...
A bit of nonsense is fun from time to time and thanks for the advice 🙂 Much appreciated.

The BG improvements started in the liver shrinkage stage (essentially a particularly strict keto diet), which impacted some of the typical diabetes symptoms. But I am on an even more restrictive (or restricted!) diet now I have had the surgery. Main aims are (in this order) via a process of texture progression - enough protein, enough liquids, building in much needed fibre. Vitamins and minerals are catered for by various supplements. Once I am keeping down normal textured food (likely to be a process of experimentation over what foods I can now tolerate in the new year), I will look at the carbs again.

Another reason they say aim for below 10 on the meter is because now 80% of my stomach has been removed, my hormones are all over the place. This means I have to watch out for reactive hypoglycaemia, which is relatively common in bariatric patients. Your body can essentially overcompensate with an insulin dump and your body is generally more sensitive to insulin post surgery (not sure of the science behind this phenomenon). The meter readings I have been getting are without any diabetic medication, so I would say that there are early signs of improvement. And as I am resetting the situation with the medications, I have the ability to reintegrate them again as and when needed, starting with metformin again. Hopefully they won't be in the future though.
 
Gary PL said:
I've had a couple of the yogurt and quark pouches. They aren't something I would be able to have all the time though, as I have one and I am completely full. Hence the Greek/natural yogurt as I can add sugar free flavour and protein in the form of protein powder or skimmed milk powder. The target is 80g of protein a day, but also 1.5l of liquids. Essentially you can't eat and drink at the same time, at least in the early days, so it's a case of little and often.

Tomorrow is texture progression day (I started early with some hummus) and have some bits I can shove in a blender like casserole, etc. Probably still a place for yogurt though.
Click to expand...
Yes the high protein yoghurts are very filling I find I can only have half a pot otherwise it is too much.
I hope you get on OK with your blended casserole.
 
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