Meter Inconsistency/Finger Prick Fatigue
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ZoeDog posted:
When my numbers got stuck for awhile and I thought there might be something wrong with the meter, I decided to compare readings on several other meters I wasn't using. I checked each with a test strip before I tried this experiment. Boy, was I surprised to see a difference of nearly 100 points from one to another, and a wide range in between. And how do you know which one is accurate! I started to think, what's the point of testing if the meters aren't accurate and I'm so tired of poking my finger twice a day! I was so discouraged that I stopped checking my sugars altogether. It's been months now. Any thoughts or suggestions? Thank you!
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mrscora01 responded:
First off, do you rotate sites when you check your blood sugar? You need to otherwise you will develop calluses. Also, you need to use the sides of your fingers as this will hurt less. I take it you are not on insulin as those of us who are test anywhere from 6 - 12 times per day.

As for meter accuracy, the industry standard is plus or minus 20%. So if your actual number is 100, it could read anywhere from 80 to 120. It gets scarier the higher you are. So if you are at 200, then it can read 160 - 140.

To check to see how good YOUR machine is, take it to the lab with you when you go. Do this several times and you will see how consistent it is and how accurate. My Freestyle Lite always reads 4 - 5% higher than the lab draw. Don't compare to the machine in the docs office as you don't know how good it is. Also, don't bother wasting test strips comparing machines. They will always be different. Find out which is the best when you go to the lab.

Cora
T1 1966, Dialysis 2001, kidney transplant and pump 2002, pancreas transplant 2008
 
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jasononsweets replied to mrscora01's response:
Who goes to a lab? Blood tests are usually done in a doctors office and sent to the lab for results...
 
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davedsel replied to jasononsweets's response:
Many people do still go to a lab for blood work. Each doctor's office does it differently. I think having the doctor's staff do a blood draw is the exception, where taking a script to a lab is a more common practice.
Click on my username or avatar picture to read my story.

Blessings,

-Dave
 
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ZoeDog replied to mrscora01's response:
Yes, I rotate sites. Yes, I am on insulin and was told to check BS twice a day. I just get tired of poking my finger and was hoping there was an alternative. I appreciate your answer, however, and I guess it just really comes down to my own denial about the number still being so high after several years of trying to lower it with diet and exercise. (Most of the meds make me too sick to my stomach.)

This is a high maintenance disease and I can't blame the meters for what I've been unable to accomplish. Although I'm in love with the meter that has me near 100 instead of the meter that has me near 200 - it's the latter that tends to match lab results! How do others do it? That is, get their numbers down and have them stay down? How long does it take to get them to budge?
 
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mrscora01 replied to jasononsweets's response:
For goodness sakes jasononsweets, what difference is there if it is drawn at a lab, or drawn at the docs office and sent to the lab? Test your blood sugar when it's drawn, note it down, and then compare when the results come in.

Sheesh!

Cora
T1 1966, Dialysis 2001, kidney transplant and pump 2002, pancreas transplant 2008
 
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mrscora01 replied to ZoeDog's response:
What insulins are you on ZoeDog? If you are on the older style insulins line R and N, it is harder to get control. There are a couple of books called "Using Insulin" and "Think Like a Pancreas" that can go into a lot of detail on how to adjust your insulin to get better control.

If you are on the modern basal/bolus then you need to learn your ISF (insulin sensitivity factor = how much one unit of insulin will drop your blood sugar) and your I:C (insulin to carb ratio - so how many grams of carb you can eat per unit of insulin taken). These and a proper basal rate (the books will help figure this out) will make getting control easier.

Once you start on the path, it is a good idea to do it slowly. it will be easier that way because if you hit normal blood sugars quickly, you will feel as though you are low (because you are used to being high) and then eat too much.

I know it's complicated sometimes, but you can do it. The books I mentioned can often be found at your public library or used on Amazon.

Cora
T1 1966, Dialysis 2001, kidney transplant and pump 2002, pancreas transplant 2008
 
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auriga1 replied to ZoeDog's response:
ZoeDog, I was diagnosed in '06 with Type 2. I am an insulin user, two of them. One is the basal and the other rapid-acting. The rapid acting is designed to bring your BS down when you eat a meal containing any carbs or if you find your BS higher than the norm two hours after a meal.

I understand that you test twice a day. You don't say when. I found that it's very important for me to test two hours after any given meal of the day. This will give you a good indication if what you ate affects your blood glucose. That 2-hour post-prandial should be 140 or below.

MrsCora's last response is right on the money. It's important to learn those facts if you can. It may take a bit, so don't lose patience. It's a learning process for all of us.

It took me quite a few months to get the basal dose I use right. The basal is a 24-hour insulin that keeps your blood sugar within range, not taking into account any carbs you eat. When I eat carbs, I need to take the rapid-acting insulin, so my BS does not go up.

I have also found that the more active I am, the less insulin I need to use. Activity in any form is beneficial for anyone with diabetes. It has helped keep my numbers within normal range.

Even though I use insulin, I still need to count carbs diligently and stay active. It all works together to keep your numbers within normal range.
 
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ZoeDog replied to auriga1's response:
Wow! I can't believe I'm just learning about IFS and I:C ratio now and not from my diabetes coordinator. Currently, I am on Humulin N, 40 units in a.m. and 30 units in p.m, but I don't know where that fits into what you all are describing. I will do my homework and research this insulin type. Initially, I couldn't tolerate whatever oral meds or injectables I was prescribed, so if this isn't the best insulin, I may be out-of-luck. .

I have noticed that increasing activity and reducing carbs does help. Yet, I struggle to do both consistently and am too easily discouraged by numbers that continue to hover around the 240 mark. Perhaps combining this with IFS and I:C factors will help me achieve results that encourage me to stick with the program!

This is the first time I've reached out to the WebMD Community and I truly appreciate the support I've received. Thank you.
 
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mrscora01 replied to ZoeDog's response:
Hi ZoeDog. I'm sorry to say that with what you are on, the things I mentioned do not apply. N is an old style insulin. It lasts up to about 16 hours and peaks at about the 6 to 8 hour mark. What I was talking about applies to MDI (multiple daily injections). This is where you take a basal insulin like Lantus or Levemir. This insulin last roughly 24 hours and is fairly flat - so no real peak. Then, you take shots of rapid acting insulin to bring down glucose and cover the carbs you are eating. These insulins like Novolog, Humalog, or Apidra, peak at about the 2 hour mark and are gone within about 4. This works out to about 4 - 5 injections per day. it's a lot of work, but you can get much better control.

If you are willing to put in the work and take the shots, you will get much better control. You do need to test a lot when you do this though.

Cora
T1 1966, Dialysis 2001, kidney transplant and pump 2002, pancreas transplant 2008
 
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auriga1 replied to ZoeDog's response:
ZoeDog, you are using one insulin that is supposed to keep you within normal range. Unfortunately, any time you eat carbs, your sugars are going to go up. Your body sounds a lot like many of us in that we cannot tolerate carbs. Our blood sugar goes up when we eat carbs.

Once again, MrsCora is right on the mark. You can't to the IFS or the insulin to carb ratio. The insulin to carb ratio is effective with the rapid-acting insulins, like the ones MrsCora mentioned. For example, at the moment, I use 1 unit of insulin to every 12 carbs I eat at any given meal. These numbers will vary with patients. It does take a lot of testing to see what works for you.

I don't know if you have available to you the newer insulins. If so, talk with your doctor. You do need to bring your BS down. Don't get discourage. It takes work. It took me many months to work with both insulins and how many carbs I should be eating.

Keep with the activity and reduction of carbs. You said you saw a diabetes coordinator. Can you see if you can get an appointment with a registered dietician? If so, explain that your numbers are too high. Also, ask her (him) if the amount of carbs you eat per meal are okay. My sugars were extraordinarily high at diagnosis (A1c of 13.2) so my dietician mentioned that 45 grams of carbs per meal would be as high as I can go. Most of the time I do much less so I won't have to take too much insulin. I have used both Lantus and Humalog and my A1c has dropped to 5.6. This A1c also takes into consideration the physical activity and reduction of carbs along with the insulin usage.

If the newer insulins are not available to you, ask your doctor if he/she knows much about the over-the-counter insulin from WalMart. There are two: Novolin 'N', a long-acting insulin which also can be used as a basal. The insert says that this insulin may last from 16-24 hours. As in most cases, individual results may vary. Then there is Novolin 'R' which is a rapid-acting insulin that can be used with meals if you eat carbs. These insulins are 24.99 per vial; 100 units/mL.

I lost my health insurance due to job loss. I have had to resort to using both the insulins from WalMart with good results. You DO NOT need a script. Educate yourself first and talk with your doctor.

It never hurts to ask about options available to you. Good luck to you.
 
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bigdaddy7734 responded:
Doesn't matter, test your blood just before you go to the doctor and compare it when you get the lab results back.
 
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bigdaddy7734 responded:
Check the November 2012 issue of Consumer Reports. They did a study on glucometers and found that 9 of them met government standards plus or minus 20%. New standards came out in January 2013 plus or minus 15%.
 
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An_249409 responded:
As you have noticed, some meters should never have been approved.

See the below for better details.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769960/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3570840/

http://bionimeusa.com/files/journal_papers/IDT_Report.pdf

Don't be put off by the European numbers, the proportional accuracy is still the same for US measurements.