To prick or not to prick: the love/hate glucose meter relationship
No one wants to prick their finger, squeeze a drop of blood and stick it onto an expensive test strip to record their blood sugar. It hurts, it's messy and when your numbers a bad, it can make you feel bad. But testing our blood sugar is the only way to know what's going on inside our bodies. The American Diabetes Association recommends that all people with diabetes, type 1 and type 2, test their blood sugars for optimal management.
For those who have been recently diagnosed with type 2 diabetes and are feeling overwhelmed, testing your blood sugars may help you gain some control during this initial stage. Dr. Jennifer Perkins of Duke University says that using a glucose monitor is beneficial for type 2 patients who are using insulin, experiencing hypoglycemia or uncontrolled diabetes. For well-controlled (A1c less than 7%) patients, and those on orals only, she recommends they test their blood glucose with a monitor a few times a week, especially when eating certain foods 'to see what they can get away with.'
Glucose meters reveal what works
Studies have shown that self-monitoring in non-insulin dependant diabetics does not improve A1c's, and may not be worth the extra expense. However, Kelly Love Johnson, diagnosed with type 2 in 2006 says she thinks a monitor is important.
"When I was initially diagnosed (and for about a year) I tested my [blood glucose] four or five times a day. After that, I was more confident about my control and only tested when I changed what I ate or the amount of exercise I did significantly, or if I didn't feel well." Kelly uses a combination of Metformin, diet and exercise to control her blood sugars and has two monitors, one on her nightstand and one in her handbag. "I see my glucose monitor as a tool to determine what will and will not work for me. The best advice a nutritionist gave me is that people are different (obviously), but in the sense that what works for one person with type 2 won't necessarily work for all. Healthy eating and exercise are imperative for type 2 diabetics, but the glucose monitor is the only tool we have to assess daily what's working."
A diabetes diagnosis, a fresh start
Krista Wentworth agrees with Kelly. Her diagnosis with type 2 diabetes in 2010 at 22 years old came as a big surprise. "I was a bit overweight, but not overly so. I was a varsity athlete in high school, and had a history of yo-yo dieting. I thought I had a urinary tract infection and with no local place open on a Sunday afternoon that would also take my insurance, I went to the ER. That night, I ended up admitted to the hospital where I was diagnosed with diabetes."
Krista was told to count carbohydrates and check her blood sugars both before and after eating to see how specific foods affected her. "I remember it being sort of a whirlwind. I use a FreeStyle Lite meter that is easy to use and helps keep me on track and understand how my body reacts to certain foods. Now, I test at least twice a day, sometimes more depending on how I'm feeling and what I'm eating that day. I bring a record of my numbers with me when I meet with my endocrinologist. We review them together and it has helped him adjust my medications along the way."
Krista says she sees her diagnosis as a 'wake up call,' a time to start life fresh and suggests that along with using a monitor, recently diagnosed type 2 patients should be proactive about their health. "There will be a lot of information thrown at you at once, but just take in all that you can and educate yourself. You need to be proactive -- ignoring it will only make things worse. It's really the time to put you and your health first."
Diabetes is different for everyone, and there is no 'one size fits all' standard when it comes to pricking your finger, but a drop of blood a few times a day is a small price to pay for a healthier you.
Guidelines for using your glucose monitor
Who? If you use insulin to manage your type 2 diabetes, you should test your blood sugars 2 to 3 times a day. For those who manage type 2 diabetes with diet and exercise, you may not need to test as frequently.
Where? Rotate! Don't use the same fingertip over and over. Some glucose monitors allow you to use your arm.
Why? Knowing your numbers can help you better manage your diabetes.
When? When you test is entirely up to you but in order to get the best records, use the following timeline: First thing in the morning, before and after meals, before and after exercise and before you go to sleep.
How? Wash your hands (especially if you've been cooking because it's been shown that residue can affect numbers), use your lancing device (remember to change the stickers frequently so they don't get too dull), gently squeeze your finger for a small drop of blood (not too big and not too small or you could waste the strip and get an error reading!), place the blood on the strip and countdown…5, 4, 3, 2, 1!
Interview with Dr. Jennifer Perkins, Duke University
Interview with Kelly Love-Johnson
Interview with Krista Wentworth