Wakeup Blood Glucose Test

Posted by @canada @ronaldtseng, Nov 21, 2022

What is the right testing procedure to do 1st Wakeup Blood Glucose Test?
#1 Wakeup Blood Glucose Test had the huge different when doing the testing at bedroom vs sitting room?
#2 Need to sit down for how long before Blood Glucose Test?
#3 Why have huge different result between using 1st blood vs 2nd blood Blood Glucose Test.
#4 When is the best time to do Wakeup Blood Glucose Test?

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@annabelle6dawgs

I have the "dawn phenomenon" in which my blood glucose starts to rise about 5am from 100 to about 120 at 7am breakfast. It continues to rise after eating breakfast. I can see this each morning because I have a continuous glucose monitor. So you maybe experiencing this same phenomenon. I don't see a correlation between sitting and waking because it just continues to rise making each subsequent reading higher than the rest. My blood glucose is most stable from 12:00 midnight to 5:00 a.m. when it hovers around 100. I am not a healthcare provider but just wanted to share my experience with you.

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@annabelle1245 I’m late in welcoming and responding to you. I apologize. I’m catching up. I have a continual glucose monitor (CGM) also. When you got yours was it explained to you that it doesn’t actually test blood sugar? It is inserted in an area where it can test interstitial fluid. There is a slight difference between blood sugar results and CGM results. It is a bit like a roller coaster 🎢. It can take awhile for the tail to catch up to the head. If something seems wonky do a glucometer finger stick. My CGM manufacturer told me the acceptable specs for differences between the two tests. Have you ever experienced this? What did you do about it?

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I do understand that the CGM measures glucose in the interstitial fluid not in blood. I don't understand you question "Have you ever experienced this?" If you mean have I experienced a difference between a finger stick and a simultaneous CGM reading mine are usually within 5 points so that is not a significant difference. I have seen more of a difference when comparing HbA1C lab results to ADA-translated CGM reading. For example my last HbA1C test was 5.1 but the ADA-translated CGM predicted 5.6, higher than the actual lab result. There is nothing to do about the difference other than to be aware of it. I would anticipate that each individual may be slightly different. I hope this is helpful to you.

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@annabelle6dawgs

I do understand that the CGM measures glucose in the interstitial fluid not in blood. I don't understand you question "Have you ever experienced this?" If you mean have I experienced a difference between a finger stick and a simultaneous CGM reading mine are usually within 5 points so that is not a significant difference. I have seen more of a difference when comparing HbA1C lab results to ADA-translated CGM reading. For example my last HbA1C test was 5.1 but the ADA-translated CGM predicted 5.6, higher than the actual lab result. There is nothing to do about the difference other than to be aware of it. I would anticipate that each individual may be slightly different. I hope this is helpful to you.

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@annabelle6dawgs, my question was whether you had experienced discrepancies between a glucometer finger stick and your continuous glucose monitor (CGM) readings. This has happened to me and has been frustrating. It seems to especially occur in the 24 - 48 hours after a sensor change. I learned to be prepared to do more glucometer finger sticks during those times. Your HbA1C and your ADA-translated CGM reading seem pretty good (compared to mine). You must be doing a pretty good job of staying on top of things.

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@cehunt57 - after the first 24 hours after sensor application, I see a fairly good correlation between finger sticks and CGM readings. You stated that you don't see a good correlation in the 24 - 48 hours after application and this is frustrating. Are they off by the roughly the same amount with one always being higher than the other? How much do the readings differ? Have you talked to your healthcare provider about this? I am interested in understanding what difference you see between your HbA1C and your ADA-translated CGM reading if you wouldn't mind sharing.
I am really trying to do everything I can to improve my blood sugar with the least amount of pharmaceuticals as my body doesn't seem to handle those as well as nutraceuticals. I experienced significant GI issues and food sensitivities for over 10 years while on Metformin that resolved after stopping Metformin. I still have nausea with Farxiga, even when splitting the smallest dose (5mg) and taking it over two meals (breakfast and lunch). I have added 500mg Berberine TID and am working on intermittent fasting (started with no snacking after dinner and trying to eat dinner no later than 6pm and eating breakfast later to give my body a longer overnight fast). My average blood sugar is dropping and is now 103 (7-day average), down from 113 (90-day average). I have been reading books on intermittent fasting - The Circadian Diabetes Code by Satchin Panda and The Diabetes Code by Dr Jason Fung. I have listened to talks by both of these authors and it seems to make sense to me and these techniques don't cost money. I am not recommending these to you because your medical choices are yours with the input of your healthcare team. I stumbled upon these while doing research at my local library. I was skeptical but then heard from a friend that her doctor had actually recommend that she read Dr Fung's book. You can find talks by both if you google them.
I hope you find a solution to your frustration because I understand how you must feel not being able to find answers and doing more finger sticks than anticipated.
BTW I did have one time when I must have hit a tiny vein when I applied my sensor and it filled with blood and blood leaked out of the sensor and it malfunctioned. I called the manufacturer's number and they told me to remove the sensor and apply a new one and they sent me a new sensor.
Looking forward to hearing back from you.

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@annabelle6dawgs

@cehunt57 - after the first 24 hours after sensor application, I see a fairly good correlation between finger sticks and CGM readings. You stated that you don't see a good correlation in the 24 - 48 hours after application and this is frustrating. Are they off by the roughly the same amount with one always being higher than the other? How much do the readings differ? Have you talked to your healthcare provider about this? I am interested in understanding what difference you see between your HbA1C and your ADA-translated CGM reading if you wouldn't mind sharing.
I am really trying to do everything I can to improve my blood sugar with the least amount of pharmaceuticals as my body doesn't seem to handle those as well as nutraceuticals. I experienced significant GI issues and food sensitivities for over 10 years while on Metformin that resolved after stopping Metformin. I still have nausea with Farxiga, even when splitting the smallest dose (5mg) and taking it over two meals (breakfast and lunch). I have added 500mg Berberine TID and am working on intermittent fasting (started with no snacking after dinner and trying to eat dinner no later than 6pm and eating breakfast later to give my body a longer overnight fast). My average blood sugar is dropping and is now 103 (7-day average), down from 113 (90-day average). I have been reading books on intermittent fasting - The Circadian Diabetes Code by Satchin Panda and The Diabetes Code by Dr Jason Fung. I have listened to talks by both of these authors and it seems to make sense to me and these techniques don't cost money. I am not recommending these to you because your medical choices are yours with the input of your healthcare team. I stumbled upon these while doing research at my local library. I was skeptical but then heard from a friend that her doctor had actually recommend that she read Dr Fung's book. You can find talks by both if you google them.
I hope you find a solution to your frustration because I understand how you must feel not being able to find answers and doing more finger sticks than anticipated.
BTW I did have one time when I must have hit a tiny vein when I applied my sensor and it filled with blood and blood leaked out of the sensor and it malfunctioned. I called the manufacturer's number and they told me to remove the sensor and apply a new one and they sent me a new sensor.
Looking forward to hearing back from you.

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@annabelle6dawgs thank you for your response in this group discussion regarding blood sugar testing. Sharing stories and trading information is always helpful. We got into talking about continual glucose monitoring (CGM).
Here’s a little background on my need for CGM. Diabetic (Type 1) for 48 years. I have not used pharmaceuticals or nutraceuticals for treating diabetes because what I most needed was insulin. Nearly 18 years ago I had a pancreas transplant. It is only partially functioning at present and may be partly responsible for the difficulty in tracking and leveling my blood sugar. My healthcare providers include a local endocrinologist, nurse practitioners, certified diabetes educators and nutritionists / dietitians well versed in diabetes and renal nutrition. I also have a transplant team and endocrinologist at Mayo Clinic in Rochester, MN. My current treatment plan is a CGM (Dexcom G6) that I’ve had a little over a year and an insulin pump (Omnipod 5) that I’ve had for several months. The two devices work together for insulin delivery. There is a prescribed 24/7 basal delivery, plus mealtime and correction bolus’ that are calculated using device algorithms. I think it is crucial that I can rely on accuracy of the CGM to do its part in the insulin delivery system. When these discrepancies happen between CGM and glucometer finger sticks it is not roughly by the same amount or in the same direction. Two examples may explain better. A CGM low alarm (40) in the middle of the night when the glucometer showed in range (90). Another example a high CGM alarm (385) when the glucometer was only slightly above my target range and not high enough to trigger a high alarm (175). That is what is frustrating and kind of scary because the Omnipod 5 pump for insulin delivery is supposed to be working with the CGM. Thanks for letting me vent.
Oh, one more thing my HbA1C is currently 6.7. My team is happy with that. Before the pancreas transplant the A1C NEVER got out of double digits (10+)! I have not been told to follow the ADA-translated CGM reading.

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