Readings Query

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Duane Charles

Duane Charles

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It was suggested that I start monitoring my BG before meals and 2 hours after. This is what happened today and was wondering if this is 1 normal and 2 classes as erratic?
Pre-breakfast 14.4
2 hours after 10.6
Pre-evening meal 8.1
2 hours after 12.2
I realise it may also just be food related and therefore need to look at what I’ve eaten. Breakfast was porridge and this evening was some pasta/sauce with meatballs. I have only had 500ml water during the day, which is good for me. I will continue to monitor although the rest of the week may be difficult because of my working pattern. I’m open to suggestions, should I be avoiding pastas etc.? Please also bear in mind that my “vegetable” diet is very limited.
 
As you are quite early in your diagnosis and your HbA1C is quite high then the readings you are getting are indicative of that in that your fasting reading which I take as the 14.4 is high, once people start to be making changes that reading should be starting to come down towards less than 7. I do wonder however if it was an erroneous reading as then you report 10.6 as being 2 hours after a high carb breakfast.
Pre dinner is still high but consistent with your level still being high, again the aim there is to be 4-7 before meals.
Your 2 hour post dinner is showing a greater increase that you really want to see as it is more than the no more than 2-3mmol/l guidance so really pasta is not a good option as it is a high carb food and there is likely quite a few carbs in the sauce, meatballs generally not too bad if they are high meat content. Some cheaper ones are full of cereal so can be high carb. Pasta, rice and potatoes are the foods which are high carb and many do avoid or have only in very small portions, like 1 spoonful rather than a plateful.
They would have more veg with protein (meat, fish or eggs) to fill up.
There are some lower carb pasta based on edamame bean or black bean which are not bad as long as you don't overcook.
These are parameters which would apply if Type 2 and in your situation there may be other factors affecting what as you say do appear rather erratic.
I also thing you need to try and drink more fluid as that will help flush the excess glucose from your system. 500mls per day is barely enough to keep you hydrated and your kidneys functioning well
 
Leadinglights said:
As you are quite early in your diagnosis and your HbA1C is quite high then the readings you are getting are indicative of that in that your fasting reading which I take as the 14.4 is high, once people start to be making changes that reading should be starting to come down towards less than 7. I do wonder however if it was an erroneous reading as then you report 10.6 as being 2 hours after a high carb breakfast.
Pre dinner is still high but consistent with your level still being high, again the aim there is to be 4-7 before meals.
Your 2 hour post dinner is showing a greater increase that you really want to see as it is more than the no more than 2-3mmol/l guidance so really pasta is not a good option as it is a high carb food and there is likely quite a few carbs in the sauce, meatballs generally not too bad if they are high meat content. Some cheaper ones are full of cereal so can be high carb. Pasta, rice and potatoes are the foods which are high carb and many do avoid or have only in very small portions, like 1 spoonful rather than a plateful.
They would have more veg with protein (meat, fish or eggs) to fill up.
There are some lower carb pasta based on edamame bean or black bean which are not bad as long as you don't overcook.
These are parameters which would apply if Type 2 and in your situation there may be other factors affecting what as you say do appear rather erratic.
I also thing you need to try and drink more fluid as that will help flush the excess glucose from your system. 500mls per day is barely enough to keep you hydrated and your kidneys functioning well
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The 14.4 reading was the fasting read taken around 07:30 yesterday (Tuesday). I didn’t have anything to eat between the middle two readings. The only other intake was a bottle of water and a cup of black coffee when I got home from work. This mornings pre-breakfast reading was 13.7 and I’ll be testing again at 11:15. Should I be taking readings at roughly the same time each day?
 
Duane62 said:
The 14.4 reading was the fasting read taken around 07:30 yesterday (Tuesday). I didn’t have anything to eat between the middle two readings. The only other intake was a bottle of water and a cup of black coffee when I got home from work. This mornings pre-breakfast reading was 13.7 and I’ll be testing again at 11:15. Should I be taking readings at roughly the same time each day?
Click to expand...
I don't think that matters as such but a fasting reading is usually as soon as you wake up, some people find actually in bed is more consistent and then before you eat and after 2 hours whatever time that is as it will indicate the effect your meal is having on blood glucose. for that paired readings are much more informative.
Not eating for many hours, equivalent to fasting may give a higher result as your liver may start to release glucose to give you energy to function.
It is worth testing if you feel unwell.
 
Eating whilst at work is a bit of a problem, firstly it’s a fast food takeaway and secondly it’s very busy and as part of the management team need to be available to throughout the shift. I previously mentioned that I seem to be predominately doing “close” shifts and will leave work around midnight or later, not an ideal time for having a full meal as the last thing eaten might have seen several hours before. I will be talking to the store manager and his boss about D and seeing what things can be put in place to assist me.
 
I think I need to check my monitor out as BG reading 2 hours after eating the same breakfast as yesterday has gone up to 17.9. The only difference today is that I haven’t got up yet (I know, bloody lazy).
 
Duane62 said:
I think I need to check my monitor out as BG reading 2 hours after eating the same breakfast as yesterday has gone up to 17.9. The only difference today is that I haven’t got up yet (I know, bloody lazy).
Click to expand...
But what was it before, you are looking for the difference between a before eating and 2 hours after rather than absolutes when you are checking out food. Don't forget you are having something very high carb and if you are not even moving about then your body is not using up much energy.
How much porridge did you have and what type of oats were they?
Also make sure you have washed your hands before pricking your finger as any slight residue could give a falsely high reading.
 
Hi again @Duane62,

I haven't had time to read all of this throughly and you are getting feedback from @Leadinglights who is T2, understands the vagarities of T2 (which I am not familiar with) and has been offering great help to many on this forum for a long time.

My instant reaction was:
That the 1st readings of 14.4 then 10.6 were too high but definitely showing the correct trend - but were they right?
Then I immediately thought the 2nd pr of readings were not very good for your health but they told me that your body hadn't coped; I'd assumed from your other threads that the 8.1 and then 12.2 were not based on your midnight meal at the end of a long shift - so that day was a different routine to others.
My next preliminary thought was "more readings are needed". The 2 sets so far aren't even representative of your normal days

What I suggest is for the next few days change very little. More data is needed to see if there is repetition or clear trends over, say, 7 days. Pasta is not necessarily a good meal choice, without being on an insulin regime; but for now just go with what you normally do because you not only want to achieve a lowering of your BG long term but you need the fuller data to assist your T2 or T3c question. If the starting data is from different circumstances (ie after you've made distinct changes) then you might spend another 2+ years trying to establish if you are correctly diagnosed.

By all means have the conversation with your bosses about improving your working conditions for your health and if that brings a fairly immediate change in your meal frequency and timings then go with those changes, because they will almost certainly be better for you both now and in the long term. But I'm tempted to say deliberately eat pasta once or twice more this week to clarify if that 1st 2 prs of readings were out of the ordinary or just the first showing that wider trend.

I'll read back more slowly later - hopefully this evening.
 
Proud to be erratic said:
Hi again @Duane62,

I haven't had time to read all of this throughly and you are getting feedback from @Leadinglights who is T2, understands the vagarities of T2 (which I am not familiar with) and has been offering great help to many on this forum for a long time.

My instant reaction was:
That the 1st readings of 14.4 then 10.6 were too high but definitely showing the correct trend - but were they right?
Then I immediately thought the 2nd pr of readings were not very good for your health but they told me that your body hadn't coped; I'd assumed from your other threads that the 8.1 and then 12.2 were not based on your midnight meal at the end of a long shift - so that day was a different routine to others.
My next preliminary thought was "more readings are needed". The 2 sets so far aren't even representative of your normal days

What I suggest is for the next few days change very little. More data is needed to see if there is repetition or clear trends over, say, 7 days. Pasta is not necessarily a good meal choice, without being on an insulin regime; but for now just go with what you normally do because you not only want to achieve a lowering of your BG long term but you need the fuller data to assist your T2 or T3c question. If the starting data is from different circumstances (ie after you've made distinct changes) then you might spend another 2+ years trying to establish if you are correctly diagnosed.

By all means have the conversation with your bosses about improving your working conditions for your health and if that brings a fairly immediate change in your meal frequency and timings then go with those changes, because they will almost certainly be better for you both now and in the long term. But I'm tempted to say deliberately eat pasta once or twice more this week to clarify if that 1st 2 prs of readings were out of the ordinary or just the first showing that wider trend.

I'll read back more slowly later - hopefully this evening.
Click to expand...
Yesterday was slightly different for me in that I started work at 10:00 and finished about 19:00. The pre-evening meal reading was taken at about 20:20 with the after taken 2 hours later. Today is a “normal” day in the sense of work with breakfast around 09:00 and my evening meal being after midnight once I’m home. I’m now taking all my D meds in the morning after my breakfast as suggested by the DN
 
Can I also say I’m extremely thankful to everyone who has taken the time to respond to my questions, not just on this topic but everything. Yes, it seems a minefield with probably more questions than answers. Until I get a definitive answer on which variant of D I have everything is going to be trial and error.
 
I have just (on a whim) after changing the batteries in both of my BGM’s and checking the dates on the strips decided to test myself. The results were:
  • Accu-Chek Aviva 7.0mmol
  • Kinetik 11.1mmol
I have been using the Kinetik for the tests I have carried out so far, but which monitor should I take as being more accurate?
 
Slightly tricky. Shortly after my hospital discharge as a T3c I ened up with 3 meters - each giving different readings. I went back to basics, scrupulously washed my hands, dried on fresh kitchen roll and got down to 2 very close one different. I had a Surgery app't with the Nurse there and compared my differing 2 with the Practice BG test meter - back to 3 three sets of readings!

There are several posts on this forum about the relative accuracies of meters (and CGMs which doesn't affect you). @Docb, who has a background in this sort of stuff advocates ignore the decimal point and just round any reading up or down to the nearest whole number; personally that fits my ethos - the decimal point is disproportionately accurate in relation to what we need to know and what we do with the knowledge. But that rounding up or down to whole nos doesn't answer your challenge: 7 or 11?

Accuchek sent me a test solution after I phoned, because my 2 Accuchek Mobile meters were different by 2. When I took fresh results from different fingers that difference disappeared! But by then I was using fresh cartridges (equivalent of test strips) in both devices. So nothing really learnt. Do Kinetic have test solutions to check accuracy with? Can you get an independent comparison with your Surgery's meter (or A&E - but that's a pretty tedious task)? Is there a local D group near to you, try Facebook?
 
Proud to be erratic said:
Slightly tricky. Shortly after my hospital discharge as a T3c I ened up with 3 meters - each giving different readings. I went back to basics, scrupulously washed my hands, dried on fresh kitchen roll and got down to 2 very close one different. I had a Surgery app't with the Nurse there and compared my differing 2 with the Practice BG test meter - back to 3 three sets of readings!

There are several posts on this forum about the relative accuracies of meters (and CGMs which doesn't affect you). @Docb, who has a background in this sort of stuff advocates ignore the decimal point and just round any reading up or down to the nearest whole number; personally that fits my ethos - the decimal point is disproportionately accurate in relation to what we need to know and what we do with the knowledge. But that rounding up or down to whole nos doesn't answer your challenge: 7 or 11?

Accuchek sent me a test solution after I phoned, because my 2 Accuchek Mobile meters were different by 2. When I took fresh results from different fingers that difference disappeared! But by then I was using fresh cartridges (equivalent of test strips) in both devices. So nothing really learnt. Do Kinetic have test solutions to check accuracy with? Can you get an independent comparison with your Surgery's meter (or A&E - but that's a pretty tedious task)? Is there a local D group near to you, try Facebook?
Click to expand...
I’m not a fan of Facebook or whatever form it takes these days. Forums are about as far as my social media contact goes. I’m still looking for local D groups. I could ask my OH to look as they’re on there.
 
Duane62 said:
I’m not a fan of Facebook or whatever form it takes these days. Forums are about as far as my social media contact goes. I’m still looking for local D groups. I could ask my OH to look as they’re on there.
Click to expand...
I get that. I joined FB almost 3 yrs ago and felt deluged by people wanting to be my friend and FB inviting me to join other Groups that had no relevance to me. I haven't deleted that app but its definitely ignored and not used!

Could here be anything on you tube about verifying meter accuracy?
 
I just wanted to update with yesterday’s readings as they were a bit up and down. The readings were:
  • Pre-breakfast 14.4
  • Two hours after 17.9
  • At about 15:00 I did test again using both monitors. One gave a reading of 7 the other 11
  • Pre evening meal (midnight) 6.9
  • Two hours after 17.9
  • This morning on waking 9.1
For all the pre and after readings I am using the same monitor, so as to ensure I’m keeping an accurate record. Apart from some water, nothing passed my lips between meals.
 
Proud to be erratic said:
I get that. I joined FB almost 3 yrs ago and felt deluged by people wanting to be my friend and FB inviting me to join other Groups that had no relevance to me. I haven't deleted that app but its definitely ignored and not used!

Could here be anything on you tube about verifying meter accuracy?
Click to expand...
I’m not at work until 5 today, so that will keep me occupied for a while, thank you.
 
Proud to be erratic said:
Slightly tricky. Shortly after my hospital discharge as a T3c I ened up with 3 meters - each giving different readings. I went back to basics, scrupulously washed my hands, dried on fresh kitchen roll and got down to 2 very close one different. I had a Surgery app't with the Nurse there and compared my differing 2 with the Practice BG test meter - back to 3 three sets of readings!

There are several posts on this forum about the relative accuracies of meters (and CGMs which doesn't affect you). @Docb, who has a background in this sort of stuff advocates ignore the decimal point and just round any reading up or down to the nearest whole number; personally that fits my ethos - the decimal point is disproportionately accurate in relation to what we need to know and what we do with the knowledge. But that rounding up or down to whole nos doesn't answer your challenge: 7 or 11?

Accuchek sent me a test solution after I phoned, because my 2 Accuchek Mobile meters were different by 2. When I took fresh results from different fingers that difference disappeared! But by then I was using fresh cartridges (equivalent of test strips) in both devices. So nothing really learnt. Do Kinetic have test solutions to check accuracy with? Can you get an independent comparison with your Surgery's meter (or A&E - but that's a pretty tedious task)? Is there a local D group near to you, try Facebook?
Click to expand...
With regard to your question about getting an independent reading, I don’t think my surgery will help as they keep telling me I don’t need to test as Metformin and Alogliptin aren’t hypo causing medications. I guess I could try a local pharmacy and see what they say.
 
Duane62 said:
I just wanted to update with yesterday’s readings as they were a bit up and down. The readings were:
  • Pre-breakfast 14.4
  • Two hours after 17.9
  • At about 15:00 I did test again using both monitors. One gave a reading of 7 the other 11
  • Pre evening meal (midnight) 6.9
  • Two hours after 17.9
  • This morning on waking 9.1
For all the pre and after readings I am using the same monitor, so as to ensure I’m keeping an accurate record. Apart from some water, nothing passed my lips between meals.
Click to expand...
The 3rd pr (pre meal at midnight 6.9 and +2hrs 17.9) are not good news; meds seemingly not working. But I don't know how long Metformin takes to build up in your body and then start to help. I do know its not an instantaneous med. Likewise about Alorgliptin I think.

But getting from 7 at midnight to 9 on waking suggests some insulin is getting through and working - just not enough. But overcoming that high of 18 during the night is a tough call. ( all nos rounded for now).

Needs more data for trend scrutiny over a few days. Also what, for completeness, was your midnight meal? Anything in there that could have specifically triggered that huge spike?

Have you heard about the Dawn Phenomenon or Foot on the Floor effects? It is possible that one or even both could affect your waking reading. Some people take the first test while still in bed in the hope that neither DP nor FOTF can start interfering. Both of which can cause distinct raising of BG on waking because your liver helpfully (?, ! ) opens its glucose store to give you a surge of energy for the coming day. Once that glucose release is in your blood then it can only be moved on by your home produced insulin. If your insulin isn't there or is there but your natural resistance to insulin is too great then that excess (and unwanted!) glucose sticks around.

Still needs a few days of data, in my opinion. I seem to remember your Surgery told you that you weren't erratic enough to warrant considering T3c, but could start you on insulin. If I've recalled that correctly it still sits uncomfortably with me as illogical. You could have very steady and consistent high readings (ie not erratic) but that wouldn't clarify if those high readings were because your damaged panc'y can't keep up and produce enough natural insulin or because you are T2 and your body is resisting your insulin. You might want to keep this last comment as part of your 7 Dec discussion with your GP.
 
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