January 11, 2015

Two Topics for Our January Meeting – Part 1

Our January meeting was different from many of our meetings. Two members were unable to attend because of other commitments. Another member that was absent we could understand, as he was in the hospital and we could understand why, as he was in a diabetic coma because of extreme high blood glucose. His prognosis was questionable and the doctors were not optimistic about his recovery. Another member was at the hospital to alert us if anything happened.

Tim called the meeting to order and introduced Barry and A.J for the program on testing and storing the testing supplies correctly. Barry said he was feeling good about having slides for the meters and test strips used by all but one of the members. We discussed the different temperature ranges that the different meters could be stored or used in and many were surprised that the ranges varied as they did. The meters used by those in the VA system had the greatest range by a few degrees and the two meters sold by Walmart had the next temperature range. The ones supplied by the Medicare had the narrowest temperature range. The fourth meter was just above the Medicare specifications. When asked, Barry stated that the last meter statistics would be available later this month.

Then A.J started the slides for the test strips and this generated a lot of questions about storage of the test strips and use in temperatures outside the recommended temperatures. Among the new members, many were shocked and surprised at the directions given. Only one of them said she was using them within the recommended ranges as she had read the directions. A.J covered the errors from my blog here and this caused more questions. A.J said too many people waste test strips and had Tim put up the slide he had developed from my blog here. He stated that if the A1c reading was significantly higher than what the daily readings were, then people were possibly having errors in their test strips.

Barry called for a show of hands on how many on insulin were having episodes of hypoglycemia because they believed their test strips. Five hands were raised and A.J said this could could happen because they did not store their test strips properly. Then A.J emphasized the order for proper testing. Always have all the equipment available and ready to use. Barry emphasized that the case that came with their meter was probably the best for this purpose. A.J said that you should also have your testing log available at the same time.

First, have the lancing device (with new lancet inserted if needed) ready for use. Next, remove a test strip from the container, close the cap on the test strip container, insert the test strip in the slot on the meter, and once the meter reflects the code, pick up the lancing device and prick the side of a finger. Make sure there is enough blood and pick up the meter, slide the test strip slightly into the blood, and let the blood wick into the test strip. In most cases you will have a reading within five seconds. Then he said make sure that you do this out of direct sunlight and you should take less than 30 seconds from taking the test strip out of the container to wicking the blood into the test strip. A.J had me do this with Barry holding a stopwatch and it took me 27 seconds from start to finish.

This generated more questions about having enough blood. A.J said this is why you need to adjust your lancing device to receive enough blood and not forcing more blood out if it can be avoided. A.J stated that forcing blood could cause interstitial fluid out with the blood, which would cause an incorrect reading. Milking the finger is acceptable for slightly more blood. I added that I had used an alcohol pad since no water was available and I had not been handling fruit or food. I asked if anyone had noticed how I held my hand downward until I was ready to push the test strip into the blood. A few nodded their heads and Barry said this is one way to ensure enough blood.

Barry concluded that there are several things that can affect your blood glucose levels. Anemia, gout, a recent blood transfusion, and dialysis can all lead to false readings and affect these and your A1c levels. Also if you are at a high altitude, your blood glucose readings will be affected, as they will when it is very humid or hot.

A.J said we don't want to forget that handling some foods and especially fruit without washing your hands thoroughly with soap and water can create high blood glucose readings that are false. This can be the cause of episodes of hypoglycemia.

Continued in tomorrow's blog.

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