Proper time to test blood sugar? (Pre-Diabetic (cost, insulin, work)
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As you wake up, fasted. This should help track your general progress. No need to repeat every single day once you notice a pattern. Spot check from time to time maybe once or twice a month.
After meals, average 1.25 hours depending on what you eat will be the highest spike. Do this to see how you react to different foods. Set a limit and avoid foods that spike you beyond the limit. 140 is a stricter limit but one that should help you avoid complications. 180 is probably more realistic. Something like a regular soda may get you to 300 or more, that is not good.
The most important time to test in my opinion would be 2+ hours after a meal. This will tell you if you remain high or are able to come back down to normal. If you remain high, your treatment is not working well enough and you have to re-evaluate.
Part of the treatment should be diet.
T2D is progressive unless you stop it. In most cases, a proper diet will help you do that.
I am full diabetic, diagnosed in 2006, had it longer for sure..
As far as any A1C reading being good enough, I strive for a number that is as close to non-diabetic as I can. THAT is the number to shoot for. I've been as low as 5.1, I probably average a 5.5 with basically just diet. I've been as high as 7.3. I take only 1000mg metformin once a day. I used to take a second med and at higher doses, it just wasn't working till I changed my diet.
Glycated hemoglobin (A1C) test. This blood test indicates your average blood sugar level for the past two to three months. Normal levels are below 5.7 percent, and a result between 5.7 and 6.4 percent is considered prediabetes. An A1C level of 6.5 percent or higher on two separate tests means you have diabetes.
If the A1C test isn't available, or if you have certain conditions — such as an uncommon form of hemoglobin (known as a hemoglobin variant) — that interfere with A1C test, your doctor may use the following tests to diagnose diabetes:
Random blood sugar test. Blood sugar values are expressed in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L). Regardless of when you last ate, a blood sample showing that your blood sugar level is 200 mg/dL (11.1 mmol/L) or higher suggests diabetes, especially if you also have signs and symptoms of diabetes, such as frequent urination and extreme thirst.
Fasting blood sugar test. A blood sample is taken after an overnight fast. A reading of less than 100 mg/dL (5.6 mmol/L) is normal. A level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes.
If your fasting blood sugar is 126 mg/dL (7 mmol/L) or higher on two separate tests, you have diabetes.
Oral glucose tolerance test. This test is less commonly used than the others, except during pregnancy. You'll need to fast overnight and then drink a sugary liquid at the doctor's office. Blood sugar levels are tested periodically for the next two hours.
A blood sugar level less than 140 mg/dL (7.8 mmol/L) is normal. A reading between 140 and 199 mg/dL (7.8 mmol/L and 11.0 mmol/L) indicates prediabetes. A reading of 200 mg/dL (11.1 mmol/L) or higher after two hours suggests diabetes.
Generally good post, but I'd change the quote above to "MOST of the treatment should be diet." No matter what meds are prescribed, they won't work very well without proper attention to diet. You'll always be playing "catch up" chasing hi BS with higher doses. Some of those meds will cause problems....
Especially is added insulin counter-productive when started too early in the course just to make control look good on paper... Insulin forces sugar into fat cells to be turned into fat and to serve as the guards, so to speak, to keep the insulin trapped there. The bigger the fat cell, the more insulin needed. That's why many diabetics, having high BS, the insulin dose is increased and the BS comes down for a while but then drifts up again, only to have more insulin prescribed and the cycle starts again.
RE: post prandial BS checks: much more trouble than it's worth. As OldGardener notes above, with very special attention to diet and many trials & error, post prandial spikes can be controlled. BUT: those spikes only occur over a few hrs out of a 24 hr day -- and HbA1c is an average over 3 months, so spikes (within reason) contribute very little to the over all picture....More profitable (and easier) to spend attention on keeping fasting levels as close to normal as possible.
Exercise regularly: muscle burns a lot of calories and doesn't need insulin to use up sugar to keep levels low.
RE: post prandial BS checks: much more trouble than it's worth. As OldGardener notes above, with very special attention to diet and many trials & error, post prandial spikes can be controlled. BUT: those spikes only occur over a few hrs out of a 24 hr day -- and HbA1c is an average over 3 months, so spikes (within reason) contribute very little to the over all picture....
Why wait three months for your next A1C? While you are waiting, you are causing more damage and delaying the treatment you should be getting to begin with. So if you wait for your A1C and it's high and then your doctor adjusts your treatment, you have to wait another three months and then repeat the process? A PP test is exactly what you need for the moment. You can truly see if you are in control or not and to see what foods affect you how. You get instant feedback and adjust accordingly. I do not leave things to chance, that would be foolish. You need both PP and A1C to truly stay on top of it. PP's are trouble if you have to do them every day, every meal but that is not necessary, you establish an eating pattern and stick with it. You can try a PP after eating refined carbs and/or sugar just as a reminder of how high it can go.
And you are right, it should be MOST of the treatment should be diet. With me it's ALL of the treatment. I was implying the OP take baby steps. Some people are scared of drastic changes.
Some of the best times to check your BS: upon waking, right before a meal, then one and two hours after that meal, when you feel "funky" and think it might be related to BS issues, when you are going to a lab to have your BS taken, check your BS with your meter right before you have blood drawn, then see how far off your meter is.
Why wait three months for your next A1C? While you are waiting, you are causing more damage and delaying the treatment you should be getting to begin with. So if you wait for your A1C and it's high and then your doctor adjusts your treatment, you have to wait another three months and then repeat the process? A PP test is exactly what you need for the moment. You can truly see if you are in control or not and to see what foods affect you how. You get instant feedback and adjust accordingly. I do not leave things to chance, that would be foolish. You need both PP and A1C to truly stay on top of it. PP's are trouble if you have to do them every day, every meal but that is not necessary, you establish an eating pattern and stick with it. You can try a PP after eating refined carbs and/or sugar just as a reminder of how high it can go.
And you are right, it should be MOST of the treatment should be diet. With me it's ALL of the treatment. I was implying the OP take baby steps. Some people are scared of drastic changes.
Re: frequency of HbA1c-- RBCs have a 3 month "life span" in the blood. The Hb molecules pick up glucose molecules like a sweater picks up lint- once it's picked up, I stays picked up. The more glucose it runs into over the 3 month period, the more it picks up.
Let's say you run a BS of 200 constantly (very artificial, for the sake of illustration) for 3 straight months, then do a test and get 8.0. ….You get serious, start diet & exercise & insulin and your BS immediately falls to 100mg% and says steady for the next 3 months....
If you wait 3 months to repeat the HbA1c, you'll get a terrific 6.0. Great! Keep up the good work. BUT:
...If you do the next Hb test after only one month, it will reflect 2 months of 200mg% and only 1 month of 100mg%-- Let's say the test shows 7.7%. The doc may think you need more insulin and prescribe it. You follow his instructions and wind up dead in bed from hypoglycemia while you slept.
Re: post prandial BS determinations: ppBS spikes are determined by individual diet & and individual metabolic & digestive idiosyncrasies. There's no universal "normal level for a diabetic" except to say higher spikes are usual.
Another artificial illustration: Let's take your BS every 2 hrs. After each of 3 meals, you immediately spike to 180 and stay there for 4 hrs. Your other readings are 100mg%. Add 'em up and divide by 12-- you average 140mg%. Pretty good despite very hi & prolonged pp spikes. HbA1c would turnout to be well under 7.0.
Now spend most of your day worrying about and adjusting diet and repeat the BSs every 2 hrs. Let's say all your fussing gets your pp spikes down to only 140mg% (basically "non-diabetic" levels). Do the averaging again and it only falls to 120mg%. HbA1c wouldn't change much and you haven't significantly changed your risk of complications....
It's the long periods of normal fasting BS that influence the average the most, not high pp spikes. In the real world, the trick is to keep the fasting period BS low and don't worry excessively about pp spikes. More exercise and less (no) snacking between meals does the trick.
Re: frequency of HbA1c-- RBCs have a 3 month "life span" in the blood. The Hb molecules pick up glucose molecules like a sweater picks up lint- once it's picked up, I stays picked up. The more glucose it runs into over the 3 month period, the more it picks up.
Let's say you run a BS of 200 constantly (very artificial, for the sake of illustration) for 3 straight months, then do a test and get 8.0. ….You get serious, start diet & exercise & insulin and your BS immediately falls to 100mg% and says steady for the next 3 months....
If you wait 3 months to repeat the HbA1c, you'll get a terrific 6.0. Great! Keep up the good work. BUT:
...If you do the next Hb test after only one month, it will reflect 2 months of 200mg% and only 1 month of 100mg%-- Let's say the test shows 7.7%. The doc may think you need more insulin and prescribe it. You follow his instructions and wind up dead in bed from hypoglycemia while you slept.
Re: post prandial BS determinations: ppBS spikes are determined by individual diet & and individual metabolic & digestive idiosyncrasies. There's no universal "normal level for a diabetic" except to say higher spikes are usual.
Another artificial illustration: Let's take your BS every 2 hrs. After each of 3 meals, you immediately spike to 180 and stay there for 4 hrs. Your other readings are 100mg%. Add 'em up and divide by 12-- you average 140mg%. Pretty good despite very hi & prolonged pp spikes. HbA1c would turnout to be well under 7.0.
Now spend most of your day worrying about and adjusting diet and repeat the BSs every 2 hrs. Let's say all your fussing gets your pp spikes down to only 140mg% (basically "non-diabetic" levels). Do the averaging again and it only falls to 120mg%. HbA1c wouldn't change much and you haven't significantly changed your risk of complications....
It's the long periods of normal fasting BS that influence the average the most, not high pp spikes. In the real world, the trick is to keep the fasting period BS low and don't worry excessively about pp spikes. More exercise and less (no) snacking between meals does the trick.
I know how A1C works and I know averages, that is common sense. My comments stand and this is coming from a diabetic. Not to mention, it's debatable just how accurate an H1C actually is.
I prefer to keep on top of it. I don't leave things to chance. I MYSELF monitor my blood sugar light years better than a doctor could. They draw blood, run the test, talk to you for a few minutes, give you more pills and say goodbye. No advice on diet or testing. Not once have I got instructions on when and how often to test. I live with this full time, it's not from a book or an article on the internet. It's up to me, nobody else.
What I am missing here? Abnormal blood glucose levels are symptoms of insulin/pancreas issues. All I am reading here is: get the glucose under control. Fixing glucose without addressing the insulin/pancreas problems is like adding oil to a car that's leaking oil without addressing the leak.
I'm not diabetic, and you're the only diabetic you know well and you don't know yet what your final outcome will be.
OTOH- I treated hundreds of diabetics over the course of 40 yrs, making the original diagnosis in many of them and came to know the eventual development of complications (or not) in all but the last 75 or so under my care when I retired.
The average doc only gets 50% of his pts down to the target HbA1c of 7.0 or better. I got 75%+ of mine down to good control. I think that's because I explained the situation, dispelling their fantasies, and keeping it simple, individualizing the treatment plan, not using one recipe for all.
I also know about complications: they don't correlate very well with control-- plenty of pts with good control still get complications, while plenty of those with bad control don't get them...The problem is, you don't know what group anyone falls into ahead of time.
Many pts test too often. Many don't test often enough. Everybody has individual needs. Do what makes you happy, but don't tell anyone that that's the right way to do it just because it works for you.
What I am missing here? Abnormal blood glucose levels are symptoms of insulin/pancreas issues. All I am reading here is: get the glucose under control. Fixing glucose without addressing the insulin/pancreas problems is like adding oil to a car that's leaking oil without addressing the leak.
Excellent point. Good analogy.
In ancient times, the best docs drilled holes in skulls to let out the Evil Spirits. That was cutting edge, hi tech medicine in those days....We dig up their civilization and laugh at how stupid they were.
A thousand yrs from now, they'll dig our civilization up, see how we take care of diabetics and laugh at us. They'll know then how stupid we are now....
We know we're missing the real problem, but this is the best we got right now. We're treating BS in diabetics like a fool would treat only fever in pneumonia. The trouble is, we haven't yet discovered the penicillin that would cure diabetes.
To talk about "diabetes" is like talking about "infection." There are many different infections, each with different symptoms and treatments..... Same with diabetes. It's really a class of different conditions that all share a common final pathway: hi BS. Some pts get hi BS because they don't make enough insulin; others because they don't use their insulin properly; others because various other hormones, like glucagon, cortisone, incretins, leptin etc aren't coordinated properly..etc etc....We don't yet know enough about the details and are just starting to develop drugs to deal with them. ….Someday.
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