I agree with what you wrote above. I have been T1 for 37 years. No complications, good A1C'c, and test 4 times/day.
I also want to add, if you test so many times a day then you lose that natural ability for feel your lows and highs . . . at least that's the way it was with me.
I disagree that testing 4x / day is "overkill" as Stephen's endo purportedly put it or causes degradation of your ability to perceive lows and highs. Unless you have a link to a study or something? I'm not aware of studies proving that avg BG of like 100 offers any advantage over say the 135(6.5) to 150 (7.0) that doctors recommend but, given the general "hint" of the lines in studies that have shown lower A1C *generally* leads to less complications, I figure I should hedge my bets by maintaining control as close to the normal range as I can. I haven't found it caused any sort of problems to test other than the inconvenience of haggling with people at insurance companies. I've found that a few extra tests can allow you to investigate the sources of deviations in blood sugar more closely, filling in "blanks" in your record and smoothing out curves. The alternative is to eat conservatively and I sort of do that as well but I still want to test in the double digits and disagree there's any sort of negative impact from that.
Glad you nailed this one acidrock23.
Unfortunately some well meaning - confused folks who drive that drivel are helping no one.
If one's body is mostly working with smooth slowly running curves, why yes one can take less samples and generally be ok that may be sufficient.
But fact remains on any body/ equipment misbehaving and doing things out of band, intermittently, more tests will need to be done - ie cgms to catch culprits and misbehaving.
If one is tracking meals activity and bumps, it should be plain one may need:
a) wake up fasting.
b) morning meal peak
c) lunch meal peak
d) dinner peak
e) late night to bed peak
f)any insulin dose readings - assuming 1 to 3
g) a couple of spoiled out of range readings - the human body blood system is like ethernet network cable where density of traffic can end up with thicker and denser than normal packets causing high readings should one sample one of those packets whizzing by. Human system does not stoichemetrically load balance all loads - same size packets always on and off blood system like token ring network so all blood finger stick readings will be a proper average - reading always. ie watch liver dump or munch a couple of glucose tablets and watch the sudden heart stopping readings one gets on the caveman machine. CGMS is polite and averages those surges out so you do not see.
f) a few outright bad strips.
So for real work that a patient can use and get sensible info, one could easily be at 6 to 10 strips a day.
The utmost asinine stupidity is the one strip a day and the beaurocrats pushing that crap. That is not to demean a Doctor/expert who knows his patient and can understand how to minimize to one strip and assume the performance.
For the patient, that is tantamount to standing in middle of Camarillo with wet one finger up and then tell what Camarillo looks like.
My chart goes like this. I have typed it before, maybe in this thread but, at some point, I decided to "save" it to save retyping it all the time!
1) wake up, test bg
2) before eating test BG
3) before driving to work test bg
4) 2 hours after eating test bg
5) lunch test BG
6) 2 hours post lunch test bg
7) drive home test BG
8) get home, run 3 miles...oh wait, don't forget to test your bg!
9) post-exercise maybe, maybe not, maybe eat dinner and, you guessed it, test BG
10) 2 hours post BG, test BG ****AGAIN****
12) stay up late? Maybe squeeze in another one, what if you have errands to run, what if you want to exercise more (when it's nicer out, I'll run 6-7 miles during the week, more on the weekends...a lot of times, I'll run a long run on Saturday and then a 20ish mile bike ride for fun, speed and recovery on Sunday...there's several extra strips in there...
Only the earliest of T2's who are watching diet and exercising regularly have a steady smooth wave up and down. The rest of us, late T2s and T1's have BGs that can go anywhere at any time, so it's ridiculous to be expected to manage on 4 strips a day. That's like a truck driver only looking at his speedometer 4 times a day. WTF? I see a cop in the curve of the road (read complications)!!
I get smooth waves by testing a lot and keeping an eye on it. The "invisible hand" ("tasty hand?") might be food. I suspect that one could manage with less testing if you were *extremely* conservative with your food but even that can be subject to YMMV issues and other challenges.
Part of the reason I get so wound up about this issue is that every time a person with or involved with diabetes says "4 strips/ day is ok..." they are joining the enemies, beancounters who work for insurance companies and government health agencies...
You might do better buying them off of EBay. I can typically get them for half.
I also am utterly opposed to participating in the gray market. It's a medical question and medicine has failed to answer what should be a simple question...how many strips do we need? I don't find Medicare's answer of "4" to be remotely credible.
One can buy strips at amazon and american diabetes wholesale. I usually get em 1/2 off.
As I understand medicare's official policy is:
without Dr's script:
1 strip a day for type 2 not on insulin.
4 strips a day for type 2 on insulin.
With official doctor prescription, one can get more but must supply official log of use every 6 months documenting usage.