I think there's lots of different tactics (testing, food strategies, exercising, various insulin "tricks of the trade", time management). If your goal is to test less, I'd think that you'd have to adopt a more stringent food tactical plan to meet a BG goal while testing less? The patient with diabetes should be the sole party who is allowed to decide "I should test less" rather than some actuary at an insurance company or the doctor/ nurse/ CDE whored out to the actuaries there. They have no business in the "number of tests decision". There are 20,000 members, many of whom have reported challenges with various mental health issues. Thsi thread has been up for a while and we *still* don't have an appearance from anyone who has indicated they are, in fact, testing more than they need to?
It sounds like I do test more than you do, Natalie, since I don't have a CGM. I actually had heard they weren't all that reliable for the exact number, but only good for trends, but I really don't know much about them, so maybe that is inaccurate.I don't want one for a couple other reasons that I don't want two things to attach and I can barely afford my pump, let alone supplies for a second device. I definitely wouldn't want to have to check one machine with another one! That's kind of how I feel when people mention having two meters and continually checking them against each other. I did that for a few days when I got a new one, then realized it was crazymaking and picked one and put the other away.
As for how often I test: I routinely test on waking, I usually start breakfast pretty soon so I use that one for my before breakfast, than I test after breakfast, before and after lunch, before and after dinner and before bedtime. I sometimes test again right before sleeping if my number was a bit high or low when I got into bed to read. And of course I test PRN when I feel low, and when I correct either highs or lows to see if my correction was sufficient.That works for me. And yes, I absolutely agree that testing should have a purpose. When it gets excessive imho is when it is just driven by anxiety.
I have to admit perhaps for the first time on this board,I feel misunderstood in this thread. I never said doctors or insurance companies should limit our test strips - definitely not. Has anyone on this board admitted to "testing too much" in this thread? I seem to recall a few, though don't care enough to look back. But in general I think many of us have referred to being obsessive about our management, sometimes in the sense of it being necessary, sometimes in the sense that we are being too compulsive and driving ourselves nuts. I know I'm not the only one who ever said that. And to me being obsessive can take a few different forms, but compulsive testing is definitely one of them.
Or maybe I'm the only one out of 20,000 who has ever done or felt that. That would make me happy as I love being unique!LOL. Seriously, I was glad when this thread died and I should probably ignore it because I feel like I am repeating myself and I still don't feel understood. Oh well, I guess that happens sometimes.
I don't think anyone's posted that they test more than they need to because people probably don't test more than THEY think they need to. Someone who thinks they need to test 20x per day is doing it because they need to, though that's too much for me and I'm pretty OCDiabetic. Need is so subjective.
I find that I do test less with the CGM. I'm only testing maybe 7-8x a day when I know the sensor I'm using is usually pretty right on. I think we develop a 6th sense after a while. It has surprised me, though, the last few mornings when I woke over 140 (usally I'm around high 70s-80) and I felt fine.
I feel so much safer with it's alarms. I can sleep through the night without worrying about lows.
Good point, jrtpup. I guess because I have fought my own obsessive tendencies for a long time in my life, I can see that thin line between "just enough" and too much in my own behavior
And if there weren't people on here talking about being obsessive at times, we wouldn't have the term OCDiabetic.
I don't mean to say that you are advocating the limitations, I'm referring to the letter I got from Blue Cross earlier this year stating "Medicare has determined people with diabetes need 4 strips/ day so that's what we'll cover, unless your doctor can explain why you need more" or something like that. Then we have other threads where people explain that their doctors are suggesting that they are being "obsessive" testing too much, sorry I don't have a citation but I know I've seen them. That's one side. I don't seriously think that anyone with diabetes actually has an obsessive disorder, the way the people on "Hoarders" have an obsessive disorder or someone would have popped up in this thread to say "acidrock23 is full of it, I'm totally obsessive" to shut me up. There's a finite number of hours in the day and, if someone is active or out of control enough to need to test 20x/ day occasionally, they should be supported. I don't think it's a disorder. I think there's a problem when insurance companies and doctors don't support us.
I am totally obsessive about my ipod ("must have Glazunov symphonies...") but don't see any amount of testing as being obsessive. I have sort of made up the term OCDiabetic to refer to myself, most of the time, explaining why I might test twice when I come home from work and am going running or after I come home from running, then again before I go to the grocery store (one of the worst places to be low I think...) in 45 minutes? Sure it's a couple of quick tests but I don't think any actuaries or insurance doctor stooges would want to be crossing the street in front of me if I hadn't tested?
Ok, well I'm sorry that I did miss that you were responding to that (absolutely absurd!) letter, AR, rather than thinking I was saying test strips should be limited. You might have invented the term OCDiabetic but I was saying "a little OCD is a good thing" years ago - probably started with my brother who drove himself and everyone around him nuts at times, but who parlayed his obsessiveness into a highly successful career (as many so called Type A personalities do). It's kind of funny I say this, because I make a point of telling my students there is a big difference between say being diagnosed with Major Depressive Disorder and "I felt depressed the other night when my boyfriend didn't text me". But I was absolutely using the term "obsessive" in a non-clinical sense. I was not inferring at all that "there are people on here that have OCD because they test too much and they should be put on meds." Perhaps that's how this whole misunderstanding started? We all can have some of the traits of mental health disorders (can and do!) without in any sense meeting the criteria for full diagnosis with those disorders. That's why I started out listing the four D's of distress, dysfunction, danger and deviance.
Yes, I bristle as much as the next Diabetic when I hear a doctor telling someone with good control that they are "testing too much" or being "obsessive" - and it's probably turned both concepts into dirty words for many of us. On the other hand I think many of us cross a line sometimes where D takes up too much of our mental real estate and that's what I'm calling "obsessive". I think we all seek a healthy balance. Too little attention to D and our health is negatively impacted. Too much attention and we are not enjoying our lives as much as we can. Chronic illness, imho is always a balancing act and we all make different choices to achieve maximum quality of life. If I achieve an A1C consistently in the low 5's but I'm always feeling miserable, stressed and deprived, I'd rather aim for around 6.0 and enjoy my life more. Someone else maybe can achieve numbers under 5 without feeling miserable. Kind of like some people effortlessly get A's in school while others have to work 10 times harder than for a B which is also a good grade.
I HOPE I'm not misunderstanding you, Zoe. At least I'm trying to understand you!
Seems to me that you're the only one who knows what's right for you, and you have the intelligence and self-awareness and honesty to deal with that.
I'm very definitely dealing with different issues from you. I really rather totally ignore diabetes. Found out the hard way that THAT doesn't work. So overtesting is definitely not an issue for me. The reason the CGM works for me is that I can watch the trends and if my BG comes down to baseline within 3 hours after eating, the exact number really isn't important to me. On the other hand, when I binge or overeat, and either omit a bolus, or bolus way too little, that huge peak on the CGM tells me to test, and again, even if the number is not exact, the fact that it motivates me to test is a good thing, because then I WILL correct, whereas otherwise, I would just ignore it. Before I had the CGM, I didn't test as often or when I should have, so for me, it was a good investment.
However, you're not me, and I totally trust your ability to work on the things that YOU need. And you're right that the term OCDiabetic is only half in jest!
I totally agree that it's a balance Zoe. I (and I think all of us) sometimes trend towards one end (obsessive, for me) or the other (lackadasical) before re-achieveing that healthy balance. I visualize it as a pendulum that's always swinging, with my goal to have it swing very gently and not too far.
interesting topic. as I was just considering the inherent OCD behavior that comes with being a "good" diabetic. the constant charting, medication refills, perscriptions, logging everything you eat for two weeks and trying to problem solve , uploading your device, checking bg's, Dr visits...etc.., the more obsessed the better I do. But I really don't have the energy. life happens and I start living and my good numbers slip away...and something wakes me up again...fear of losing my feet, my eyes, my kidneys and the obsessive charting starts again.
Hello Acid,
Cannot be on the net, very much these days. When not trying to survive (on all kinds of levels) I try to visit when time can be found ; ).
Question for my "brother diabetic" to follow-up, if I may? What would you modify re: the tags I used to improve "credibility"? My question is certainly genuine...
Stuart
Moi? LOL
Why can't this program just put "reply" under each post..sigh.
Natalie - that's a great explanation of how you use your CGM and it sounds very useful!
But yeah, you hit the nail on the head for me! In the obsession department, being online is a lot higher than diabetes on my list! I'm pretty comfortable with how much attention I give my D and was really making general comments in this woebegone thread..lol Now being online, including TuD ...that is a WHOLE other story!
hi Stuart, to me, "Excessive-testing, excessive, mental, over-zealous, paranoia, paranoid, psychology, testing, type-a, zealous" listed under the first post have some implications that I would generally try to avoid, barring evidence of excessive testing. I haven't seen anything to make me believe it exists? I have seen a lot of people with a lot of control but I've never seen anyone with too much.
It's key for me to have something else to do, so that I 'fix' diabetes so it doesn't get in the way of getting wasted (c. 1987) or running (these days...)
MountainCat, you said : First when the drug store says 'You're cut off. You've exceeded your limit, insurance has declined your billing'...Maybe GOOD news for you !! Living in the same province , BC , this is how it worked for me ...it is one's Doc , who has to set the limit , who in turns let the Pharmacy know ...Pharmacare will fill the order ..been through the process several years ago ..Doc has set my limit for 400 strips monthly ...and so far I have not used the limit . No questions asked at my Pharmacy either.
If I ran out of test strips because of limits imposed by doc or billing, I would get really upset and anxious. The only reason I'm comfortable not testing all that much is that I know I CAN. That is, when I'm behaving. When I get into a screw it mood and don't care at all, then, yeah, I might not test at all, and THAT could kill me.
does anyone keep written logs of bg...food...exercize...etc...and why or why not?
Hello Jeffri:
Thank you for taking part.
Are any of these fears remotely smaller (long term) because we test? Or looking solely at the short-term numbers (readings right in front of us), are we less frightened something might/will happen in a little while?
The approach we use causes problems... a fundamental anxiety?
Stuart
Hello Terry:
A list of pretty strong negative words typically get used about testing, a particular test and the process more generally... The emotions surrounding tests, testing generally to me seem often negative. Don't hear people going "...I @)#*@*#@ LOVE TO TEST..." too often right -weak, brief smile-?
Don't have the answers, but trying to explore the emotions connected with testing; what is considered excessive, what is too little testing? When does some line get crossed indicating a problem exists? Is resistance. a disgust, a reluctance... about testing indicate a problem exists you think?
Fundamentally until tests are entirely bloodless, non-invasive though I perform them too, by definition, they harm us. Testing is self-injury. And I suppose I want to get my head around that basic issue...
With luck, and time, perhaps my diabetic peers will help figure out the bigger pieces involved?!
Stuart