What's the point of finger prick tests?

[Quokkagirl]

The point of doing it is that if you record your readings every day, eg in a spreadsheet, then as you build up the number of readings you can insert a graph with a trend line that will show whether your levels are rising, falling or flat, otherwise you're dependent on your next HbA1c without any idea of how you've been doing in the meantime.

I understand that fully. I can see the point of that, but if I start the day with a high reading, what am I supposed to do with that information on that day? Do I spend my day trying to bring down those numbers somehow? By doing what? Diabetes is a 'big picture' disease, I feel, not an hourly disease but the day to day management is the key to getting the better big picture. I'm just wondering how to react when I start the day high.

 

[Quokkagirl]

I can’t tell you the last time I checked my BG. I find it a pointless exercise, in my own case. However if I was on any meds that could cause a hypo, I would be checking all the time.

I have no idea what Metformin is doing in my body, no-one has ever told me what is supposed to happen!

Your story sounds like mine. I've had every diabetic medicine known to man - all of which has helped to mess up my gut. I'm now threatened with insulin. I hate the obsessing with numbers and not knowing what I'm supposed to do with the information when I get it other than the standard lose weight/exercise more routine. It's a relentless drag.

 

[Inka]

Thank you. Yes, I take Metformin and Gliclazide. My HbA1c tests are up and down - sometimes very encouraging and sometimes a disaster with no apparent change in my every day eating and living patterns.

That must be very frustrating. To my mind, that’s even more reason to test - so you can try to see where these annoying highs that push your HbA1C up are happening. That will allow you to try to address them.

You mentioned stomach problems. Perhaps you’re absorbing your food erratically and that’s contributing to the highs?

 

[gll]

Thank you. I've never considered testing before I get up...could you explain why it might be enlightening please? To be fair, I've had little advice on the daily monitoring.

Our bodies sometimes "help" us when we get up by dumping glucose into our systems to help prep us for going out to hunt for food (our bodies never got the message that we don't actually hunt for food anymore but wander to the fridge).
It is often called "foot on floor".
Checking before getting up can give you a much more accurate reading of how overnight has been.
There is also another "helpful" thing that sometimes happens called dawn phenomenon that does about the same but during the hours before waking.
BG is weird

 

[Leadinglights]

If you start to keep your daily increases from the meals you eat to no more than 2-3mmol/l then you should find your morning readings will start to go down as you are not overloading your body with too much carbohydrate. You can then aim at your 2 hour post meal readings to be no more than 8.5mol/l.
You should then find your morning readings will start to be below 7mmol/l.

 

[Amity Island]

Thank you. I've never considered testing before I get up...could you explain why it might be enlightening please? To be fair, I've had little advice on the daily monitoring.

Many people (diabetic or not) get a rise just before getting out of bed in the morning. It's known as dawn phenomenon. It's the body getting ready for the day, releasing some extra glucose. Those who are type 1 sometimes add in extra insulin in the early hours to offset this rise.
So if you are 9 when awake, you could quite possibly be less than that during the night which is a good outcome.

 

[Deleted member 21371]

I am supposed to have a liquid diet due to liver problems but Slimfast shoots me into double figures which scares me. I've stopped measuring as I don't know what to do about it, maybe change to Exante? Ignorance is bliss but also stupid. I do feel we need to measure and know what's what.

There are only around 20g of carbs in a standard shake?
Have you thought of testing before the two hours and again after to get a picture of what sort of spike you are getting before and after the two hours?
There is a lot of difference between a spike the may just be hitting when you test and a longer one.

 

[Glen More]

Hi all,
Diabetes management is the key buzzphrase and part of that is taking finger prick tests. To be truthful, I've never worked out the purpose. It gives you a snapshot in time - e.g. if it's high when you get up in the morning (mine is usually around 9) what are you supposed to do about that? I'm not sure how they can help you manage the condition if you're on the high side. I can see their value for low readings, but I don't know what I'm supposed to take from the regular raised readings - other that the usual exercise, diet stuff.
And another question if I may - people talk a lot about certain foods causing raised levels and this being different in individuals. How the heck do you find that out, considering most people eat a combination of foods at meals.

Some of you seem so sorted - how do you do it? It's all still a mystery to me - more like black magic than science and it's beating me.

Hi Quokka
I was diagnosed as Type 2 last October and did the finger prick test 2hrs after every meal up to Christmas as an aid to help me re-adjust my diet. This was useful but it was clear that the test just after I got up and before breakfast (fasting reading) was the best guide to how I was managing my diabetes. I still do these fasting readings and keep a record of them on a spreadsheet. Over Christmas with the eating indulgencies these readings were generally around 9 but with a return to my adjusted diet slowly crept down to where I would expect them to be which is 6.0 to 7.5. I have since had spikes to around 9.0 which do not seem to tie in with my meals the day before. A couple of times I have repeated a high test result and it fell back into what I expect it to be. I have also noted that some high results occur when I am very tired as well. So the message here is that the finger prick test is not an accurate value but a guide as to how well you are managing your diabetes. For the reasons I have just given I average the last 7 day results on the spreadsheet as this gives me a better trend picture. I can foresee that after I have used this data to understand my diabetes management and in conjunction with my Ha1bc results that eventually I can stop the daily fasting test and just do it periodically.

My adjusted diet does not cut out any food types but just readjusts the amounts of which types of food I eat. I also do a lot of vigorous walking as well and as a consequence of both of these have lost a lot of weight.

It is not an absolute necessity to do the finger prick test if you are only on metformin but I would recommend that you do, at the very least, the first thing in the morning fasting test to help as a guide to how you are managing your diabetes. Each person will give different advice and only you can decide on what you think will work best for you.

I am also assuming that from your name on this site that you have been to Rotnest Island 🙂 Lovely place.

 

[Quokkagirl]

That must be very frustrating. To my mind, that’s even more reason to test - so you can try to see where these annoying highs that push your HbA1C up are happening. That will allow you to try to address them.

You mentioned stomach problems. Perhaps you’re absorbing your food erratically and that’s contributing to the highs?

I strongly suspect you're right, thank you. The gastric problems are under review and I have the opportunity to discuss this when I next see the consultant

 

[Quokkagirl]

Hi Quokka
I was diagnosed as Type 2 last October and did the finger prick test 2hrs after every meal up to Christmas as an aid to help me re-adjust my diet. This was useful but it was clear that the test just after I got up and before breakfast (fasting reading) was the best guide to how I was managing my diabetes. I still do these fasting readings and keep a record of them on a spreadsheet. Over Christmas with the eating indulgencies these readings were generally around 9 but with a return to my adjusted diet slowly crept down to where I would expect them to be which is 6.0 to 7.5. I have since had spikes to around 9.0 which do not seem to tie in with my meals the day before. A couple of times I have repeated a high test result and it fell back into what I expect it to be. I have also noted that some high results occur when I am very tired as well. So the message here is that the finger prick test is not an accurate value but a guide as to how well you are managing your diabetes. For the reasons I have just given I average the last 7 day results on the spreadsheet as this gives me a better trend picture. I can foresee that after I have used this data to understand my diabetes management and in conjunction with my Ha1bc results that eventually I can stop the daily fasting test and just do it periodically.

My adjusted diet does not cut out any food types but just readjusts the amounts of which types of food I eat. I also do a lot of vigorous walking as well and as a consequence of both of these have lost a lot of weight.

It is not an absolute necessity to do the finger prick test if you are only on metformin but I would recommend that you do, at the very least, the first thing in the morning fasting test to help as a guide to how you are managing your diabetes. Each person will give different advice and only you can decide on what you think will work best for you.

I am also assuming that from your name on this site that you have been to Rotnest Island 🙂 Lovely place.

Thank you. All these answers are so helpful. And yes, Perth was my base for a few years. Rotto was my happy place.

 

[Quokkagirl]

If you start to keep your daily increases from the meals you eat to no more than 2-3mmol/l then you should find your morning readings will start to go down as you are not overloading your body with too much carbohydrate. You can then aim at your 2 hour post meal readings to be no more than 8.5mol/l.
You should then find your morning readings will start to be below 7mmol/l.

Thank you

 

[Quokkagirl]

Our bodies sometimes "help" us when we get up by dumping glucose into our systems to help prep us for going out to hunt for food (our bodies never got the message that we don't actually hunt for food anymore but wander to the fridge).
It is often called "foot on floor".
Checking before getting up can give you a much more accurate reading of how overnight has been.
There is also another "helpful" thing that sometimes happens called dawn phenomenon that does about the same but during the hours before waking.
BG is weird

thank you

 

[Quokkagirl]

The value of testing is to enable you to make better food choices. The aim is that your 2 hour post meal increase is no more than 2-3mmol/l and not about 8.5mmol/l if it is consistently more than that then you know your meals are too carb heavy and you can reduce the portion size of the high carb food in the meal, cut it out or make a substitution for something lower carb.
It is a good idea to keep a food diary so you can spot problem foods or even time of the day when you had that meal.
I have seen that people can tolerate a slice of toast at lunch time but not for breakfast.
People can cope with say 20g carb if it is pulses but not potatoes or bread but they will only know that by testing.

Thank you so much. This explains it in a way I can understand - how to use the information I get. No-one has ever explained or encouraged this - in fact my gp has actively discouraged finger pricking in the past but has been very medication-orientated, which I believe has damaged my gut in the long term. I'm now threatened with insulin and am trying to avoid it if possible.

 

[Quokkagirl]

Have you tried home made soups which can be made very low on carbs.?

Yes, and I've made some great soups, but man cannot live on soup alone. It can become extremely tedious.

 

[Quokkagirl]

Welcome to the forum @Quokkagirl

Self monitoring of BG levels is commonly recommended on the forum, but as @Kopiert says, it doesn’t suit everyone, and there is absolutely no reason for you to do it if you find it upsetting or demoralising.

One of the shortcomings you identify - that it only shows a moment in time - can actually turn out to be an advantage. Conversely an HbA1c can give you very helpful information about overall trends, but it’s not so great at answering very specific questions:

Can I eat bread? How about wholemeal? Or seeded? Are wraps better? How about bagels? Or crispbreads?

How do I cope with fruit? Are apples better than oranges? Can I eat bananas OK! Are berries my best option?

The part of your diet that has the biggest impact on your blood glucose levels is the carbohydrate. But there are a lot of details, unexpected exceptions, surprises, and peculiarities. If you are attempting to manage your diabetes with your diet, then those details become really important. A moderate or low carb menu often works well - but which carbs should you keep for flexibility, and which should you avoid? BG monitoring can help you find that.

As others are suggesting, a common tactic on the forum is to use pairs of BG checks, one before and the second 2hrs after the first mouthful, to see the ‘meal rise’ from whatever you’ve eaten. Ideally you’d want this to be 2-3mmol/L or less. If you see a much bigger rise in BG, take a look at the main sources of carbs in the meal and consider portion reduction, swaps or changes. In a sense, to begin with the numbers themselves aren’t all that important. It’s the difference between them that you want to reduce. And if you get your meal rises down to a fairly modest level, you’ll find your overall levels - even your morning BG generally come down in time.

In a relatively short space of time you should build up a picture of the sorts of sources of carb, and the portion sizes, that your metabolism can cope with.

If you are interested in this approach you may find test-review-adjust by Alan S a helpful framework.

If you need to self fund your BG meter, the most affordable meters members here have found are the SD Gluco Navii or the Spirit Tee2 - which both have test strips at around £8 for 50

Really helpful, thank you. I shall get the book and get the spreadsheets done. Thank you again - this is what I needed to know.

 

[Annette&Bert]

Your story sounds like mine. I've had every diabetic medicine known to man - all of which has helped to mess up my gut. I'm now threatened with insulin. I hate the obsessing with numbers and not knowing what I'm supposed to do with the information when I get it other than the standard lose weight/exercise more routine. It's a relentless drag.

also my life is tied to sitting, exercise is impossible for me. I now have a very low opinion of GP practices.

 

[Mrs Mimoo]

I am supposed to have a liquid diet due to liver problems but Slimfast shoots me into double figures which scares me. I've stopped measuring as I don't know what to do about it, maybe change to Exante? Ignorance is bliss but also stupid. I do feel we need to measure and know what's what.

Exante do low sugar shakes. They are a bit harder to get smooth than the others but they are good. Slimfast is not a rmeal replacemelnt really.

 

[Deleted member 21371]

Exante do low sugar shakes. They are a bit harder to get smooth than the others but they are good. Slimfast is not a rmeal replacemelnt really.

Why isn't Slimfast a meal replacement?
I used it for six weeks at the start of this year.
Salted caramel is particularly good.

 

[andyp64]

This is a very good question!
When I first read it, I thought ..... well the answers obvious! But it isn't! 🙄
I would agree with you that "testing for testing sake" is pointless. It just costs you money for test strips and leaves you with sore fingers.
However ..... as has been mentioned by others above, it can help in the "Sherlock Holmes hunt" for specific food items that spike your BG levels. The "before and 2-hour after" comparison will highlight what has an affect on you - everyone's diabetes is slightly different.
For example ---- I found Fanta Zero drink (sugar free) caused me to spike - I now avoid it. On the other hand, Pepsi Max is fine.
Also, Weetabix spike me but porridge doesn't.
My suggestion - use testing for rooting out specific problem foods. After that, just test once a fortnight or so to check nothing has changed overall.
Thoughts anybody????