June 8, 2016

Have Diabetes; Do You Eat to Your Meter?

Many people do not eat to their meter. Why won't they at least do something to make it easier to manage their diabetes? Here are some of the excuses I hear:
  1. The doctor doesn't want me to test.
  2. The cost is too high.
  3. I forget to test too often.
  4. I am not that interested.
My feeling on this is you are not concerned about your health and are not taking your diabetes seriously. That being said, I have met a couple of people that could not find the money for testing and for that matter even their medications. Both did afford shelter and most of the food they needed. They lived on very limited income, did their own cooking, and stretch their money very well. Several of us did write some testing supply companies and the companies for their medications.

The doctor for one of the individuals would not support the request for testing supplies and this prevented her from obtaining them. It took convincing her to change doctors that finally got her the testing supplies. The doctor was highly put out and told her that the ADA advised using the A1c only and she did not need to test. He even continued trying to block her obtaining testing supplies until someone asked her if she had been in the military to which she answered yes. Once we had her apply for benefits and they looked at her income, she will received all her medications and testing supplies for no copay.

We talked to the other individual and he said his doctor had asked him the same question and when he said yes, he had been sent to the local VA office and was also receiving his medications and testing supplies for no copay.

Both are testing more frequently and are trying to eat to their meter now and like both have reassured us, they are bringing their A1cs down into the 5's and one hopes to be in the 4's by the next A1c. Both are happier and thanking those of us that helped them.

I would urge anyone to read this by Kelley Pounds on “eating to your meter.” It is more complete than many other sources.

The best selection from her blog is this - “If you have diabetes, you may also be familiar with the ADA (American Diabetes Association) targets of less than130 mg/dl pre-meal and less than 180 mg/dl post-meal. PLEASE DISREGARD THESE TARGETS. These targets WILL NOT protect you from serious diabetes complications. Just because these are considered “average” or “normal” diabetic blood glucose levels, it is also “normal” for many with diabetes to develop heart and kidney disease, strokes and undergo amputations. These are considered just part of the “normal” progression of diabetes by organizations like the ADA. PLEASE, disregard these targets!

So let’s review:
Normal BG: Pre-Meal – less than 85 mg/dl, Post-Meal – less than110 mg/dl BEST
AACE Targets: Pre-Meal – less than 110 mg/dl, Post-Meal – less than140 mg/dl ACCEPTABLE*
ADA Targets: Pre-Meal – less than 130 mg/dl, Post-Meal – less than 180 mg/dl UNACCEPTABLE

*Acceptable - as a starting point for those with advanced diabetes. This should be the maximum acceptable blood glucose level for those with diabetes.

So, if you look more closely at these targets, notice that this leaves you NO MORE than about a 25 point spike in blood glucose to maintain normal blood glucose and NO MORE than about a 30 point spike in blood glucose to maintain “diabetic normal” blood glucose. We will discuss the ADA targets NO MORE.”

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