Number of tests question?

One of my coforumites asked me how I could arrive at an average of 14 strips/ day, wihch might be an ok number. Adding it up, I’ll arrive at a bare minimum of 10. I figured I’d put it up here so people could comment if they think this is ridiculous or appropriate. I guess the next step would be to come up with an acronym and uniforms for our militia group to wear when we’re feuding with insurance companies and government agencies.

  1. wake up test, which can be a wake up and eat test. If one woke up, spent time getting ready and then ate, you might smoke a couple now. I’ll call it one?
  2. test 2 hours later to see what’s up, if I were going to eat a snack, I would try to snack and bolus. I get to work @ 7 and two hours after I eat is 8 and then I don’t eat lunch until noon, so I could perhaps see an additional test
  3. lunch test
  4. 2 hour post parandial test
  5. Before I drive home from work test.
  6. pre exercise test
  7. post exercise test
  8. pre dinner test
  9. 2 hours after dinner test
  10. pre bed test

To me, this is ths BARE minimum number of tests that should be prescribed, or 300/ month, except in February. I can get this number a lot but, OTOH, I can also see a need to test before you eat in the morning and, reasonably and prudently, to test before you hop in the car, which gets you up to 11? I tend to run lower in the afternoon and ate lunch today and skipped snacking so I ended up a bit lower and will have to test again before I run. I will probably run about an hour so, reasonably, I will test after about 1/2 hour of running? If any number is off, as happens occasionally, you would need a correction bolus. If it were LOW, you might need to test again in 15-30 minutes, depending on how low it was. 10 seems unrealistic since with any diversity in your activity level. I think a dozen ought to be at least the standard and it also seems as if it would be relatively easy to push it higher with any sort of regular exercise program which is, of course, recommended for EVERYONE!!

You said “which gets you up to 11” after “test before you hop in the car.” I am guessing since you went from 10 to 11 with that statement, you were adding 1 test for driving. I would actually add 2 strips for driving, not 1. If you test before you hop in your car to go to the grocery store or mall, you can easily be walking around for an hour and you really should test again before hopping in your car to get home.

Even if I am in my 60s, I test again in 15-20 minutes because sometimes I keep going lower. I like the 2nd test to make sure my BS did start coming back up again.

You should also do the occassional 3 AM test just to check overnights if you happen to wake up.

And then there’s the times you screw up and place the drop before it’s ready, that’s one more. And if you have a Dexcom it requires tests every 12 hours and if these don’t fall within your testing schedule you could potentially add a couple more. And sometimes it just goes low for now apparent reason all through the night and you have to test at least once to double check and then again to make sure it’s good… and on and on and on. I test bare, bare minimum 8, more often than not 10, sometimes 14 or more.

Thanks, I keep forgetting about the “before you drive” tests, which I should no longer neglect as I had a hypo while driving just a few days ago.

I’ve been struggling so much with highs that the lows always seem to come at me like lightning out of the blue, but of course I should test before I drive because that would be the worst time for me to go low and not realize it until I’m quite loopy.

I also neglect the “wake up” test as I take Synthroid when I wake up and then I have to wait an hour until I can eat, so I think “why bother?” and just wait and test right before breakfast. The problem of course is that (when I’m working) I hop in the car, commute to work and eat breakfast at my desk; a “wake up/pre-commute” test should definitely be added to my schedule on work days!!!

I think insurance should cover “as many test strips as the diabetic patient wants”, because you know there are plenty more people who test 0 to 3 times per day than their are people who test 12 to 14 times per day. It all averages out to a number with which the insurance company should be able to cope!

Of course test strips are OUTRAGEOUSLY over-priced. If ink pens were as overpriced as test strips, a basic pen would cost you $100 (or one dollar per “use”). It’s highway robbery.

I’ll bet it costs about a fraction of a penny to manufacture a test strip. I’d love to have a look at their books. I thought usury was one of those deadly sins, but we have some of the most usurious medical supply and drug companies imaginable.

I often have to test as soon as I arrive home from running errands. I get so frustrated with traffic tie ups, construction and moronic drivers I tend to drop from driving. I’m a minimum of 15 strips a day and have to fight with my insurance every month over those numbers. It’s ridiculous!

Sometimes it’s a hassle but I have always gotten insurance to pay for what ever I’m using. I’ve had to have my Dr. write a letter of necessity in the past but more often he just writes the prescription for what I use. They always question it and are quite shocked but they fill it! :slight_smile:

I totally went off on the Blue Cross person about the “letter of necessity”, pretty much “what the hell is the prescription for. She’s a doctor and wrote that I need that many?” Plus, now i have a copy of her letter and it says "he needs that many because he tests 17x/ day [i think maybe she was checking the *pinging* when I put the CGM # in as a reading, to check iOB?] because he exercises a lot and has frequent hypoglycemic episodes. I am waiting for the “you are a drug fiend and should take less insulin so we will cover less insulin and you will have to cover your deficit with OTC R”

I had a medical person , who I told to , that I test about 10-12 times daily ask : don’t you think this is excessive testing ?? …I did get the strips I asked for .I also mentioned, I have never been in ER due to Diabetes. …I must give the person much credit for listening !

Oh, you crazy insulin fiend. Don’t you know that insulin is a gateway drug for Skittles?

Your making me think about this…

  1. wake up 7am
  2. breakfast at work 10am
  3. lunch 2pm
  4. 2-3 hours after lunch to verify dex is still working right
  5. before dinner 7pm
  6. Couple hours post dinner 10ish
  7. midnight
    8)1-2 am pre bed time test
  8. bedtime test

I can cut any of those down as the Dex is usually only off 10mg in one direction or the other. the swing line is about 90mg/dl. I think that I have cut back on testing though. I use the Dex to keep me in line more than before. Before I would test 12-15 times easy. Shhes at bed time you could count on at least 3 tests (once every 15 min) to observe trends.

I personally thought I was going to be an excessive tester when I was put onto insulin because I was so hypo afraid. I actually tested more when I was on diet/exercise only. I have been on insulin for 2 months now and am only testing about 5 times a day (I am stocking up on test strips for when I become pregnant and must test many times a day). Before insulin when I was diet/exercise controlled only I was testing about 8 times a day so I knew how much exercise I needed to do to lower my bg (which was multiple times a day) and how many carbs I could eat which was very few anyways. I do believe the more you test the more you know and can do something about it and acheive tighter bg levels. I am about to increase my insulin and my testing to get under tighter control because I have been seeing a lot of 140-180 numbers and I need to lower all of my numbers to have a healthy pregnancy. I do not think there is such a thing as excessive testing just more knowledge to acheive the best bg possible. Keep up the great work!

I think an individual’s needs really vary (much more than simply type or whether you use insulin or not). W/o a cgm, if you really wanted to see the effect of a food and insulin then just the regular 2 hour pp won’t tell you that much (you might miss the 2 hour spike). If you change up your eating habits often you and really want to know, you could end up having a higher strip count.
On the other hand, if you’re being frugral with strips you may end up doubling up. Like for me, I usually excericse after work so my post excerise also doubles as pre dinner and then my 2 hr pp for dinner is usually the pre bed test.
And the cgm’s accuracy really affects the number of strips I use (when it’s off I test more often esp. because I don’t sense lows and can only rely on a “feeling off” factor which could easily also be a high or just normal but tired/dehydrated/forgot to eat lunch feeling.
Also I don’t drive on a regular basis so that cuts out extra testing as well
To sum it up though, I agree with the others who said that insurance should let it be up to the individual ~though maybe we’re all secretly masochists who enjoy pricking ourselves numerous times a day :wink:

This is why it infuriates me when people talk about “tight” control as testing 3-4 times a day. When I tested that little I would typically average about 140 with an A1c around 8 (so you can go ahead and burn those conversion charts while you’re at it, even when I test 10+ times a day and average 120 I barely clear 7 if I clear it at all).

When my PCP asked, I just said that there are at least 3 meals in the day – so one pre and one post meal and you’re already at 6 (enlightened look crossing his face at this point). Add on 1 for my evening walk to the T, 1 for my afternoon snack since it tends to be a little bigger, 1 pre-exercise, and 1 bed time and I’m at 10. When you add on all of the incidentals – anytime the CGM beeps, anytime I wake up at night, anytime I exercise more than an hour, etc – it’s well over 10. So, in the nicest possible way, I say go #$!% your 3-4 tests buddy, I need 12-14.

I’ve wasted numerous strips by putting the drop in too early or too late (the meter powered down). And also reminds me that you can also end up with DOA strips.

When I’m not pregnant, 10 times per day is a good number for me. I often eat similar foods, and with the CGM find that I can get by with less than 10 per day if I’m not doing anything unusual - which leaves me with spares for those days when I do need them.

At the moment, I’m testing more like 17 times per day, plus using the CGM. I get a kick out of telling medical staff that when they ask.

Ha ha!!! I’m a user, I admit it. Love it. Can’t get enough! Love that high I get from jabbing my finger tips and sticking myself with needles! OK, are there really people who stock pile and sell on the black market?

Maybe the Dr. should write “yes, they really use this” on the bottom of the prescription. Do you think that will work?

AMEN to that!

Unfortunately, there are people that do that. I knew someone on another board that got a ton of strips from a coworker because the coworkers husband did not use very many and his supply company kept sending them to him. Look on eBay sometime and see how many people are selling test strips. They have to come from somewhere and they did not walk in a store & get them for $30 a box and sell them for $5 a box.

I have been having arguments with my GP surgery this week on this very issue - I get prescribed 3 x 50 strips per month and always run out and need more. This week they refused to prescribe more, it ended up really messy with me getting upset/angry and got my hospital DSN involved - the strips were prescribed eventually but it was a stressful time.
I have asked that my prescriptions are increased to 4 boxes per month (and even that is being tight with testing) but they won’t adjust it.

I am now 4 months experienced with my pump - but still tweaking basals, still occassionally testing through the night, still testing before and after exercise and when walking my dogs, not counting testing for the hypo mid zumba last week…frustrating isnt it…

I reminded the GP very clearly that in 4 months I have reduced my hbaic by 1.4 already - and reminded them what it would cost to hospitalise me with ketoacidosis, or treat complications…

Thank god I have my hospitals support with this one…