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What metric to watch?
I got diagnosed with Type 2 diabetes a month ago after routine blood tests showed an A1C of 13.
I have a Stelo, and am seeing pretty dramatic changes in my numbers through diet and exercise, but I am also concerned about the amount of time I am spending obsessing about it, and feeling anxious. I feel as though I need to pick one or two metrics to watch closely.
If you were going to pick one or two, which of these would you say is most important:
Time in range
Average blood glucose
Fasting blood glucose (I measure with a fingerstick each a.m.)
Highest point it goes to
“Spikes” which is what Stelo calls it when your number rises dramatically in a short period of time
Also how do you balance keeping your blood sugar in range with other aspects of healthy diet? For example, if I include fruit in my meals my blood sugar rises more quickly after, but of course there are benefits to fruit too! Similarly, if I eat high fat foods my blood sugar looks great, but at what cost to my heart? How do you strike a balance?
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@louiserivers
I would love to know the foods you eat!
In theory the CGM makes finger sticks redundant.
However in practice it's not entirely unreasonable to "get a second opinion", all the testing devices have pretty wide error bars (that is, are only guaranteed within plus or minus 15% or so) so you could have an 85 and 115 from the same blood droplet. In practice they are usually closer than that, but now and then they might also be a bit worse.
I have two brands of meters, no CGM. The more expensive one seems more accurate, the cheaper one, when the reading is going high or low, tends to read higher or lower, exaggerates the deviation by 5-10 points. I could still get by on just the cheap one, but it's good to have a calibration like that.
I doubt if many people with CGMs also do finger sticks.
BTW you'll see this on A1C readings, too, variations of as much as half a point between a lab test and an office machine - and there are home A1C meters if you want one, but it's a dollar or more per test strip, last time I looked.
Don't really need it, average BG converts with a formula like your CGM is showing you.
HTH
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1 Reaction@anonymom3
Yes, I like to exercise before a reading, not after a meal. Most recommendations are for after and they make sense, but may not improve readings as much. But you don't go swimming for 30 minutes after a meal, and all that. I think it's not that crucial.
If you already get plenty of exercise that's enough, it's not a case of more is always better, in fact too much exercise can get your body releasing more glucose and raise your readings! It's mostly harmless, just the body doing what it should, but it messes up the record, lol.
Y'know, here' a thing, if your A1C is already down to 7.1 then the Ozempic is not particularly necessary. Now, losing weight is also helpful for controlling diabetes and Ozempic (and such) is great for losing weight. Metformin is a cheap, standard pill that truly helps - but it commonly has a side effect of loose bowels, manageable for most people but for some, not. First day or two is rough but then it settles down - or doesn't. Well Ozempic is fashionable, too, so what the heck!
You want to learn to count your carbs, in the foods you eat. There's tons online and in print. It's not as complex as it looks, there are really just a few general rules, and one of the general rules is: read the labels on the back of the package! Soon you can go out to a restaurant and read the menu and guess pretty well what the meal will be. And like everything else, just getting within 15-20% does the job. You can also ask for a referral to a nutritionist who does know something about diabetes. And there are various tips and tricks to help, too, once you have the general idea.
Hope that helps.
It took me about ninety days, and a lot of Internet time, before I had all the drugs and diet and exercise worked out for my case. I was lucky, perhaps you were too, that such a high reading could be so quickly moderated. Others are not that lucky no matter what they do.
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1 Reaction@carbcounter & @anonymom3 My daughter is a school nurse who helps almost 100 kids manage their diabetes. Adolescents are notoriously poorly managed due to puberty, lifestyle, family denial/dynamics, and not wanting to be "different" so it can be a challenge. She always has her kids double check unusual CGM readings with finger sticks, which sometimes makes her unpopular with parents and providers. Everyone should be lucky enough to have such a diligent advocate!
The bottom line, according to her, both high and low readings should be confirmed with a finger stick.
I have been around diabetes for almostww233 my entire life. I remember my Granmere and my friend "peeing on a stick" back in the 1950's! And boiling and reusing needles and syringes.
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6 Reactions@anonymom3
Plant protein is what has worked for me.
I put a scoop of plant protein powder (see photo) + 1/4 of a protein shake (see photo) in 12 oz of coffee. Tastes like creamy hot chocolate!
Flax seed + chia seeds + Greek yogurt work well in my overnight oats recipe
(see 4 photos).
Sunflower seeds also taste good in Greek yogurt.
I don’t eat red meat. Turkey and tuna are my protein sources.
For your question about if you should use finger stick along with CGM. I have found my Dexcom G7 CGM has been off by 30-50 mg/dl at times. I’m able to recalibrate my CGM on my phone app. Also the first 24 hours, after applying a new sensor on upper arm, I have had many inaccurate low alerts on CGM. With all this variation, one time when I had my 6 month labs, my A1C was 7.5, but my CGM had been telling me my 90 day average was 6.5. I was very disappointed. My endocrinologist told me to trust the finger stick and recalibrate my CGM to sync with the finger stick. Blood is more accurate than interstitial fluid. I googled this and she is correct.
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1 Reaction@louiserivers
I had heard that blood was more accurate than interstitial fluid too, which is why getting two wildly different blood results, in the space of a minute, confuses me. To be clear, it goes like this.
I wake up, my cgm says my blood sugar is 152, which is in the range I usually fall in the morning. I test and get 218 or 72, something that is very far from 152. I think "Wow, what is that about?" I immediately test again and get 148. I test a third time, and get 143. Meanwhile a few minutes later my cgm reads 150, and the curve stays steady till I eat an hour or two later, so it isn't an issue of my cgm lagging.
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2 Reactions@anonymom3 Some cheap meters are not very accurate. You also have to make sure your fingers are clean with no residual soap/alcohol/water residue, so the small sample is not contaminated. At 150 the fasting glucose level is about a 7 A1c. Average glucose will be higher with 210 equal to a 9 A1c. The average needs to be over 300 to get a 13 A1c.
My average, according to Stelo, and my fasting blood glucose have been similar recently. Usually around 140 for both. Is that not normal that they are similar?
@anonymom3 Fasting should be the lowest your glucose levels get. Before I was on diabetes medication my fasting levels from overnight were always high (115-130) and would stay high if I did not eat. After I ate, they hit the low point (90-105) usually in 2 hours and stay there until I ate again. Your blood glucose goes up when you eat so it must take a dive at some point if your average is the same as the overnight fasting level. I learned to eat breakfast to knock down the overnight glucose increase. So not normal but may not be all that unusual for diabetics. This should change after you start Ozempic or other medication.
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2 Reactions@anonymom3 Knowing how to read labels and count carbs is helpful. On nutrition labels, the "total carbohydrate" grams will include any added sugar, as well as carbs from fructose and starch. Would get a nutrition count booklet such as Calorie King, and ask doc for referral to Registered Dietitian Nutritionist (RDN).
hen
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