Your initial instincts were correct! You need to test more than six times a day to maintain good control. If your endo will not override the insurance company with a letter of necessity for more strips, the insurance company will try to cut your strips to save money. And if the endo and Nurse CDE don’t stick up for you, they will get away with it. I truly hope you can find an endo team that can help you in your quest to take care of your health. Many out there will. Why should diabetics PAY for substandard care? We should vote with our feet.
By your slender photo, I am guessing you are Type 1. RUN, don’t walk, to find a more up-to-date endo team who will look out for your best interests. Please.
Emma, take care of yourself first, and if that means testing 20 times or 2 then do it. Like a lot a people here have said, find a care team that will help you control your BG the way that’s best for you, regardless of what the “guidelines” say. Good people are out there – my endo prescribed 10 times per day when I asked without even questioning me about it. Take care of yourself and have a wonderful weekend!
The only 4 times idea comes from thinking you only need to test before meals so you can set your bolus appropriately. And the 4th test is so you don’t go to bed with a risk of going too low. But testing more often is the only way you can really tell what effect a given meal is having, if your basal rate is right, if your bolus is right, if you can exercise without danger of going hypo, if you can drive without danger of going hypo, if you can snack without going hyper through the roof, etc,. etc.
As a new T1 especially, the knowledge you’ll gain from additional testing is priceless. Once you get into a set routine with good control, it may not always be necessary to test 2 hours after lunch if you eat the same thing every day and it’s consistently OK. But the more you test the more knowledge you’ll have about your control.
The only problem with testing too much is that it can stress you out or cause a roller-coaster BG ride if you don’t understand the delay times necessary to see the effect of corrections. For example:
- You test 2 hours after you eat and you’re at 250 (I think that’s 13.8 in UK units)
- You take an extra bolus shot for a correction
- You test 1 hour later and you’re still at 220 (12.2)
- You take a second bolus shot for a correction
That would be bad, as your corrections would pile up and you’d likely crash too low in another hour or two.
Another example would be:
- You test 2 hours after a meal and you’re 90 (5)
- You eat an extra 10 carbs because you’re afraid of going low
- You test 15 minutes later and you’re now only 85 (4.7)
- You eat another 20 carbs
That would be bad, because you haven’t given the first 10 carbs enough time to really kick in, so you’ll likely go high in the next hour.
None of this really has anything to do with the honeymoon phase, other than the nurse might fear your lack of experience could cause you to over respond, if you test too much, like in the scenario’s I gave above. Also, I see you’re from the UK. It could be that in your health care system 4 times daily is simply the standard treatment levels alloted.
Emma I only test 4 x a day but it sounds like a really good idea to atleast check your bs 2 hours after eating since you were just diagnosed.
My prescription says test 10-12 per day, but if I need more they send a new prescription. I think it helps that my CED’s daughter has T1D. I usually test 8-18, it totally depends on the day. I test: before each meal (4), mid-morning and mid-afternoon (2), 2:30 am (1), 5am (1),before any snack (0-2), before driving (0-6), before exercise and halfway through depending on length (1-2), and any other time that I feel “off”.
Well I just had a similar experience. I am currently trying to get a total referral for my diabetes care at the local Joslin Diabetes Clinic in Dayton, OH. My gen med dr. left the practice so they transferred me to another dr. in the clinic. I went to my appt. and since she was not in the office, I was handed over to another dr. Background info…this clinic has NO idea whatsoever on how to deal with a diabetic…ex - when first going to dr. I requested to be put on Humalog after being on Reg for 20 yrs. She handed me a prescription and sent me out the door. I ended up having to research it online to figure out my dosages. Back to story…the fill in dr. asks me some questions and then I ask for a new prescription for my strips…telling him I test an average of 10 times a day. He looks at me as if I had grown a third eye and excuses himself to “Confer” with a colleague. I sit and wait until he and his partner return. She then proceeds to third degree me…how long have I been diabetic? How long have I been on my pump? How old am I? then tells me…“Well 10 is excessive and 4 times a day is adequate.” I just sit there dumbfounded until she says,“We’ll write if for you THIS time but you need to follow back up with Dr. ---- to discuss this.” WTF! I was so mad at the time that I didn’t have a snappy comeback but I made the decision right there to go as far as I needed to find a clinic that catered to diabetics. The new place is an hour away but I think well worth it. I am waiting now for the referral to get straightened out since they sent the Joslin Center a referral for a refresher course in diabetes management. How dare someone question our right to test as often as we deem fit to gain better control over our illness! You would think they would applaud our intense efforts for control.
This is a big issue to me. I am a Vietnam Vet and I am getting my equipment and supplies from the VA. Being a T2 diabetic, I am allowed only one bottle of strips per quarter, so I am allowed to test my sugar only 1 time every three days. I have complained to the VA that this is not enough, and that I wanted to test more often. I am trying to respond to the numbers by delaying my meals if my BS is high or getting more exercise to bring the high BS numbers down. I don’t want to eat a meal on top of a high BS. So far they won’t let me buy any more strips no matter what. I am told that it’s a VA policy and they don’t believe that T2 diabetics can influence their health through testing. I was told that once I became a T1, I could get all the testing strips I want. I am very frustrated with them. I contacted my Congressman, Honorable Ben Chandler, through constituent services and was told that this is the VA policy and he did not employ medically licensed professionals and was therefore unable to make decisions regarding medical care. He advised me to go to the local Health Department and request more strips there. I don’t think he had the time to waste on me. I can’t believe other veterans aren’t complaining about this VA policy.
Wow now THAT is totally upsurd! I never in my life would’ve thought that the VA would be like that…but then our government doesn’t take care of any of it’s citizens…even their military. Why does our government…in charge of one of the most powerful countries in the world not stand up and offer universal care to everyone? I think it’s because the government is actually ran by the money from big corporations and insurance companies whose government financing calls the shots on healthcare.
My son is 5 and he (we) test his sugar an average of about 12 times a day. Sometimes it’s less and sometimes (especially if he goes low) it’s more.
Drexxy,
Good point! They also just give us Medicare patients just enough to keep us alive but NO more then get upset at us when for lack of meds we run out of control! It has seemed to me on more than a few times they want to make it look like their doing everything for us when in reality their doing the bare minium. Sorry just my 2 cents worth. After seeing what they done to my grandfather who was a WW 2 vetran and my dad who is a Vietnam Vererian it gets really discusting but that’s our goverment it really doesn’r surprise me anymore!!!
James, that’s ludicrous to say BG testing can’t help influence T2 care, of course it can. Two ideas come to my mind. 1) You might try finding some urine test strips. While not nearly as good as BG strips, it would give you some sense of your control for the day and it’s a lot cheaper. 2) Years ago there were strips that you could visually compare with a chart (no meter) and you could cut them in half to save money. I don’t know if they are still available, but it might be worth looking for them.
I test on average 10 times a day. Most of the time it’s probably more. It’s part of how I have pretty good control over diabetes and my doctors have always encourages me to test as many times as I feel comfortable.
Wow James that’s sad - I understand that studies have proven T2s don’t get anywhere by testing more, but that, I think (?), was based on testing 3 - 4 times a day. Either way, it all depends on their ability to deal with what they see. If you see a number and it’s just a figure, then more testing wont help - but if (like you) you delay eating, or get in more exercise, or lose some of the carb from a meal… then testing more IS helping.
Personally I believe any diabetic should have as many as they like - after all, we don’t use them for FUN!!
BTW James, you can’t ‘become’ a T1 from a T2. You’re either one or the other. It’s not about insulin / pills etc, it’s about the cause of your diabetes (auto-immune vs - well, they reckon obesity & pancreas strain & genetics but I don’t think anyone knows 100% what causes either type)
Your nurse is obviously not a diabetic. What reason do they give for not testing more than 4 times a day? Is this some arbitrary number or is it a scientifically derived number? Or better yet, did she read it out of some ADA book? Tell your nurse to tell you her source of info. And if your nurse can’t give you specific reasons for that number, find a new nurse.
As for me, I test as many as 12 times a day. It all depends on what I am eating and how tight I want to keep my sugar levels.
Of course, ideally, you should have some idea of what food your eating and how it will effect your sugar levels. But testing is the ultimate way of knowing what your levels are.
Tell your “nurse” he/she doesn’t live with what you have and if they’d like to take your place, they are welcome to it. In the mean time, keep testing and maintain as close to normal blood sugars as you can. It’s the only way to avoid long term complications.
Always fighting for the individuals right to protect and maintain their personal health.
Andrew
Dang James!!! that is so unfair!!!
Oooh I just had a big issue with this at the pharmacy yesterday. I am still furious!
Doctor gave me a new script for strips yesterday. He wrote it for 100 strips but he also wrote… test bid before meals… well bid is only twice a day. I never looked at the script though so I didnt know there was a problem until I went to pic up the script.
The pharmacy tech grabbed my package and told me 35.00. Right away that bothered me because last time it was 20.00. Nothing I could do about that, I guess the insurance company changed their coverage. But then I noticed there were only 50 strip in the bag. She said…well that is what the doctor ordered and your insurance comany will not allow any more than that anyways. I argued with her that he wrote 100 and that is what I needed. Shekept telling me that she couldnt do anything about it. I told her that no diabetic should ever test just twice a day, they are crazy if they did. Well then she got mad and said she is diabetic and only tests twice a day. So (angry me) told her she was crazy and risking her life. So I aked for a refund.
I went straight to my car and called the insurance company. I was so lucky and the insurance lady was so nice. She checked for me and told me I could have as many as I want and it would be 35.00 regardless of the amount.
Then called doctors office and asked them to please rewrite the script for 100 strips and call it into another pharmacy. Dumb me should have asked for more but I wasnt thinking straight.
So basically I test 3 times a day and sometimes 4. I always wish it were more. Sometimes I want to know what my sugar is and cant do it.
Type 2 by the way if that makes any difference at all.
I am still debating on calling that first pharmacy back and complaining about the pharm tech. She doesnt have the right to say that 2 a day is sufficient, she is not my doctor.
If she was indeed the pharm tech and not the pharmacist, than yes you should call and complain. The techs are in no position, diabetic or not, to give advice on the treatment of disease. Legally, she can’t dispense more than the prescription is written for (unless you buy them over the counter), but regardless, sounds like the attitude needs some adjustment.
Hey James,
Have you tried medicare or medicaid? If not, it’s worth a try. There always advertising that they give out supplies if you need them. At least that’s how I understand it. After all, it is America’s “FREE” health care system.
Contrary to popular belief, we already have “Universal” Health Care. It’s called Medicare and Medicaid.
(I know, nobody asked. Sorry for being so sarcastic.)
Peace.
Andrew
P.S. One more thing, try contacting Liberty Medical. There website is libertymedical.com. It’s worth another try since you seem to be quite concerned about your health, which is a very good thing. Not that many of us out here.
Andrew,
I cannot say anything about Medicade but Medicare will only take care of so much. James you might wan to try getting your Dr to aprove more testing threw Medicare that way you can get the teststrips you need. Their Insurance coverage is pretty good.