Thanks ar ;) Exactly what I meant.
Exactly! Avoiding even ONE hospitalization for DKA will pay for TENS OF THOUSANDS of test strips. Avoiding even ONE serious complication (e.g. kidney failure requiring transplant) will pay for TENS OF THOUSANDS of test strips.
How short-sighted and silly to focus on trying to limit testing, rather than focusing on ensuring that our test results are used to improve quality of life and reduce complications. That is, use the results to HELP diabetics.
When my doctor sees all my numbers when her office downloads my meter data she usually thanks me for "all those great numbers" but she doesn't really use them for anything good or helpful (I do all my own management these days, like most diabetics.)
Maybe it would be helpful to take all those meter values and aggregate them somehow, correlate with other test values (e.g. A1C's, albumin, triglycerides, whatever) and/or correlate them with outcomes (complications, in-patient stays, etc.) and/or correlate them with basic patient data (age, type of D, time since diagnosis, dietary approach being followed during test period, exercise program being followed during test period, weight, sex, etc.) and come up with some useful recommendations?
When my brother (God rest his beautiful soul) lay dying of kidney cancer, he made it clear to us that he would be willing to try another chemo protocol if the data from his trial would be USEFUL to medicine, but otherwise, he was ready to let go. I feel the same way about all my medical data: if it can be made USEFUL to medicine (while protecting my privacy), then why not? It seems silly/wasteful that we have these zillions of test results and that they're not really being used by many of our doctors to help us OR to HELP other diabetics.
Rather than limiting our testing, I'd like "them" to focus on USING the data to help me and to help all other diabetics, too.
I agree. If anyone in my HMO wants to correlate the data from my meter with the number of test strips they've covered, the numbers are right there in my meter. Don't limit me because someone else is cheating. Prosecute the heck out of them and let me test a lot on training days or weird hypo days or sick days without giving me any grief.
FWIW I try to test as little as possible. If I feel well that generally means 9-10 times I am in good range. I spent the majority of my diabetic life never testing and it wasn't till 1999 that I went on MDI and started understanding what I needed to do. On a daily basis I can get by with very little to no testing. Sometimes that I don't do it I cause more problems then help but the percentage is small. My AlC's tell the big picture of things and indicate to me that what I think is going on generally is. I could probably be close to as accurate as a CGM meter just from my symptoms.
where do you think i am?...on top of the game or exceptional or???read about me on other blogs..groups,,etc...i'm curious...
I'd say there's no question you're on top of the game!
THANKS :) :) smile
I agree that it's not irrational to test, or even test frequently (I should do it more often). As with everything else, it only really becomes a problem if you allow it to get in the way of other important things you need to do throughout the day. We always have to fight to get the balance right...
I think this all comes down to balance. The tighter the control I strive for, the higher my average stress level gets and the best way to get tighter control is to test more. I have eaten the same breakfast and lunch, test a whole lot and study my BG and CGM data daily to make adjustments. All that work ontop of the other responsibilites of life can be too much. It can be a delicate balance.
I think there is too much testing, but it is different for everyone. It can be tough to balance the balancing act of diabetes with the balancing act of life.
Well put, Capin101. I feel I was trying to say something similar but it just wasn't coming across.
I think it depends on control and experience. I've had it almost 30 years and test approx 4 to 10 times a day. If you are sick, you need to test more often as it can make sugars wacky! For a young child, definitely before every meal, when waking in morning, before bed. Teach them good habits. I've seen people who don't even test and should be!! I'm so used to my sugars I can tell you pretty close to what it is.I am unaware when it goes low sometimes. I've heard you lose awareness if it happens too many times. That is why I usually check so much. Once, I went with someone for Easter weekend 4 hours away and almost there I felt my pump site with no tubing. I comletely 'freaked out'. I was like a drug addict needing my drug. Then...... I felt my pump, realising I had changed the site before we left and never removed the old one! Wow, scary!!! Felt like an idiot when I realized what I'd done, but.... Do not be without insulin or a way to take it ever!!
Another time, I had someone take me to the hospital because I couldn't get my sugar down. It was so high it wouldn't read. I'd assumed my pump wasnt working so I'd taken shots, after hours and over 100 units(yes, 100) of insulin, I asked someone to take me to the hospital. I couldn't walk, trouble breathing, sick, etc.
ER Dr said it is very dangerou to take so much insulin in such a short time but, in the same breath, he said I was lucky I'd taken that much or I might not have made it. He said I was lucky lucky! apparently, I'd had some type of virus that caused my sugar to go out of control. They kept me a few days and let me out after I'd spoken with the Dr on the phone. They wouldn't let me use my pump, they'd given me a meal that was not diabetic(hawaiin punch pop sickle, numerous juices,jello, dinner, etc). I'd made them take the pop sickle away. They MADE me eat all of it if I wanted to go home and did not give me any insulin!! Then, they told me I couldn't go home bercause my sugar was 300!! I made them put the dr on the phone, told him what they did and he was shocked. he immediately made them give me my pump and told them to release me. Sadly, the nurse was oriental and she actually had trouble understanding things. hate to say it but, please be your and your kids advocate!! it was a teaching hospital and a sunday night, but still, no excuse! It could hurt someone who didn't know better!! Even with a CGM, they are still considered not alwats accurate. They tell you it is used only as a warning sign, but you should still test regularly.
If testing is a lot, be sure to gave dr specify how many strips per month and how many times to test daily. I agree with acidrock23, no such thing as too much testing!!
How old are the kids/kid??
-tammy
when in hospital i always do my own testing & pumping & eat regular food & count carbs & bolus accordingly. it works for me.
Good for you, Shoshana! You just reminded me; I've never been hospitalized, but have heard horror stories like Tammy's. So I need to tell my doctor at my next appointment that I want him to put an order for me to manage my own blood sugar if I'm hospitalized.
Thanks to you, too, Zoe. I wouldn't have thought of doing that. My doc is affiliated with the hospital where I'd go so I'm sure he could do something like that!
I usually do too shoshana but since I went in with the bg problem(even though it was due to an underlying bug) they would not let me. Funny thing is, before I had gove to hospital, I kept treating myself hourly as I know how long it should take humalog to work. They'd said the amount I'd taken could be dangerous, then they said it's probably what saved me!! I think part of the problem that day(2nd & last day of stay) was a nurse that didnt speak or understand english very well. I've had numerous surgeries and such. My endo always scripts orders for 'patient to use as was instructed by endo' - meaning, patient knows what she's doing and will take care of it herself!!
When you go in with a bg problem, they want to monitor closely and do it themselves, just beware....
My endo is part of the same hospital, only at a different location. That didn't help...
at my hospital i don't have my regular endo but one i knew from before who knows me well so he takes good care of me...lucky me.
I think that a person who was obsessive wouldn't actually ask themselves if they were becoming obsessive?
Maybe not at first, but in time if it had some negative impact, others commented or they saw that others didn't do it as much or it just stressed them out more and more..they would. Actually even Obsessive Compulsive Disorder has a criteria of recognizing that the obsessions or compulsions are excessive or unreasonable (which is what makes it heartbreaking).
Your observations about your own tendencies are interesting. I find the CGM to be a comfort, and have gotten to the place where I test only if I need to calibrate, or if the CGM shows a BG significantly out of line, or if I feel low, and at waking and bedtime. So I don't test as much as I used to, but I think I test at times when it is rational to do so.
If you're not using a CGM, then you should probably be testing more often than I do, but I think the important issue is always what are you going to do with the information. And if the test shows you are in a good place, and don't need to do anything, well that's great! :-)