Friday, April 20, 2007

Testing on a Budget

I'm very lucky to be in a country where diabetics in the past have successfully lobbied for specific support within the government health system to assist good diabetes control. I'm eternally grateful for the pioneers who created Australian medicare and the NDSS.

However, I'm daily reminded that others overseas are not so fortunate. Consequently, some have difficulty following the full Test, Test, Test regimen as Jennifer suggests because of strip cost.

For them, I suggest a "one strip a day" method. This works more slowly than following Jennifer's advice completely - but it can still work. When I say "one strip a day" I'm not counting the FBG or other tests the doctor wants - discuss with the doc if you can cut back there. In hard economic circumstances I can't see that doing FBG every second or even third day is going to be a problem for the doc - but check to be sure. Let's face it, the "average" type 2 out there is testing FBG maybe once per week, doing absolutely nothing with the result, and wondering why their A1c goes up every 3-6 months.

This other daily test strip is purely to let YOU know what's happening when you eat.

First, it will take a few extra BG tests for two or three days to discover when your peak timing is. Once you know that for each meal, you can focus on that timing. Some reckon you also need to test before meals to see what the rise was; in these circumstances I would see the pre-meal test as a waste of a strip. Just concentrate on the absolute peak level. Target one meal per week. Most of us have problems with breakfast, so I'd recommend starting there.

Test at the peak spike time, just for breakfast, until you have modified your breakfast to the point where the spikes are acceptable to you. I use Jennifer's guidelines, which are similar to the AACE, but check with your doctor if in doubt. Concentrate on that meal for one week, by that time you should have something workable. I've given some alternative breakfast ideas here, but think outside the square and find what works for you. There is no law that decrees cereal, juice, milk or toast before noon. I just finished a kransky sausage with one dry-fried egg before typing this (it's 7:40am here:-) That will be followed with black, cinnamon-infused coffee.

Then concentrate on Lunch for week two, Dinner for week three and so on. Then repeat over the next three weeks. Over time you will find a range of foods that are OK - and a range of foods that aren't - and slowly build a safe menu base.

Cheers, Alan

1 comment:

jpatti said...

I want to add - sometimes your "peak timing" can be pretty variable.

I began on Smylin a few months back and I have yet to discern any rhyme or reason for when my peak will occur. Symlin is supposed to cause slowing of gastric emptying so you'd expect the peak to be later, but it varies. I can't find a "rule" about this with regards to macronutrient content of the meal either - doesn't matter if it's low-carb, low-fat, or what - it just varies.

Also, if I take enough Novolog to keep my postprandial peak under 140, I go low before my next preprandial measurement. It "seems" as if Symlin slows down the action of Novlog too.

In short, there's just too many variables to figure it out properly. I am considering stopping Symlin cause of this.