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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.
You presume to know a lot. I am not the only diabetic I know well, how would you know? Why don't you come out and say you are a doctor if that is the case. Plain and simple, are you a doctor? Not that it matters, I could make up anything if I wanted to.
Just to cut to the chase, I don't rely on my doctor to treat and monitor my diabetes. If I did, I would be on a certain road to death. In my experience, that is as far as doctors and diabetes go. Doctors in my experience do nothing but treat symptoms and never the cause, they are reactive instead of proactive. An A1C is a reactive way to treat, I prefer the opposite, to stay right on top of it and no this is not just anecdotal, many do it that way. If the A1C was the best way to do it, then why did they come out with Continuous Glucose Monitors (CGMs)?
All of that has nothing to do with the OP's question which is when to test. That is all he/she asked and I gave my answer. It's no more right or wrong than your answer especially considering the context of where it's being asked, on an internet forum to complete strangers, You are saying YOUR way is the right way and nobody has any say in this. Really? It doesn't work that way, at least not here it doesn't.
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.
Hi everyone. This is my first post here, after looking around a bit.
I would sure like some guidance regarding times of day to check my glucose level - before or after breakfast, lunch, dinner? All of the above?
I'm pre-diabetic, with an A1C currently at 6.1 . Over the past decade or so, getting my A1C checked once/year, I've ranged from 5.8 to 6.3 (a year ago) but currently I'm at 6.1. I'm on a gram of Metformin twice per day (a big pill in the morning, and one in the evening.
I have a Livongo test meter and strips, and I'm not concerned with costs, if that matters.
The past couple of weeks, I've been testing once/day in the morning after a cup of black coffee but before any food. My numbers have ranged from the high 90s to 117, and once 127. It seems to me higher numbers are associated with more "white" foods which I know I need to eat only in moderation.
If you were me, what times of the day would you test, and would you do it both before and after meals?
For what it's worth, with the shelter-in-place directives, I've lost 7 or 8 pounds by not snacking.
Many thanks for your guidance.
You may get by for now with 1 test/day, in the AM fasting. Do you have a program, or does your meter figure 7 day 14 day 30 day 60 day averages? You could get an ap for the phone to show you a graph of your results. You should take note of what got it to 127. May have been once a year birthday cake?
If the A1C was the best way to do it, then why did they come out with Continuous Glucose Monitors (CGMs)?
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Without getting into theories about greed & motivation, the ultimate goal (not yet achievable) is to mimic Nature as closely as possible with nearly continuous glucose monitoring & coupling it with nearly continuous insulin pump injections....That would be great for Type I pts but counter-productive in Type II until they got to the point of Islet cell depletion.
Prior to the availability of HbA1c tests, many pts learned to cheat by starving themselves for a time prior to anoffice visit, come in and have a perfect FBS, then go home and eat like pigs until their NeXT visit. An HbA1c catches their cheating.
Both the HbA1c and the BS determinations give us important info and complement each other.
Am I a doctor? Re-read the post you quoted, particularly the part about individualizing the treatment plan.
Without getting into theories about greed & motivation, the ultimate goal (not yet achievable) is to mimic Nature as closely as possible with nearly continuous glucose monitoring & coupling it with nearly continuous insulin pump injections....That would be great for Type I pts but counter-productive in Type II until they got to the point of Islet cell depletion.
Prior to the availability of HbA1c tests, many pts learned to cheat by starving themselves for a time prior to anoffice visit, come in and have a perfect FBS, then go home and eat like pigs until their NeXT visit. An HbA1c catches their cheating.
Both the HbA1c and the BS determinations give us important info and complement each other.
Am I a doctor? Re-read the post you quoted, particularly the part about individualizing the treatment plan.
It sounds to me like you are old school. Obviously, the old standards have not worked too well up to now, considering how much of a problem T2D is. Drastic lifestyle changes and new methods as well as the old ones are the best way to tackle this problem which is only becoming more and more prevalent. T2 is mainly brought on by lifestyle which can be adjusted and people are finally waking up. Yes, there is a genetic component to it but in most cases it can be averted by following a healthy lifestyle. A1C is still a valid way to diagnose but it should not be the only way to monitor. This is my opinion, that is all anybody here can offer.
Without getting into theories about greed & motivation, the ultimate goal (not yet achievable) is to mimic Nature as closely as possible with nearly continuous glucose monitoring & coupling it with nearly continuous insulin pump injections....That would be great for Type I pts but counter-productive in Type II until they got to the point of Islet cell depletion.
Prior to the availability of HbA1c tests, many pts learned to cheat by starving themselves for a time prior to anoffice visit, come in and have a perfect FBS, then go home and eat like pigs until their NeXT visit. An HbA1c catches their cheating.
Both the HbA1c and the BS determinations give us important info and complement each other.
Am I a doctor? Re-read the post you quoted, particularly the part about individualizing the treatment plan.
I'm new to this whole type 2 diabetes , and I appreciate your insight as an experienced professional. Sadly, the internet is also a place for various cranks and dipsticks telling us that they have the secret answer.
Prior to the availability of HbA1c tests, many pts learned to cheat by starving themselves for a time prior to anoffice visit, come in and have a perfect FBS, then go home and eat like pigs until their NeXT visit. An HbA1c catches their cheating.
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I see this attitude in doctors occasionally, they seem to think that type 2 diabetes is something you get by being a pig.
Sorry, I have no idea. I am tempting to give the safe, routine answer: talk to your doctor. The trouble is most doctors are guideline-based. But we all have seen what the guidelines did: create an epidemic of obesity and diabetes in America.
I always advise to eat to your meter, which means test your blood sugar before you eat, then test 1-1/2 hours later to see how much that particular food raised your blood sugar. If it raised your blood sugar too high (my personal limit is 20-25 points), then don't eat that food again. That's how you learn what you should and should not eat. (Doing this keeps my A1c in the high 5s, because I never eat anything again that has raised my blood sugar more than 20-25 points.)
Otherwise, test your fasting sugar first thing in the morning to see how that's going, see if it's getting better or worse.
Sounds like a good approach. I'm going to try that. Thanks!
GBL should be checked after 8 hrs of no meal. MOF, I think, they raised it to 10.
Hence, it's first thing am before first meal.
Only water is allowed in that time. Any other drinks, teas, coffee, etc, will skew your results.
6.1? I thought threshold is 5.6 for period of 2 moths and 2 consecutive readings.
Coffee is bad. Dang. I'm a home coffee roaster.
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