How important is BG testing?

Hey. I am a recently dx'd t2 person on metformin. My last A1C was 10.8%. I'm going into my PCP a week from today to talk about my health, and I was interested in getting some feedback to take with me.

It has been almost a month since diagnosis, I've been working on changing my diet and have been on 500 mg of met 2x per day. I've been having a lot of trouble figuring out if I'm high or low or what is going on, and ending up feeling like crap/having headaches because I feel like I'm flying blind. From what my doctor said at the last appointment, it seems like she regards testing as unnecessary for me at this point because I'll be fine to figure it out and testing is expensive and most people don't test regularly anyway.

Should I push for getting a glucose meter and testing strips? Not knowing feels really frustrating, but I do understand that there is a learning curve. Alternatively, poking myself doesn't sound like tons of fun.

Your curiosity will help with diabetes. I'm am not type 2 so I haven't walked your exact path.

Testing is your lifeline to learning about how you work. You need to learn about your post-meal blood glucose curve and how various foods lead to certain results. You can only learn this if you test, keep a written record (at least for a while), and change diet as needed. There's a wise expression that you'll see written here often, "Eat to your meter." If your meter doesn't like it, cut it out and try something else. You'll discover that carbohydrates primarily drive BGs, but fat and protein play a role as well.

There are several T2s here that sport A1c's in the 5% range. Most of them limit carbs to some extent. There are lots of low-carb articles here and elsewhere on the net. It's a blood glucose, weight loss gem!

Yes, I would push for all the test strips you can get. You may have a fight on your hands as insurance companies and Medicare are getting stingy with strips. It's short-sighted policy that they will live to regret.

Test, record, learn, repeat. Don't worry about the poking, after the first ten thousand or so, it's no big deal ;-). That's actually one of the easier things to get used to.

I noticed in your profile that you were just diagnosed last month! There's a lot to know about diabetes and it will benefit you greatly to learn a few details. There's books, videos, and forums like this. I realize that diabetes is never on anyone's chosen path, but how you respond will define part of your character. You have the potential of restoring some of you insulin sensitivity together with the possibility of reducing or eliminating medications. That usually involves losing weight if needed while changing the way you eat. Best of luck to you!

I think I would get a new doc. Testing is really the only way to know what is going on and imo it is the cornerstone of diabetes care.. if that is a good way to phrase it. The more you test in the beginning the better because then you can see how certain foods and exercise affect you. There is no point taking medication that affects your bg and having no idea what is going on imo. The finger sticks aren't fun but you get used to it pretty quickly. I recommend using the one touch mini ultra lancet device and lancets because they are super fine and much less painful than nearly all of the other ones I tried. Great advice from Terry. Good luck!

hi morphic! im sorry to hear about your diagnosis. its a big life change, but it seems youre on the right path, doing your own research and trying to take control of your health!
i completely agree with meee and terry. you NEED to test to see what your bg is pre and post-prandial, to see what different foods do to bg and to keep on top of things. the fact (if its true) that most people dont test is a ridiculous argument to deny you strips-if everyone jumped off the brooklyn bridge....
i would also get a new pcp or get a referral to an endo, see if theyd be more helpful.

if all else fails and you cant get the strips on prescription, walmart has a $15 meter (relion brand) and 50 strips are about $9 or $10, much cheaper than the big brands and quite accurate in my experience. i am only allowed three strips a day and so have to supplement with the relion ones.

let us know how things go!
m

I agree with all the people above, testing is important and will teach you a lot about your body. I would not know what to do without testing.
About poking: its not much fun, but there are worse things in life, and in my opinion it is worth it in exchange for a bg result that tells you what your actions made with your glucose level.
take care
SC

Taking control of things can be pretty challenging but can also provide a unique and fulfilling sense of accomplishment. Running your A1C at 10+ for long periods of time increases your probability of experiencing complications pretty significantly.

The problem with your Dr.s approach is that T2 is a highly variable condition. Since diet is a keystone of any T2's treatment you need to test frequently to find out your bodies response to various foods. When I was first diagnosed I tested before each meal and at one and two hrs. postmeal. It soon became obvious which foods were causing me problems. I then eliminated the problem foods and my A1C plummeted from 13.2 to 5.6 in a matter of months.

This is called the eat to your meter system, basically you set a blood sugar target, mine is to never go over 140, and eliminate or reduce quantities of the foods that cause you to exceed your goal. I wound up drastically cutting carbs to the 30 to 50 G/day range, not because I was following a diet given to me, but because my meter told me this is what I needed to do. You will find an explanation for the "eat to your meter system" on the bloodsugar101website. Pay particular attention to the topic "How to lower your bloodsugar".

You are unlikely to get support from your Dr. Mine felt once or twice a day is sufficient and hinted that I was perhaps OCD for testing so frequently. Testing at this frequency is indeed pointless if you do not act on the results, but if you use the results to change your treatment it is the fastest path to a good A1C. After the initial testing was over I cut out the 1 hr. post meal testing because the type of slow acting carbs I was now eating caused no spike at that point. I kept up the other testing because it was a positive reinforcement that kept me on my new diet. Now 4.5 years later my testing is much reduced. I have no problem sticking with my diet, so the need for positive reinforcement is diminished. Now the purpose of my testing is to alert me that something has changed and my treatment needs to be adjusted.

You don't need a prescription to buy a meter and strips but one is needed to get insurance to pay for them. If you can't get a script I would recommend purchasing them yourself, it's an investment in your long term good health. The cheapest strips right now are the Relion brand from WalMart.

Many of us who follow this system wind up eating a low carb high fat diet. Again you may experience push back from your medical team. You will have to research the pros and cons of this approach and make your own decision. I would recommend the Low Carb Dietician Blog to acquaint yourself with the arguments for adopting such an approach, it is well researched, footnoted and well written.

TestTestTest......They caught me early with a 6.9 A1c. I tested 8-10 times a day and brought it down to a 5.1 in 7 months. It is the only way to figure what you can and cannot eat. Period.....Oh I'm a T2 for almost 8 years, diet and exercise only so far...Good luck...

It bothers me when doctors tell patients not to test. Testing is the only way to control this monster.

Terry said that he is not Type2 and hasn't walked your path but I'm T2 and I have walked it, I recognize that the advice he and the other posters have given is dead on right

One of the biggest obstacles to successful treatment of T2 is an indifference that is often seen in those that have it. T2 is not an in your face disease like T1 but the need to get on top of it is just as important. There is a tendency to view the consequences of T2 as a future problem, nothing is further from truth. The sooner you become aggressively involved the better. Your doctor is doing you no favor with his or her no testing advice.

I smiled at Terry's statement that testing is no problem after the first ten thousand of so. He was dead on right about that one too.

Thank you all for the responses! I feel so much more confident going in ready to ask for what I need, and equipped to handle it if the doctor doesn't agree. I also feel slightly less intimidated by the self-poking aspect :)

That's great Morphic, good luck :)

You have gotten great feedback. But let me also give you my perspective. When I was diagnosed, it was three months before I finally got a meter. And at the time, I was told that I was testing so that my doctor could monitor my condition. I consider that the first of many mistakes that my medical team made in the treatment of my diabetes. It took me a while to realize that this is "my diabetes." I am at the center of my care and after years of bringing specific logging of my blood sugars to my doctor and having them ignored, I now realize that I test for myself. And that testing should be actionable. As others have mentioned, you can adjust what you eat to attain better blood sugars and change your patterns of exercise and activity. So I would urge you to take charge of your diabetes.

Now, the second suggestion is that you get aggressive. On average, metformin has been shown to reduce your A1c by 1% for newly diagnosed patients. With an A1c of 10.8%, metformin alone will still leave you with an alarmingly high blood sugar. I would urge you to be more aggressive and if your doctor won't help, you may need to find one who will. In fact, the American Association of Clinical Endocrinologists (AACE) recommends starting insulin in new T2 patients with an A1c > 9% either be immediately put on two or three medications or be put directly on insulin. In my opinion, giving you a fractional dose of metformin and be told "wait and see" isn't what I would consider good care.

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Wow, those numbers are really helpful (and alarming). Those documents were very useful too. I'll definitely try to bring it up with the doctor on Friday. Thank you!

My meter is a trueresult. I got it free with the purchase of 100 strips which were about $25. My last insurance covered one strip per day. In my opinion that is not enough.

I have been T2 for nearly 15 years. I think I would change doctors but it can be hard to find one that will really listen. Sometimes you just need to do what you need to do and to some degree ignore the doctors.

I also eat to my meter and have kept my A1C under 6.0 for the last several years. I don't low carb anymore but I eat lower carbs. I take a boatload of drugs. I exercise like a fiend.

It is good that you are asking questions now. If you don't advocate for yourself it is likely that no one else will.

Great advice Brian, I totally agree. I didn't comment on her A1C but that is way too high or sure. Morphic if I were you I would try to keep your A1c at 6 and below, really 5 is best, but if you're on insulin lower than 6 may cause too many lows for some people. The only thing I would say is try to lower the A1c gradually, not really rapidly because some people get retinopathy if they lower a high A1C too quickly.

I'm not a type 2, but I was misdiagnosed as one, and went to a doctor originally with a t2d diagnosis, she told me to test 2 times a day (which would not be enough for me but maybe for you) . The most important tests are when you first get up and before you go to bed. If you only test 2 times a day, make those your times because your pre-bed blood sugar and wake up blood sugar (fasting) tells you a lot alone. If your a1c is 10.8%, you definitely NEED to be testing because then you can figure out if your metformin is enough, so you probably would also wanna add a few more tests in there at least until you know for sure if your treatment's working right. I'd say if you can't get one from this doctor , and live in the US , get a Reli-on meter of some sort from Walmart or a true/nipro meter from cvs, walgreens, stores like that. They're pretty affordable and accurate. I have a reli-on confirm for a 2nd back up, while right now I have a bad batch of strips that's way off, they typically match my onetouch ultra meters(which match the lab) and a box of 100 is only $36 I think? Like if you can manage to get one off this doctor, good for you, but I really think that you need to switch. Your doctor should give you one or at least recommend one for you.

It’s tremendously important, but only when there’s a point to it. I tested 10+ times a day when I was first diagnosed… Until I figured things out a lot, then I realized I was testing constantly when I could already guess the results pretty accurately, and testing when I already knew that my levels were where they should be. I’ve realized that for me over-testing was becoming a compulsive behavior, and have since forced myself to test less. Generally test 4 times a day now, sometimes less depending on circumstances… I definitely don’t think going from 10+ to 4 has reduced the effectiveness of my management at all

I’m was 7.1 and someone on here helped me out to encourage me to eat low carb high fat diet… I just started testing my blood a week and a half ago and I have been well below the stated numbers and it has helped me to not eat out of my radius to keep them low… you can get a free meter from one touch.com verio flex and it has an ap to sync to your phone! Can’t say enough good things about it! Please go to their website to see if you qualify and they will send you an email and then forward it to your Dr so he can write you a prescription for it! It will be the best thing you can do to help control this high number(s). It isn’t difficult, hard or bothersome… I test once per day and learned I needed to prick just to the side of my finger pad to get enough blood as I ruined a lot of strips with not enough blood. Your diabetes coach will help you learn to use it…