January 28, 2015

Help in Diabetes Management Education – Part 2

Part 2 of 12

Blood glucose testing will depend on how many test strips your insurance company will pay for and then on your budget. I don't expect everyone to able to test for what is ideal, but I will list the ideal first to give you a basis. This is also one reason I urge people to ask their doctor for extra test strips at the beginning to help them determine what works for their food plan and which foods to limit or eliminate. This will also allow you to determine the time from first bite or last bite to the peak in your blood glucose. This varies for each individual and you should determine what your peak is for each meal. Many have their peak at one hour and others at two hours. Some like me peak at about 90 minutes and others a two hours and thirty minutes. This is a variable that you must determine for your body. This can change as you age, so be aware of this.

The first time for testing is when you wake. This is also your before breakfast blood glucose test (termed preprandial). Then you should test about one or two hours after breakfast. Do this for each of your meals and then before going to bed. Then you should always test before and after exercise unless you are on oral medications that do not cause lows (hypoglycemia). Read my blog on blood glucose levels that are safe for exercising. Some people with type 2 diabetes do exercise with blood glucose levels that are too low or too high.

If you are on insulin, you should test before and after exercise. With the position of the ADA and actions by some states on people driving with low blood glucose levels, it is also wise to test before starting to drive and stop and test if you feel low. Some states are suspending driver's licenses when it can be determined that an accident happens that is caused by hypoglycemia. Other causes include if you are stopped while driving during an episode of hypoglycemia. In other words, know the law in your state. The above link is to a prior blog on driving, and this is the link for the 2105 guidelines for diabetes and driving – actually a use of the 2014 guidelines which was not changed for 2015.

Most people on oral medications are limited to one or two test strips per day depending on the medication. Those using insulin are generally limited to three test strips per day. This means that you are limited in the testing you can do and what you can do for experimenting. I know quite a few people on oral medications and on insulin that purchase the extra test strips to be able to experiment and determine the best postprandial time to test. They also used the extra test strips at the beginning that their doctors were able to have approved to determine what foods they could eat, what needed to be limited, and the foods they needed to eliminate.

Developing their meal plan was also a priority for them and a few that needed to spend their own money for extra test strips to do this experimenting. When I meet someone that has done this or even receive an email about the success from doing this, I always feel good for the person. This is management at its best and means to me that the person wants to learn how best to manage his or her diabetes. Oh, yes, we all make mistakes or errors, we are human, but if we learn from these, we are better for these mistakes.

1 comment:

Denise said...

Great recommendations, Bob. Strips can be pricey but they are absolutely critical to ensuring you can live a long, healthy life with T2, so what's more important, budget-wise, than that?