To test or not to test? That is the question.

[I_am_me]

Hi

I’m a newbie with loads of questions...

So I have read a lot of information over the last few days. My head feels like it wants to explode! I am kind of getting to grips with what I have to do moving forward, but there is a lot of conflicting advice. So I am going to ask this...

Do I invest in a Blood Glucose Meter? Should I be regularly testing to get to grips with my BG levels?

Some say yes, others say no. If I do am I going to be getting obsessed with it, is this a good thing or a bad thing? If it was essential to managing my diabetes then shouldn’t it be available on the NHS? Of course the NHS doesn’t prescribe everything I understand that.

I am happy to purchase the kit and I am thankfully in a position that the costs won’t break the bank (I have already saved loads of cash over the past couple of months by Boris closing down all the coffee shops) But is this essential and if it is then the next mine field is which one? I would prefer to buy one that will last, after all this diabetes is unlikely to be going away anytime soon, unfortunately I suspect it will be around for good! But equally I‘m not rich enough that I want to be ripped off by the price of the strips Etc.

Please help?

Newly diagnosed Type 2
HBA1C = 53

 

[adrian1der]

Hi @I_am_me I use one to keep track of where I am up to and to see the impact of food choices. I test in the morning (approximates a fasting level) and then before and two hours after new dishes. If I have big rises after a meal then I know I can't tolerate the dish. If I'm eating something I've done before and understand then I don't bother monitoring. It is the only way to understand what food you can and can't eat. Hope that helps

 

[Kaylz]

@I_am_me they are available on the NHS but generally not to unmedicated diabetics or metformin treated, those on hypo causing medications do get them, they used to give to some unmedicated or metformin treated but cuts stopped most of that and my MIL had her strips stopped, it would be worth asking if they would though as you may get someone that understands and sympathises xx

 

[Drummer]

The Spirit Healthcare tee 2 is what I got, as the cost seems reasonable - I am told that if you phone up and offer to buy a good quantity of strips they will give you the meter free.
I have seen this 'you'll get obsessed' before - and I can't see how - you test before you start to eat and two hours later. You might check your waking level once in a while, but as you see how various meals affect you, there is no need to keep testing the same foods over and over once you sort out how much of what you can eat.

 

[Docb]

You ask a very good question @I_am_me to which there is no simple answer.

I spent most of my life as an experimental scientist and the one thing in that job you learn very early is that you need to work what you are going to do with information before you start gathering it. Making measurements has to be part of an overall plan, and if you do not have that plan, then there is little value to be gained from making the measurements. If you want a current example of that idea, look at covid testing. The idea is to get people isolated if infectious. Well there is a lot of testing capacity - we hear a lot about that - but all seem to agree that the number of people actually isolating as a result of that capacity is not significant in terms of controlling the virus. Leaves you to wonder why all that money was spent on the testing.

You have also got to understand that measuring blood glucose is not an exact science. It wanders about a lot sometimes for no apparent reason. The measuring instruments are amazing but are nowhere near as accurate as the decimal point on the screen would suggest. It does not help that you are trying to assess the glucose level in your body from a tiny smear of blood taken from somewhere just under the skin at the end of your arm. None of these things worry the likes of me very much because we know from long experience the problems involved with measuring stuff and make allowances automatically.

Those are the negatives.

The positive, and if you are able to work with the negatives it is a big positive, is that it gives you rapid feed back on things you have control over; in particular what you eat. Test before a meal and test again a couple of hours after and your blood glucose will go up. Do it over a few days or weeks and patterns will emerge. You can look at the patterns and see if anything in your diet consistently gives bigger rises than other things. That gives you targets for things to cut and you can check this by testing.

The other positive is that you can keep a track of your average blood glucose over time. In simple terms, if your average is below 8 then you will be below the HbA1c diagnosis limit. If it is in the 6's then you will be below the "pre diabetes" limit.

So for somebody like me, high HbA1c which needed to come down sharpish, a bit of a number nerd who understands measurement error in complex systems it is a no-brainer. Get one and use the feed back to get things under control.

At the other end of the scale it will be of limited value to somebody who is not comfortable with numbers, is a bit haphazard in their experimental technique and as such focus on tiny details rather than looking at the bigger picture. For that person getting a meter might be a source of confusion rather than enlightenment.

Question is, where do you fit into that spectrum?

 

[I_am_me]

You ask a very good question @I_am_me to which there is no simple answer.

I spent most of my life as an experimental scientist and the one thing in that job you learn very early is that you need to work what you are going to do with information before you start gathering it. Making measurements has to be part of an overall plan, and if you do not have that plan, then there is little value to be gained from making the measurements. If you want a current example of that idea, look at covid testing. The idea is to get people isolated if infectious. Well there is a lot of testing capacity - we hear a lot about that - but all seem to agree that the number of people actually isolating as a result of that capacity is not significant in terms of controlling the virus. Leaves you to wonder why all that money was spent on the testing.

You have also got to understand that measuring blood glucose is not an exact science. It wanders about a lot sometimes for no apparent reason. The measuring instruments are amazing but are nowhere near as accurate as the decimal point on the screen would suggest. It does not help that you are trying to assess the glucose level in your body from a tiny smear of blood taken from somewhere just under the skin at the end of your arm. None of these things worry the likes of me very much because we know from long experience the problems involved with measuring stuff and make allowances automatically.

Those are the negatives.

The positive, and if you are able to work with the negatives it is a big positive, is that it gives you rapid feed back on things you have control over; in particular what you eat. Test before a meal and test again a couple of hours after and your blood glucose will go up. Do it over a few days or weeks and patterns will emerge. You can look at the patterns and see if anything in your diet consistently gives bigger rises than other things. That gives you targets for things to cut and you can check this by testing.

The other positive is that you can keep a track of your average blood glucose over time. In simple terms, if your average is below 8 then you will be below the HbA1c diagnosis limit. If it is in the 6's then you will be below the "pre diabetes" limit.

So for somebody like me, high HbA1c which needed to come down sharpish, a bit of a number nerd who understands measurement error in complex systems it is a no-brainer. Get one and use the feed back to get things under control.

At the other end of the scale it will be of limited value to somebody who is not comfortable with numbers, is a bit haphazard in their experimental technique and as such focus on tiny details rather than looking at the bigger picture. For that person getting a meter might be a source of confusion rather than enlightenment.

Question is, where do you fit into that spectrum?

So I love numbers and statistics, working our the mean median and mode of a specific problem to try to understand and solve it. So yes I probably fall into that nerdy category and I am fine with that. I am clearly still getting to grips with my diagnosis and trying to work out if I should be testing and collecting the data on me! Some say yes, some say no. Also what equipment would I need to buy, which is the best value for money (Not necessarily the cheapest) for long term use and data collection etc.

 

[I_am_me]

Some great advice here. So the overall consensus is testing is a good idea to identify foods my body can and those that my body can’t tolerate. But the next dilemma is which one?

 

[Kaylz]

As you seem to already be aware they can be quite expensive to self fund so it depends on what you can afford, the SD Gluco Navii and the Tee 2 that @Drummer mentions are the 2 cheapest we know of to self fund, as a Type 1 I was given an Accu-Chek Aviva that I like but strips are in the £20 odd range for 50, I'm switching to a Contour Next One meter which you can apply for a free one online and strips for those are around £19.99 for a pot of 50 xx

 

[rebrascora]

The 2 meters most recommended on the forum by members who self fund are the SD Gluco Navii or the Spirit Healthcare Tee2. They boith cost about £15 for the basic meter and extra test strips are £8 for each pot of 50. You only get 10 test strips and lancets with the basic kit, so you would need to order at least a couple of extra pots of strips and a bopx of lancets with your meter as you get through quite a lot of test strips in the first few weeks.
There are slightly cheaper meters on the market but one or two p[eople have reported problems with them on the forum but the above two mentioned have been tried and tested and generally work well. Sometimes there are special offers on with the testing strips so you might get them cheaper.

 

[DaveB]

The simple answer is Yes but don't be obsessive about it.

 

[Pine Marten]

I would say, yes, get a meter and test different foods to see what effect they have - you might be surprised! For example, I was very fond of Linda McCartney Deep Dish pies, and early in my testing career I had one with veg for dinner. Before the meal I was 5.something, 2 hours later it had shot up to 12.something! No more pies for me...

I tested a lot in the beginning, but now test very little, unless I try a different food, but I do find that if I don't test for a while I can easily creep back into eating something that I know is not good for me, so testing can certainly keep you on the straight and narrow. My meter is a SD Codefree from Home Health, which has now been superseded by the SD Gluco Navii. A plus point with Home Health is that if you check the 'I am diabetic' bit they take off the VAT 🙂 .

 

[Docb]

So I love numbers and statistics, working our the mean median and mode of a specific problem to try to understand and solve it. So yes I probably fall into that nerdy category and I am fine with that. I am clearly still getting to grips with my diagnosis and trying to work out if I should be testing and collecting the data on me! Some say yes, some say no. Also what equipment would I need to buy, which is the best value for money (Not necessarily the cheapest) for long term use and data collection etc.

That's good so go for it I say. The basic machines are good enough because all you need are the raw data and they all have to conform to the same spec so they will all be equally good at measuring it. I'd rather do the data manipulation myself because then I know what is going on.

I suggest you get a spreadsheet going early on and then you can cut the data anyway which suits your fancy. That's where I started and I've just put together an Access data base which automates all the graph drawing and calculates some basic stats on variability. It was a bit of a shutdown project for me because I had to relearn how to cope with all the Access idiosyncrasies and was more a bit of fun than a necessity. Next thing is to try and work out an algorithm to estimate HbA1c from the spot readings just to see how close I can get!

 

[Ljc]

Go for it but don’t get obsessed by testing.
Just test just before eating then two hours after starting to eat.
Sadly many health professionals will not recommend people test unless they are on medications that can cause hypo’s, IMO this is a cost saving measure that could end up causing diabetic complications.

Once you have learned which foods you can and can’t tolerate, you can cut down on testing, just do some spot checks and when you’re trying something new.

As your not on meds that can cause hypo’s, you don’t need an all singing and dancing meter, the two mentioned above are perfectly good basic meters.

I suggest you get a pot or two more strips than you think you will need to get you through say a month of testing, as most people have a bit of fun initially when trying to persuade enough blood to appear and or get it on the test strip before the meter switches off.
Don’t worry you’ll soon become an expert .

 

[everydayupsanddowns]

With an A1c of 53 you may not need to make very drastic changes to your meal plan... and you could make those based on guesswork - but in yoir shoes I think i would find it helpful to know whether it was bread, or pasta, or rice, or potatoes (or all of them!) which caused the big rises.

Checking with a BG meter allows you to find the happy surprises - foods which have a reputation for BG spikes, but which your metabolism and gut biome are absolutely fine with.

Conversely it also allows you to check any foods which have a ‘slow release’ reputation to see if they behave as if you were eating jam. (I’m looking at you porridge!)

Either way a small amount of information gathering can be hugely helpful.

And of you find you are testing repeatedly and not taking any action, or are feeling weighed down by it - you can stop 🙂