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Permalink Reply by Alison on August 1, 2007 at 4:53am

I test Tony when he wakes up, before lunch, before dinner, before his bedtime snack, and at 2 a.m.-these are the numbers that I chart for the endo's. I do test him more often when he's had exercise (before and after) or if he's acting funnier than a toddler should or if he's sick.

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Permalink Reply by Billy2sheds on August 1, 2007 at 4:57am

Its a bit of a tricky one... as you're right in saying that there may be more to the story than meets the eye if you are only checking when you get up and before eating. However, on the flip side you don't want to have to do it too much!

I'd recommend that its probably worth every once in a while to do a check 2 hours after your meals just to make sure that you're not doing something terribly wrong... and if the readings appear to be in the right range then go back to your normal routine. Suppost it's a bit of a case of fine tuning but reassuring at the same time.

For me - I'm struggling a bit currently with getting my levels back down within a good range so I've been testing a lot more than the normal routine. Once I hopefully get things back under control I'll be going back to the same routine as you.

Hope this helps?

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Permalink Reply by Daena on August 1, 2007 at 5:04am

i'm instructed to test 4 times daily - before breakfast, before lunch, before dinner and at bedtime. when i was first diagnosed, i tested 2 hours after eating just to see what kind of effects certain foods will have on my bg. now that i can roughly gauge that, i only test post prandial once in a while, especially if i am eating something new.

i also test once before and twice after exercise, at intervals of half an hour. i do this so that i know how my bgs are affected by exercise, and also to detect hypos early especially if i do not exercise close to a designated mealtime. i also tend to test when i need to have a meal later than usual because i tend to go low easily that way. and of course, i test everytime i think i am feeling funny.

johnson & johnson has probably earned a lot of money from me because of all the test strips i order.

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Permalink Reply by Swirlydoodle on August 1, 2007 at 5:57am

Well I am one of those who tests 10 times a day so I say "All of the above." For years I did the four times a day routine, testing before each meal and bed. Since that is when you are probably giving yourself insulin, it is really important to test then, because it isn't good to be dosing blindly. But lately there has been more evidence that those post prandial spikes can cause damage too, so it would be good to at least spot check those times.

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Permalink Reply by Jonah on August 1, 2007 at 7:01am

You want to know how high you're peaking to, but it's not crucial- just interesting. I often test 3 hours later to make sure that I'm all the way back down, and that I'm not too far down, because I'm hypo unaware.
Testing before meals is infinitely more valuable IF you are a type 1 diabetic with no insulin resistance. You need to be able to calculate dosages of insulin.
If you have insulin resistance, or if the before meal numbers tend to run high and you need to troubleshoot, then testing before and after meals become important.
If you're only doing one or the other, do the before meals.

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Permalink Reply by Jenny on August 1, 2007 at 7:53am

How badly do you want to keep your retinas, feet, kidneys, etc?

If you don't test after eating, you have no idea how high you are going and there is a ton of evidence supporting the finding that it is post-meal highs sustained for hours that damage organs.

Your doctor's advice is scarily bad, though common. Just remember it isn't HIS eyes, feet, kidneys that fail if his advice sucks.

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Permalink Reply by Ken Winters on August 23, 2007 at 4:33pm

Caleb,

I'd really encourage you to change your practice. An A1C only shows you your average, it doesn't tell you how much time your spending in the damage zone (> 150 or > 180, depending on what you read) or how much time you're dangerously low. No one can know their body well enough to distinguish between a BG of 140 (doing good), 180 (should improve) or 220 (damage in process). While you might physically recognize 65 (too low) or 240 (too high and I gotta pee now) there are many levels in between you want to avoid.

When I only tested once a day, I thought I was doing pretty good (my A1C made the Doctors happy). But once I started testing 7 times a day I discovered my control wasn't so good after all and I was spending way more time in the danger zone than I wanted too. You're only given one set of eyes and kidneys, do all that you can to keep them healthy.

Ken

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Permalink Reply by Nicole on August 1, 2007 at 8:16am

I test before and afer any food, upon waking and at bedtime, and pre-driving. This typically amounts to 10-15 tests per day.

I would say what matters is how you're using whatever information you gather. I test all those times to make changes, adjustments, and to know where I am and where I'm going at times I think are important. The information is helpful as I work to gain tighter control.

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Permalink Reply by Chloe on August 1, 2007 at 9:03am

Like most everyone else, I test typically in the morning, before meals, bedtime and before exercise. I'll test after a meal if I'm not sure about how that food will affect my blood sugar.

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Permalink Reply by Libby on August 1, 2007 at 9:17am

I test before and after meals, especially if I'm eating something new. I usually test one hour after, not two, because I used to spike high after eating but be back to normal by two hours. I have read that the fluctuation can be just as damaging as consistently high blood sugars, and it certainly made me feel horrible. I try to keep my blood sugar as close to the normal range as I can, including those two hours after eating. I need to test at an hour to find out what I can eat to stay in my target range.
By the way, for those doctors who assure you that it is OK and normal to spike to 160 or 180 after a meal, I have tested a few non-D friends and found that their BG only goes up about 20 points even after 100 grams of carbs! So that is what I aim for, a 20-30 point rise. This means I can only have really low carb meals but it is worth it to stay healthy. My A1C went down from 7.2 to 5.8 after I started testing for the post prandial spikes and avoiding them. My fasting and two hour numbers had always been in the normal range so it was definitely those two hours that made my A1C higher.

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Permalink Reply by mollyjade on August 1, 2007 at 11:10am

I test (or intend to test) when I wake up; before I eat; before I go to bed; before, during, and after any strenuous exercise; and before driving (if I haven't tested recently). I test two hours after a meal if I'm eating something I'm unsure about or if I'm adjusting my insulin doses or even just to see sometimes.

If I were going to test either only before eating or only after, I'd go with before. When you get a high or low number after a meal, you need to know what it was before the meal to decide if it has anything to do with what you ate.

I used to be on the standard four times a day schedule, but I never discussed the numbers with my endo, and they didn't make any sense to me. Now that I have a new endo, we actually do things based on those numbers, so I feel more motivated to test.

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Permalink Reply by aaron f on August 1, 2007 at 12:17pm

All the great insights i've had about diabetes management have come from myself. As someone else pointed out, it's not your endo's kidneys who are going to fail.

It's not that you should disregard your endo, but once a person really commits to taking control of their diabetes they'll probably soon realize they know the disease a lot more intimately than their endo ever will. That's been my experience, in any case.

In response to your question, I test as necessary, typically 5-12 times daily.

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