A Test You Can't Fail - Part Four - What Does it Mean?

You have done your tests and have your results.  What in the world do they mean?

First, understand that while your numbers will fluctuate, the ADA refers to ranges.  The American Diabetes Association has a good article on glucose levels.  Again, because I love simple, think in terms of the following ranges as goals to achieve:

Fasting Glucose Test - This is your first test of the day: 70 to 120 is the target range.  This range is the goal.  The Goal.  You may not be seing these numbers.  I remember my first test in the middle of the day about 30 minutes after I had lunch.  My number was over 300.  I had no clue what that meant.  Now I know it was way, way, way too high.  My first morning reading was 297.  Again, very, very, very high.  Now my morning readings are 85 - 95.  Rarely do they go above or below.

As I started my way to gaining control over diabetes, my morning readings started to come down 10 and 20 points a day.  Sometimes they went up from one day to another, but I was learning what I could eat and not eat.  But, when you look over a week's or month's time period, there was a downward trend.  These morning readings are a great indicator of where you are in your battle to control the disease.  If you are only going to test once a day, this is the one to do.

Evening/Night Test - This one was a challenge for me.  Think in terms of a range of 110 to 140.  I, again, want to stress I am not a doctor, this is just what I found to be about right when I test at night as I was gaining control.

Diabetes control is a journey - remember that.  When I first started testing at night after I started medication, I was happy to see anything around 160.  Due to eating changes, exercise and medication, that number came down pretty quickly to around 130.

I just did a test and found that I was at 91.  I ate about 2.5 hours ago - so it was low even for me.  Most of the time I my tests show 95 to 125 - there are a lot of variables such as what did I have for dinner, how long ago it was, and have I had anything to eat since dinner.

After Eating - This test is done two hours after you start eating a meal.  This is important enough to repeat - two hours after you START a meal.  For me, start means when I take my first bite.  The goal here is less than 180 for a Type 2 Diabetic.

You can control diabetes.  You really can.  I know in the beginning it might not seem so easy, but it's all about a series of choices.  The better choices lead to control and lower test numbers.  Other choices lead to higher results.  But sometimes you don't know how certain foods will effect you.  sure, there are guidelines, but we are all different.  You only learn how a food will effect your body after you eat it - and you learn through testing.  If you get a higher number, it's a food to avoid.

I started with very high numbers - VERY high.  Through diet, exercise and medication I am controlling the disease.  Do I miss apple pie, french fries and cheese cake?  Well, yeah.  But, I want control of the disease because I have respect (fear) of what it can do to me - the complications can be severe.

Remember, you cannot fail this test; you can only fail to test.  Even getting a high number provides a lesson.  If you are just starting treatment, you want your readings to trend down.  If you have been under treatment for awhile, you want fairly level readings near or in the normal range - at least that's the goal and it's one that is attainable!

Here is a good article from Diabetes Self-Management on glucose levels.

Don't let diabetes win. Battle and control it!  You can do it...I know you can.  Keep your food diary and learn from it.  If needed, lose weight.  Take your medication.  And, TEST.

A Test You Can't Fail - Part Three - How to Test

During the last few days I have been reading instructions on various sites about how to test using a glucose meter.  Most of them are pretty good and get the high points really well.  However, there are a few things they miss, which can make all of the difference in the world when testing.  So, here is the process I follow for testing.

When do I test? I test when I first get up in the morning before I eat or drink anything except water, and then at night before going to bed.

The steps I always follow are:

1. I wash my hands carefully using plain soap; soap without any fragrance.  I found scented soaps would effect my readings - make them higher.  The last thing I ever need is a fasle higher reading.
2. Dry your hands using either a clean hand towel or paper towels.  I use paper towels because I know they are not putting anything on my fingers.  If you paper towels are scented, do not use them.  (Heck, I don't even know if scented paper towels are made, but I thought I'd hammer the un-scented thing one more time.)
3. Give the hand you are going to test on a few shakes to get blood into the tips of your fingers.  This might be more important for you to do in the morning than the evening.
4. Get the lancet ready.  Do whatever you need to do like inserting it, or cocking the lancing device.  Just make sure it's ready to go.
5. Insert a test strip into the meter.  For me, the insertion of a strip turns the meter on, so I have never had to physically turn a meter on with an extra step.
6. Lance the side...the side of your finger.  It's less sensitive than your finger tip.  I have no clue why every picture I have ever seen of someone lancing their finger shows them using their finger tip.  It hurts far more than using the side of your finger.  In fact, I don't even feel the lance about 50% of the time on the side of my finger.  By the way, I have used one of two fingers on the same hand for the last few years - I don't vary it.  Do what's best for you, though.
7. Squeeze your finger a bit so a drop of blood appears.  It doesn't take much to test - far less than a drop.
8. Apply the testing strip to the drop of blood.  It will pick up the blood it needs through capillary action.  Be careful not to touch your skin with the strip - it could pick-up contaminants that will effect the reading.
9. Rinse the blood off of your finger as your meter gives you results.
10. Dispose of the lancet properly - in a medical sharps container.  DO NOT put it in the trash.
11. Dispose of the testing strip in the same manner.
12. Record your reading on your log.
13. Put your meter and supplies away.

I know supplies can be a bit pricey, but use lancets and strips only once.  That's important so I will repeat it - use lancets and strips once and then discard properly.

You have done it!  You have taken the test you cannot fail.  But, will fail in your battle on diabetes if you do not test!

There are so many meters on the market, that I won't get into any one brand right now.  If you do not know what your meter is capable of, or the information you can gain from it - learn.  Read the directions that came with the meter, or find them on the internet at the manufacturer's site.

As always, thank you for reading.  Fight the good fight and you will win your war with diabetes.

"Victory is always possible for the person who refuses to stop fighting." ~Napoleon Hill

"Be kind, for everyone you meet is fighting a hard battle." ~Philo

A Test You Can't Fail, Part Two - The Dawn Phenomenon

Remember, you cannot fail your daily glucose test; you can only fail to test!  There is so much more to testing than we are sometimes told, I am going to have to make this a three-parter.  This entry is about the Dawn Phenomenon - a topic every testing diabetic should know about.

You are doing your twice daily tests - maybe even more often.  One of your tests should be in the morning after you get up and before you eat or drink anything.  This morning test theoretically provides a fasting glucose reading - provided you have not had a midnight snack.  If you have a midnight snack, it will likely elevate your glucose, and it will show up in your morning reading. Common sense, huh?

And, you are keeping a record of your test readings, or they are being kept in your meter.  Over a few weeks you see them go up anywhere from 10 to 20 points.  Why?  Welcome to the Dawn Phenomenon (DP because it's easier for me to type).

 The DP happens sometime in the early morning.  For me it's sometime after 6:00 am - others might find it happening earlier or later.  What does it do?  Well, it's your body's response in getting ready to get up and moving - it releases some sugar to get you going.  Why does that matter?  Your blood sugar reading goes up and does not provide an accurate morning reading.  So, if you test before it happens, you get a lower score; if you test after, your reading will be higher.  There's not a whole lot you can do about it, either.  It just happens.  I will tell you that I try to test in the morning before 6:00 so I see my lowest reading.  Want to know more about DP - read it here.

I learned about the DP because my late night readings were suddenly higher than my morning readings.  I couldn't figure it out.  I thought it was my meter.  I was wrong.  It seemed that I was testing a bit later in the morning AFTER the DP had taken effect.

All you can do is to just be aware of the DP and how it might effect your readings.

That you are testing at least twice a day is great - good job!

A Test You Can't Fail, Part One

The whole idea of having to test my blood twice everyday was a huge challenge to me...just the idea of lancing my finger to get a drop of blood kind of made me a bit scared.  Looking back on it, I don't know why it was like that, but it was.  I just did not want to prick my finger.  Why make yourself bleed?

Why indeed?  Well, first, I have to tell you that pricking my finger was no big deal.  Yes, there is a bit of pain, but if you read the directions on how to use your glucose meter (which I strongly suggest you do), you will learn where to use the lancet so it really isn't painful.  I won't kid you, there is just the tiniest bit of discomfort once in awhile.  But, if you prick the side of your finger - yes, the side, and not the tip, you may not feel a thing.

Wait, that's important enough to repeat - prick the side of your finger!  Somewhere between no pain and very, very, very little pain.  Got it?

And, while I am at it - you only need a little drop of blood.  The scientists have figured out how much you need to give up and it varies from meter to meter.  For me, it's just a bit bigger than the head of a pin.  I'm serious.

Meanwhile back at glucose testing - which is what you do at home with your meter - it's suggested that most Type 2 Diabetics test twice a day.  Once in the morning just after you get up and then once at night before bed.  That's it.  Twice a day.  Now, when I was just figuring things out in the beginning, I was fortunate because my doctor prescribed enough strips and lances so I could test three times a day.  The truth is sometimes I tested three times, other days two times and sometimes even four times a day as I was learning how to manage diabetes.  I got so much good information from doing this.

I tested in the morning, before lunch, two hours after lunch or dinner began, and at night.  I knew what my body was doing when; I knew about what my glucose reading would be within 10 points after a few months even as it was going down and stabilizing.

What did I do with this information?  I wrote it down in my food log.  Learning what I ate and seeing my reading gave me invaluable information and immediate feedback.  I very quickly learned what I could and could not eat.

For example, some folks can eat wild brown rice.  Not me.  Any rice no matter the color or type causes my readings to go up.  And, I loved rice!  But, I learned that if I wanted to control diabetes, rice did not love me and became a 'has been' in my diet.

then, again, I learned that a basic (stressing the word BASIC) hamburger really didn't hurt me.  You know the kind - a basic hamburger from In N' Out.  Not a lot of dressing and the bun is not huge.  Although, I found that any number of french fires - any number - were off my menu.

How did I learn this?  By frequent testing and comparing the results to what I ate.  Recording everything - food and test results in the food diary helped me so very, very much to begin to gain some sense of control.

The message here is clear, I hope.  Test.  Test often  Keep a food diary.  And, use the results to learn how to best manage diabetes.  That is the first step to gaining control.

Remember, to manage diabetes you have to give yourself a glucose test at least twice a day; more often during the first few months if possible.  It's a test you cannot fail, but you will fail to manage diabetes if you don't test.