This week I'm finishing my series of columns focusing on blood glucose monitoring. The topic will likely come up again.
Many diabetics have problems choosing the right blood glucose meter. And with so many on the market, where does one begin?
The website of the Mayo Clinic (mayoclinic.org) has a staff-written article titled "Blood glucose meter: How to choose." It starts by telling us that when selecting a meter, it can help to know how the devices work.
To use most meters, you must first insert one end of a test strip into the device. Next you stick a clean fingertip with a special needle or lancet so that you can draw a drop of blood. Then, carefully touch the other end of the test strip to the blood and wait for a glucose reading to appear on the screen. Voila!
It's really an easy process, so I wonder why many people, including me, balk at testing.
According to the article, there are a few factors to consider when choosing a meter:
• Insurance. Checking with your insurance carrier is a good place to start. Some providers limit coverage to specific models or limit the number of strips they cover.
• Cost. Meters vary in price, and so you should shop around, especially if insurance won't cover many of the strips. The strips are usually the most expensive part of monitoring because new ones must be bought, over and over. A cheap meter may be great, but if the strips it requires are pricey, are there any savings?
• Ease of use and maintenance. Can you see the numbers easily on the screen? Are the meter and test strips easy to use and manage? Does it require a small or large amount of blood?
• Special features. Many people have special needs that should be considered. Some meters are compact and easy to carry. Other brands are large, with strips that are easier to handle. People with impaired vision could benefit from a larger screen or a "talking" meter. Some screens have a back light for easier nighttime reading, and some are manufactured to withstand extreme temperatures.
• Support. Many meter manufacturers include a toll-free number on the back of the meter or packaging that you can call for help. Some offer online manuals on a website.
• Information storage and retrieval. Consider how the meter stores and retrieves information. Some meters track information you'd normally write down. And there are some that offer the ability to download your blood glucose readings to a computer or phone, and the results can be emailed to your doctor.
I had a nice email from a Type 1 diabetic military veteran. He uses an Accu-Chek Aviva that he received about 20 years ago from Veterans Affairs in Fayetteville. Every three or four months, the VA downloads his blood glucose numbers to his primary-care medical personnel file. He says his only problem was changing batteries now and then
SMART INVENTION
Test strips are fascinating to me. There's not room for a lot of detail here, but according to the website of the American Diabetes Association (diabetes.org), the strips contain enzymes that create an electrochemical signal. When that signal is exposed to blood it makes an electric current. The current speeds through the strip and is read by the meter as glucose concentration.
All I can say is thanks to whoever came up with that!
Of course the blood can't get to the meter without first being forced out of your finger. There are a variety of disposable lancets, but they're all really just very small, sharp pieces of metal. They come in many forms and needle diameters, so personal preference is probably the most important thing there.
FASTING TEST?
I also received information from Marcia Ford, a nurse practitioner and diabetes educator from El Dorado. She offered her educated thoughts on glucose monitoring.
Ford stresses that checking shouldn't be looked at as a burden or a "ball and chain." If you look at diabetes as a condition that is about 99 percent dependent on self care, barely monitoring our glucose levels does not make sense. The glucometer is a tool that should be considered a friend.
After mentioning that I normally test fasting sugars, Ford says that is a mistake. She says it's like sticking a thermometer out the window in the morning and thinking it will be that temperature all day.
And you can't think your sugar is fine just because your fasting numbers are good. The problem can often be connected to what you are eating, so I can see where just checking in the morning does not take into consideration what I'll be eating that day and how it affects my blood glucose.
But that doesn't mean you have to check many times a day. Ford suggests that if you only feel like checking once a day, you should alternate. Take your fasting numbers one day, then two hours after breakfast the next day, two hours after lunch the next day, two hours after dinner the next, then at bedtime the next day.
After a couple of weeks you will see where your problems areas might be. Maybe you need to change your food a little bit or your medication. And after exercise, you should see a dramatic downward change in the blood sugar, too.
If it sounds confusing, you probably should consult your doctor or a diabetes educator for help.
KEEP IT COMING
Quite a few readers responded to my last column, and most shared their glucose meter stories and offered advice. I really appreciate it.
Several mentioned buying strips online through companies like Amazon.com. And at American Diabetes Wholesale (adwdiabetes.com) you'll find a variety of diabetes-related products as well. But I'm sure there are more companies.
Olivia says that she uses Walgreens Truetrack and buys 100 strips for $49. She also recommended Wal-Mart's ReliOn meter and strips. Her self testing showed they were comparable to each other.
Mark plugged FreeStyle meters. He says they can work in conjunction with a $20 software program called Co-Pilot. It will read, save and print readings which, he says, saves the hassle of writing them down.
As for recording, most meters come with log books to record your numbers. In an article I read a doctor said that he can pretty much tell if a patient is truthful in checking and recording his real numbers. Truthful log books tend to be dotted here and there with a little blood. Spotlessly clean ones make him suspicious.
Email me at:
rboggs@arkansasonline.com
ActiveStyle on 08/11/2014