August 6, 2015
Self-Monitoring of Blood Glucose – Part 2
Continued from the previous blog.
One exception to hand washing is when you have not been eating fruit (and have fruit juice on your fingers) or are away from an area where you can wash, then using an alcohol pad is better than not cleaning you finger where you will test. Occasionally it might be wiser to use the second drop of blood and you may read my blog here about this.
The purpose or goal of SMBG is to collect information about blood glucose levels at different times during the day to assist you in creating a more level blood glucose. You will use this information to adjust your regimen in response to the blood glucose values. This will mean adjusting your food intake, physical activity, and possibly medications with your doctor’s direction.
This is the reason for testing in pairs. One reading postprandial is worthless and tells you nothing. It does not tell you what the increase may have been from the food consumed, or even if you need to reduce your food consumption. Okay, if the preprandial dinner reading was 105 mg/dl and at 90 minutes postprandial, the reading is 148 mg/dl, then this means that the increase was 43 mg/dl. Now this says something and depending on the goals you have set, you can make adjustments. Do you need to reduce your food consumption (the carbohydrates), do more physical activity, or if on insulin adjust the dosage injected? I would always encourage reducing the number of carbohydrates. With the information given, you need to potentially do a correction injection of insulin, but this is not the action you should take on a daily basis.
I found the extra expense for test strips well worth the money. I was able to determine what my high point after meals were. Yes, this has changed over time, first more minutes and now less. Presently, my high point is normally reached at 105 minutes. When I started testing, I quickly found out what foods needed to be eliminated from my food plan and which foods needed to be limited. Even this has changed, but not drastically. Learning what 'new to me' foods do to my blood glucose has helped.
Yes, in the first five years, I used a lot of test strips. I am happy that I did, as I often know when a food may spike my blood glucose and drastically limit it. Most of the time I am right and have good results. Yes, occasionally I have a surprise. Most of the time for the good, but some bad as well.
It is wise for anyone with type 2 diabetes to learn self-monitoring of blood glucose and what the readings mean. Testing in pairs is the best way to learn. Today's doctors do not have the time or the desire to teach. This applies to certified diabetes educators as well. The registered dietitians will be more than happy to teach anyone that isn't knowledgeable because then they can promote whole grains and other foods promoted by Big Food. I keep meeting people that learned the hard way that these teachings damage your health rather then manage diabetes.