Tired of finger pricks

[Lucyr]

im not always hypo aware i am 95% of the time but every so often i get the sneaky one that creeps up on me

How many times in the last 2 weeks say, have you felt fine and either the waking fingerprick or the nurses fingerprick, showed you to be hypo?

 

[Satan’s little helper]

Long acting insulin takes hours to start working, it’s fine to take it so long as you’re treating the hypo. If you’ve tested on waking not hypo, and not taken any insulin, and don’t feel hypo, then you’re unlikely to suddenly be hypo at 8:45 when the nurse gives you your basal. If you delay the basal, you may end up going too high as there will be a gap in insulin coverage as well as the hypo treatment. Obviously you don’t take rapid acting when low as that works quicker but Gail isn’t on a rapid acting.

I’m more deeply confused by your response on clarification. I don’t have a nurse administering my basal. I also take mine before bed. The difference is nominal if I happen to go low treat with an appropriate amount of carbs to nudge BGs back up & give “it” an hour before I inject.

 

[Lucyr]

I’m more deeply confused by your response on clarification. I don’t have a nurse administering my basal. I also take mine before bed. The difference is nominal if I happen to go low treat with an appropriate amount of carbs to nudge BGs back up & give “it” an hour before I inject.

Gail has a nurse administering her basal and it’s her thread not yours so our responses need to be relevant to Gail’s situation and what you do eg taking it before bed not in the morning isn’t really relevant

 

[CliffH]

You don’t need both a waking test and a pre insulin test given the insulin dose is not adjusted based on the result. So could drop one or both of those

The night one depends, if you ever need to eat something based on the result (ie not hypo but lower than you want before bed) then you might want to keep that one.

I agree: I'd be inclined to just keep the "waking" one (as a 'fasting' reading) and possibly the night-time one. If the nurse doesn't trust Gail to take her own waking reading, though, that's a different conversation.

 

[Lucyr]

I agree: I'd be inclined to just keep the "waking" one (as a 'fasting' reading) and possibly the night-time one. If the nurse doesn't trust Gail to take her own waking reading, though, that's a different conversation.

I’d probably keep the nurses one and drop the waking one, just as the easiest path, but since Gail said it’s needed to check if hypo that’s why I suggested checking how many asymptomatic hypos it’s actually picking up first.

 

[CliffH]

i need the morning one to testthat im not hypo the nurse one nurse insists on testing to cheak my levels are not to low to admister insulin

In that case I suggest dumping your own "waking" test - assuming that you're not eating anything between that test and the nurse's test?

 

[CliffH]

Sorry? Can you elaborate? If I was low/hypo, I would never administer any insulin until my BGs had been brought back to a stable condition. Even my basal can sometimes cause a low after it’s meant to be or has tailed off?

I wouldn't give myself any insulin if I were even close to hypo: I'd either omit it completely or wait until my blood sugar was normal again.

However, this raises the possibility, @Gail, that you need to discuss with your team whether or not you're on too much insulin anyway, if you sometimes (as a Type 2?) have hypos.

 

[Satan’s little helper]

Gail has a nurse administering her basal and it’s her thread not yours so our responses need to be relevant to Gail’s situation and what you do eg taking it before bed not in the morning isn’t really relevant

What is relevant is taking insulin whilst having or recovering from a hypo is dangerous advice. The OP has initially asked if there phone is compatible with a sensor. This is not your platform either.

 

[CliffH]

Long acting insulin takes hours to start working, it’s fine to take it so long as you’re treating the hypo. If you’ve tested on waking not hypo, and not taken any insulin, and don’t feel hypo, then you’re unlikely to suddenly be hypo at 8:45 when the nurse gives you your basal. If you delay the basal, you may end up going too high as there will be a gap in insulin coverage as well as the hypo treatment. Obviously you don’t take rapid acting when low as that works quicker but Gail isn’t on a rapid acting.

@gail2, is the nurse fully aware of all the detail of diabetes, insulin and hypos? Remember the Mental Capacity Act: the nurse can't insist on doing anything (including fingerpricks) without your informed consent!

 

[CliffH]

I’d probably keep the nurses one and drop the waking one, just as the easiest path, but since Gail said it’s needed to check if hypo that’s why I suggested checking how many asymptomatic hypos it’s actually picking up first.

I agree: it needs unpicking.

 

[helli]

As with many threads, this one has taken itself on a wiggly journey.
It started with the question about reducing finger pricks with alternatives such as a watch (seems to be agreement that this is a bad idea as there is little/no evidence that this works) or a CGM (a more costly approach bit one many of us follow).
@Lucyr posed the interesting question about whether finger pricks could be reduced which has taken us into a different realm which I think is about merging two or removing one test a day.
I have always tried to have a purpose to my testing rather than to write it down in a book/file/app. This could be to track progress, check I am ok (not hypo or hyper) and to calculate/adjust medication (insulin) dose. To my understanding, the latter is more relevant for bolus dosing when carb counting which is not relevant for someone with type 2 using only a basal insulin whereas the tracking progress test can be useful for adjusting basal insulin.

Reading back through the tread, I haven't seen anyone ask why @gail2 wants to reduce finger pricks and whether reduction of one test would help.
Is it "just" the inconvenience or do you find it painful? Do you fear the results? Or are you looking to gain more insights from the data without need to increase your finger pricks? Are you looking for a short term solution or something for the foreseeable future?
Maybe it is worthwhile signing up for a Libre trial to see how you find it now you have a smart phone which should be compatible.

Sorry, I have rambled and posed a bunch of questions but it did occur to me that I don't understand why you are tired of finger pricking.

 

[Lucyr]

What is relevant is taking insulin whilst having or recovering from a hypo is dangerous advice.

It’s the nurses decision in Gail’s scenario anyway

 

[Lucyr]

Maybe it is worthwhile signing up for a Libre trial to see how you find it now you have a smart phone which should be compatible.

I’m not sure, a libre sensor is quite expensive when self funding and not adjusting anything based on the results? I understand Gail’s diet is already great given all her weight loss success and no bolus insulin. Once a day insulin doesn’t qualify for any funding. No harm in a trial of course though.

 

[Inka]

It’s the nurses decision in Gail’s scenario anyway

Yes, it’s different for Gail as she’s not the one administering the insulin. I was told not to inject insulin when hypo but that was because of the potential for mistakes. As it happens, I ‘inject’ my basal when hypo - because I use a pump. And that’s fast insulin too. Basal insulin takes a couple of hours or so to get going and then works slowly.

 

[rebrascora]

I am happy to inject basal insulin when hypo if I am hypo when it is due, because it obviously takes time before that insulin will kick in as Lucy rightly says and if I don't inject it then (before I get out of bed on a morning or when I get into bed on a night) I will forget or be asleep.

 

[Merluza]

@helli's questions touch on important points. Moving to a CGM in order to reduce finger pricks probably isn't the best way to go if that's the main or only reason and as @Gail isn't managing her insulin it further reduces the point in using one. Also they may give more information than is needed and just lead to unnecessary upset. I still think that a well organised finger pricking routine, one that works for you, is as good as anything, when I went a week or so having to revert to doing that I was perfectly happy with my control, in fact just as happy as using a CGM.

They take some adjusting to anyway and the first month or so of using them, for me, was a bit difficult as I adjusted to the way it worked and the different approach needed from just finger pricks. When I had ones that weren't working properly I was doing just as many finger pricks as before and sometimes more.

 

[Inka]

In addition @Merluza , I wonder if Libre readings will be ‘accepted’ or if the nurses will still want to fingerprick. It might be the case that they do at the set times.