Massive difference in finger pricks, stressing me out

[SianyBee]

So to add to my awful anxiety today I did three finger pricks one after another (as an experiment as the other day different hands were 2mmol different!) as my current sensor seems to be playing up. Yet again my right hand was lower than my left, I got a 5.4 on waking then 15 min later a 7.5 amd an 8.4!!?? I've no idea which one is true and this stresses me out quite a lot as I don't trust my new sensor for dosing purposes yet. Anyone experience this?

 

[rebrascora]

That looks like a case of Dawn Phenomenon or "Foot on the Floor" syndrome. This is when the liver pumps out extra glucose on a morning when we wake up or sometimes even before we wake up, to give us energy to start our day. It is believed to be a throwback to prehistoric days when we needed to go out to hunt and forage for food. I inject 1.5 - 2units of quick acting insulin as soon as I wake up to try to offset some of it as it will increase my BG levels by as much as 3-6mmols. This morning I went from 6.6-7.9 in the 12 mins before I injected my Fiasp without even getting out of bed. Try not to worry about it as it is normal although it affects some people more than others, but working out a strategy to deal with it, like my insulin jab as soon as I wake up, helps. Maybe start with just 1 unit if you go that route and if you are lower than 5 when you wake up then maybe don't give yourself any. It is one of the wonders of Libre that we are able to see these issues and figure out ways to compensate.

 

[Inka]

Could it be Feet on the Floor syndrome @SianyBee ? That is, blood sugar rising as soon as you wake up/get up?

 

[Inka]

Ha @rebrascora beat me to it I’d also say that glucose meters have a margin of error and it’s completely normal to get different numbers.

I’d continue to test to see if it is, FOTF, but I’d mainly not do multiple tests like that. The exact number doesn’t really matter. If, for some reason, you do need to do more than one test, I tend to take the middle one if there’s no obvious answer.

If your Libre is adding to your anxiety, don’t be afraid to ditch it. They can cause obsessive thoughts and ruin your peace of mind.

 

[stephknits]

I go up very quickly as soon as I get up, so they could all be accurate. The 5.4 on waking and then the other two are basically almost the same. I would suggest looking at Dawn phenomenon as a possible explanation.
Try to remember that although the tests look very accurate with the decimal point, they are a helpful indication, rather than set in stone. There are so many other things that affect our blood sugar, such as weather, stress, time of the month, stuff we did yesterday etc etc, that we are only really ever doing our best guess and aiming to get it near right. this is just one part of the puzzle and the info is there to help us.

 

[SianyBee]

Thanks both that makes sense for today but the other day I had a 2mmol difference right in the middle of the day from different hands. My right hand being the lowest . So this seems to be a consistent thing with the lower hand being my right? And also The other week my right said I was 3.8 but my left said 5.2!! So do I treat a hypo or not based on that?

 

[Amity Island]

So to add to my awful anxiety today I did three finger pricks one after another (as an experiment as the other day different hands were 2mmol different!) as my current sensor seems to be playing up. Yet again my right hand was lower than my left, I got a 5.4 on waking then 15 min later a 7.5 amd an 8.4!!?? I've no idea which one is true and this stresses me out quite a lot as I don't trust my new sensor for dosing purposes yet. Anyone experience this?

Hi SianyBee,

It's the fact that this is happening in the morning plus the fact that between each test it was rising (not up and down random figures) that would point me to believe it's dawn phenomenon. If that is the case, nothing to worry about at all, perfectly normal. I just add in an extra unit to my breakfast bolus to counter it. So if I need say 2 units of insulin for each 10g of carb upon waking, for a 40g carb meal that would be 8units, so i'd take 8 + 1 = 9units.

Trouble is, as a libre user, I have noticed this can happen before waking, a couple of hours after waking and many times not at all. That's why testing is important to catch any mis-matched insulin doses before next meal.

 

[Amity Island]

Thanks both that makes sense for today but the other day I had a 2mmol difference right in the middle of the day from different hands. My right hand being the lowest . So this seems to be a consistent thing with the lower hand being my right? And also The other week my right said I was 3.8 but my left said 5.2!! So do I treat a hypo or not based on that?

Either way, they are exceptionally good readings. Certainily where many diabetics aspire to be. With readings that low, if you are in doubt about that 3.8, no harm in a jelly baby to make sure readings from both hands are in target range of 3.9 to 10.0.

 

[Inka]

Thanks both that makes sense for today but the other day I had a 2mmol difference right in the middle of the day from different hands. My right hand being the lowest . So this seems to be a consistent thing with the lower hand being my right? And also The other week my right said I was 3.8 but my left said 5.2!! So do I treat a hypo or not based on that?

If you get a 3.8 and a 5.2, the answer is probably somewhere in the 4s. So, if I felt I needed some carbs, I’d have them. If I was about to drive or exercise, I’d definitely have them. But, I rarely have that situation as I only test once. I only repeat a test if the result looks dodgy (eg I think I might have food on my hands) or to confirm a higher than expected sugar before correcting.

I urge you to stop multiple tests. It’s not necessary and won’t be helping you in any way. All your meter is doing is showing that you’re in range, low, or high. The exact number doesn’t matter as it’s a snapshot of an ever-changing situation.

 

[SianyBee]

If you get a 3.8 and a 5.2, the answer is probably somewhere in the 4s. So, if I felt I needed some carbs, I’d have them. If I was about to drive or exercise, I’d definitely have them. But, I rarely have that situation as I only test once. I only repeat a test if the result looks dodgy (eg I think I might have food on my hands) or to confirm a higher than expected sugar before correcting.

I urge you to stop multiple tests. It’s not necessary and won’t be helping you in any way. All your meter is doing is showing that you’re in range, low, or high. The exact number doesn’t matter as it’s a snapshot of an ever-changing situation.

Thankyou. To be fair I've only done the multiple tests on these three occasions. The first time as my sensor alerted me to a hypo but I felt fine, the second as I thought it seemed too high and this morning as a pure experiment and also as my libre was chucking out some up and down readings , I do find new sensors take time to settle over a day or so.

But yes I will stop doing it unless I have good reason, I agree with you. I've self referred for counselling now so should hopefully hear something back shortly xx

 

[rebrascora]

The other week my right said I was 3.8 but my left said 5.2!! So do I treat a hypo or not based on that?

Did you feel hypo?
If the first reading was a 3.8 then yes, treat it. If I had tested twice and got both those readings I might have just had 5g or 10g carbs rather than the full 15g and checked 15 mins later. If you had got the 5.2 first and not tested again then obviously you wouldn't have taken a hypo treatment but if you were actually going hypo then you might have felt it shortly afterwards and tested or scanned again.
Am I correct in thinking you have a Libre as well as doing finger pricks, since you mention "sensor" in your first post? It sounds like you are expecting more accuracy from your testing kit than it is capable and as @Inka suggests, a break from the Libre might be worth considering if you are getting stressed by the info. 40 years ago people used to have to wait until they had a wee, get a sample, boil it up in a test tube with a reagent to find out if they were high or low, by which time they were probably 3-4 hours from that reading actually being relevant.... and there are people on this forum who managed their diabetes like that and not only survived but thrived, so try not to get too uptight about the information you are getting from your technology and just use it as a rough guide in combination with listening to your body. I do sometimes wonder if we start to reply to heavily on the wonderful kit we have, if we will lose the ability to detect hypos just because we are too busy looking at the display to check with our other senses, if that makes sense.
I know on the odd occasion that I have been without a Libre sensor overnight I have felt really vulnerable which is stupid because I managed just fine before I got it, but we do perhaps put too much onus on it sometimes.

 

[SianyBee]

Did you feel hypo?
If the first reading was a 3.8 then yes, treat it. If I had tested twice and got both those readings I might have just had 5g or 10g carbs rather than the full 15g and checked 15 mins later. If you had got the 5.2 first and not tested again then obviously you wouldn't have taken a hypo treatment but if you were actually going hypo then you might have felt it shortly afterwards and tested or scanned again.
Am I correct in thinking you have a Libre as well as doing finger pricks, since you mention "sensor" in your first post? It sounds like you are expecting more accuracy from your testing kit than it is capable and as @Inka suggests, a break from the Libre might be worth considering if you are getting stressed by the info. 40 years ago people used to have to wait until they had a wee, get a sample, boil it up in a test tube with a reagent to find out if they were high or low, by which time they were probably 3-4 hours from that reading actually being relevant.... and there are people on this forum who managed their diabetes like that and not only survived but thrived, so try not to get too uptight about the information you are getting from your technology and just use it as a rough guide in combination with listening to your body. I do sometimes wonder if we start to reply to heavily on the wonderful kit we have, if we will lose the ability to detect hypos just because we are too busy looking at the display to check with our other senses, if that makes sense.
I know on the odd occasion that I have been without a Libre sensor overnight I have felt really vulnerable which is stupid because I managed just fine before I got it, but we do perhaps put too much onus on it sometimes.

I don't tend to get many hypo feelings at 3.8 so wasn't sure really, so maybe I was at 5.2 ,I just ate a sweet and a biscuit and carried on.

The lowest I've had a hypo at is 3.3 and always whilst walking, I feel them sometimes but others not so much. I tend to notice them more if I am sedentary but they are nothing like I expected, more of a sinking feeling like something inside me is dropping. Yet I've had one hypo where I was 3.9 and felt really shaky And confused. They all vary so much. I was terrified of night hypos which is why I was given a libre early on. It has really helped with that anxiety and shown me that I never drop over night. I stay super steady apart from one time after I was diagnosed, I have an apple with peanut butter every night before bed and it seems to work a treat. So yeah I think I do rely on the libre for peace of mind and would feel lost without it especially on long hikes as it is fab for notifying me of impending lows. It's also given me confidence with bolus adjusting for my hikes so I now know to take half the insulin or even none if I am under 6 🙂

 

[everydayupsanddowns]

Sorry that the limitations of the technology are stressing you out @SianyBee - and I agree that it’s really not helpful to have results that are different enough to prompt a different response.

For all the illusion of decimal point accuracy, BG meters and sensors are only really providing ‘ish’ measurements of a value which is constantly rising and falling. The handbooks always say to recheck if any result doesn’t match how you are feeling,

I just had a quick look for an animation/gif I’ve seen on the past which shows about half a dozen, maybe 10, identical meters lined up and all drawing samples from the same droplet of blood, and all giving slightly (or significantly!) different results, but unfortunately I couldn’t find it.

Some meters certainly seem more variable than others. I’m not sure which brand you are using, and whether you self-fund, but you might look into a different meter such as one of the Contour Next ones that uses their XT strips or a Roche Accu Chek whichboth have a good reputation.

The consistent difference from arm to arm is a weird one, and I have no explanation that that except that blood is not entirely homogenous, and I suppose that different bits of blood flowing in different locations may have different concentrations of any number of factors (oxygen, blood glucose, cholesterol, iron, etc etc).

Maybe just pick the arm that most seems to reflect how you feel and stick with that one?

 

[rebrascora]

I am guessing it is normal to feel hypos differently at different times and under different circumstances. Like you, some I hardly feel anything or get into the low 3s before I am aware and other times I can feel them coming at 4.3. The rate your levels are dropping may have something to do with it, but it is rarely consistent. I have found that my hypos symptoms have totally changed too, so I used to notice my peripheral vision going blurry initially and maybe tingling lips but it is a while since I had those signs. Sometimes I get that sinking feeling you describe or a feeling of very mild indigestion or my head/hearing feeling woolly like my head is isolated from my surroundings. I tend to only get the heart pounding, sweating signs about 10 mins after I have treated a bad one and yet at the time of treating it, I may not have felt bad at all.

 

[Leadinglights]

The outward symptoms visible to an observer do seem very different between people. One colleague began to get very jerky movements in the arms which progressed into the whole body becoming jerky whereas somebody else suddenly would lose concentration and start slurring words fortunately in that case they managed to say they were diabetic and I found glucose tablets in their bag. You could easily see how in both cases it could be misinterpreted as them being drunk.

I looked after a diabetic dog for a couple of weeks and the timing of her eating food and the amount of exercise was very critical, I was instructed to give her honey if she was hypo which did happen on a few occasions, she started to be confused and staggery.

 

[Inka]

Thankyou. To be fair I've only done the multiple tests on these three occasions. The first time as my sensor alerted me to a hypo but I felt fine, the second as I thought it seemed too high and this morning as a pure experiment and also as my libre was chucking out some up and down readings , I do find new sensors take time to settle over a day or so.

But yes I will stop doing it unless I have good reason, I agree with you. I've self referred for counselling now so should hopefully hear something back shortly xx

I hope I didn’t sound like I was criticising you @SianyBee I spoke out of experience. It’s very easy to torture yourself and obsess and worry when you have any medical condition, and I find diabetes a particularly aggravating one because in a way you can’t ever have a break because you have to eat obviously so are forced to think about your diabetes numerous times a day, which is bad enough in and of itself.

I found the first year or two of Type 1 very hard emotionally, and the only real answer is to get yourself into a way of thinking and a safe headspace where you can step outside any anxieties and live your life while controlling the diabetes but not letting it be your master or take over the focus of your life.

Your diabetes lives with you, you don’t live with it. It’s an annoying passenger not the driver. X

 

[Docb]

Hi @SianyBee. The other week I did all ten fingers in rapid succession one morning just to see what the variability was because we see a lot of people who get anxious about repeat tests not being the same. What I got was a variation in reading from a minimum of 4.2 to a maximum of 5.6 with all values in between.

I reported it here..

What's in a number?

We have a lot of members, particularly those new to testing, asking about blood test results and what they mean or what is a "good" number. As many of you are aware I like numbers, mostly because they are what they are and do not have any opinion. This morning, I woke up, got out of bed, did a...

forum.diabetes.org.uk

What you are seeing is what you might expect from multiple tests. The blood is not homogeneous, and its composition will vary as it travels around the body and what number you get will depend on the journey that particular drop of blood has taken in its travels. I've decided that I will only ever report blood results to the nearest whole number (the decimal point is meaningless) and accept that whatever number I get it could easily have been one lower or one higher. So if my meter says 5.7, I read that as a 6, but it could equally easily have been 5 or 7.

So to take the numbers in your first post. The 5.4, I read as 5, which means probably somewhere between 4 and 6. Similarly, the 7.4 is somewhere between 6 and 8 and the 8.4 is somewhere between 7 and 9. In reality the difference between those two readings is not significant. The difference between your first reading (5) and the second readings (7 and 8) is probably real and likely due to something you have done but it is so small you need not react to it.

The way I look at it is that T2's should be only be reacting to blood glucose readings if you are consistently in double figures or more importantly, if the reading is very different to what you might expect, and by very different I would say more than three units. For us the best use for a blood glucose monitor is weeding out foodstuffs which give big rises in blood glucose so we can avoid them.

For non T2's using blood glucose monitoring to work out insulin doses, it's much harder and from what I can see, it takes experience to get a perspective on how to react to readings. In the first instance I would suggest that you treat the readings you get from your meter are a very good guide to where your blood glucose is at (and a damn sight better than the alternatives) but you have got to remember it is a guide. As time goes on, you will get better at interpreting your readings and will know what to react to and what to ignore.

 

[SianyBee]

I hope I didn’t sound like I was criticising you @SianyBee I spoke out of experience. It’s very easy to torture yourself and obsess and worry when you have any medical condition, and I find diabetes a particularly aggravating one because in a way you can’t ever have a break because you have to eat obviously so are forced to think about your diabetes numerous times a day, which is bad enough in and of itself.

I found the first year or two of Type 1 very hard emotionally, and the only real answer is to get yourself into a way of thinking and a safe headspace where you can step outside any anxieties and live your life while controlling the diabetes but not letting it be your master or take over the focus of your life.

Your diabetes lives with you, you don’t live with it. It’s an annoying passenger not the driver. X

No you didn't, not at all, I'm very grateful for everyone's advice and comments 🙂 I'm glad I came on here this week with a few posts, it helps ease the frustration by seeing I'm not alone and that it is such an unpredictable beast for everyone.

You are spot on, I'm not in the driving seat atm, I'm clinging onto the back exhaust being dragged along as diabetes is at the wheel. I'm doing pretty great with my control 80% of the time but mentally I'm struggling as you know already. I need to accept my new normal and adjust to all the stress that comes with it and hopefully over time I will do .

I'm just getting frustrated by the constant curve balls, e.g. the last two period cycles I've always gone lower and needed less insulin but this time I've been soaring the heights. Kinda hoped there would be patterns to it all so I could stay on top of it but it is very much a reactive process rather than proactive . Which isn't the way my brain usually works and likes haha.

 

[SianyBee]

Thank you to everyone for your comments, wanted to reply individually but just on lunch and work got busy today. X

 

[Peely66]

In 31 years I've never even thought to test different fingers! I'm still here despite that.