LifeAfterDx--Diabetes Uncensored

A internet journal from one of the first T1 Diabetics to use continuous glucose monitoring. Copyright 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016

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Location: New Mexico, United States

Hi! I’m William “Lee” Dubois (called either Wil or Lee, depending what part of the internet you’re on). I’m a diabetes columnist and the author of four books about diabetes that have collectively won 16 national and international book awards. (Hey, if you can’t brag about yourself on your own blog, where can you??) I have the great good fortune to pen the edgy Dear Abby-style advice column every Saturday at Diabetes Mine; write the Diabetes Simplified column for dLife; and am one of the ShareCare diabetes experts. My work also appears in Diabetic Living and Diabetes Self-Management magazines. In addition to writing, I’ve spent the last half-dozen years running the diabetes education program for a rural non-profit clinic in the mountains of New Mexico. Don’t worry, I’ll get some rest after the cure. LifeAfterDx is my personal home base, where I get to say what and how I feel about diabetes and… you know… life, free from the red pens of editors (all of whom I adore, of course!).

Friday, January 13, 2006

Kiss the post-meal finger stick good bye!

This is my foot. This is my post-meal test strip. This is my foot kicking the test strip to the curb. That's right, I've cut three test strips from my daily routine forever. Your freaking out. I can hear it from here. I'm killing the sacred cow? Damn right, and I'm gonna barbeque it's ribs too!

The post meal finger stick is one of the corner stones of diabetes management. But I've decided I don't need it any more. It is an antique. Obsolete. Past its prime and time. Adios, sucker!

No, I haven't lost my mind. I've got something better. We use to look to this stick to judge how well we bloused the meal. The idea is to be under 150 two hours post. So if you score a 148 you go off feeling pretty smug. Until your pre-dinner stick when you find you self at 210. Wouldn't it have been cool if the test strip said "148, going uuuupp!"

Even if you are too high at two hours, it is probably too soon to take a correction. And unless you really, really, really muffed it, unlikely you'll be border line hypo yet. So our most sacred finger stick is actually our least useful from an action perspective, isn’t it?

Now I still do a two hour check, but I use the girl and I don't just look at one number. I look at the recent history and think about it, plan ahead. A quick scroll shows what's going on. I always hope for a number around 150. Scrolling backwards I'm happy to see a slow decent from the 170s or 180s. That is if all is right with the universe.

But when all is not right with the universe I can make an action plan. If I'm high or still rising I know that I didn't use enough insulin. A correction will be in my future. I can ride the wave and knock it down at the crest. If I'm lower than expected or dropping fast some more desert will be in order.

Like finger sticks, at two hours post there is not a hell of a lot I can do with the Guardian info, yet. But unlike finger sticks, I can see clearly where I've come from and I can make a reasonable prediction about where I'm going. Very, very, very cool indeed.

So I didn’t just kick one test strip to the curb. I kicked 1,095 of them to the curb in this year alone. Printcrafter’s stock tip of the day for test strip companies: Sell.


Anonymous Anonymous said...

What's that sucking sound? Oh no... $850.00 is escaping the test strip market! Aiiieeeeee!

3:38 AM  
Blogger Scott K. Johnson said...

I've often questioned the whole 2 hour marker. Like you say, it's too early for a correction - heck, with that damn tail, the Humalog/Novolog is usually messing around with things for at least three plus hours...

10:24 AM  
Blogger Sandra Miller said...


We've always struggled with this post-prandial number. Always.

Joseph rarely goes without spiking into the 200s two hours post-meal. And if we correct, he's low less than two hours later... if we don't correct, more often than not he's back in range by the 4-hour mark.

Quite frankly, if he's 150 or less at two hours, I know we're in trouble...

Your post illustrates yet another way in which the Guardian could give greater insight into exactly what's going on with blood sugars. Far more insight than those damn finger sticks.

Oh, and as always, wonderfully written!

12:40 PM  
Blogger Allison said...

I've never done a post-meal reading, I just test throughout the day to see where I'm at. I've never considered this to be a post meal, just a general guide on how I'm doing.

My active insulin time is 4 hours, which means it isn't until 4 hours after I eat that the insulin I took at my meal is finished working. This is the same for most people. 70% of the insulin is done after 2 hours, but not until 3 or 4 is it finished. That's why having Symlin is so nice. I don't skyrocket at 1 or 2 hours before floating back down to earth. It's nice, but unfortunately still not approved for children (Sorry Sandra!).

4:20 PM  

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