[Diabetes-talk] Diabetes management strategy. Was Re: raw peeling fingers.

[Michael Park]

  Hi there.

I have read this thread with much interest. Personally, and judging from 
my own experience, it is necessary to test at least three times a day, 
and I say this for the reason that it is important to try and keep 
sugars stable rather than low.

I must say that I am not too excited about people who say that your 
readings should be this or that, for as I understand it, the damage that 
is rendered to the body through diabetes, differs from person to person 
and from circumstance to circumstance. Testing at least three times a 
day not only gives you an idea of the pattern according to which your 
blood sugars move, but in my experience, it also gives you an idea of 
what levels would be suitable for you.

The nursing sister I mentioned in my previous post, who actually helps 
me to monitor my condition, is herself rather dogmatic about fasting 
sugars. According to her, a good fasting sugar should be anything 
between 90 and 110. Now this system works well for me, but I have 
encountered situations where I have helped other diabetics, where the 
patterns suggest that they should have sugars over 110 for fasting, for 
the simple reason that they cannot get them down to those levels.

I disagree with the dogmatic statement that sugars in a diabetic should 
specifically be one thing under certain circumstances and another under 
other circumstances. I have often argued the point with my nursing 
sister friend, not because I cannot maintain those levels myself, or 
because I have to starve to death in order to keep to those levels (and 
incidentally, I don't starve when I maintain those levels), but I have 
counselled folks before today who simply would find it impossible to 
maintain their sugars at that level.

Regular testing is important also because the process of identifying 
movement patterns in blood sugar levels and stabilizing sugars, can take 
up to six months to accomplish.

The other important factor is to be able to learn to listen to your 
body, because you may find yourself in situations where your glucometer 
is not available to you and you need to take action because your sugars 
fall too low.

The other day, I attended a seminar and was told before hand, that lunch 
would be served at 12 noon. As it turned out, lunch was served a full 
two hours late and because my sugars are by nature very volitile, I fell 
into a hypo and was useless to the conference for the course of the 
afternoon proceedings. Needless to say, I had somewhat to say to the 
organisers, for this was a conference geared to the disabled and I had 
gone to considerable lengths to inform them of my condition, and to my 
mind, my informing them, simply fell on deaf ears. Furthermore, the lack 
of consideration was highly embarrassing to me.

Being able to listen to my body tells me in advance whether I am going 
to go hypo or not and I know that my chances of going hypo are 
particularly good if I have a fasting sugar below 90.

I have got this down to a fine art so that I can estimate my blood 
sugars to within 10 points before I even get to pricking my finger. This 
morning, for instance, I guessed that my fasting sugar would be 86 and 
sure enough, my test showed that it was 88--a reading which is lower 
than acceptable.

Again, I personally take issue with people who say that your HB1c3 
should be at a specific level, for the simple reason that hB1C3 is based 
on your actual sugar levels and in my view, it is difficult enough to 
determine what those levels should be, let alone, what one's HB1C3 
should be.

I will probably have mine taken when I go to the diabetic clinic on 
Wednesday, and my guess is that my HB1C3 is going to sit between 105 and 
115, somewhere.

Finally, I would be inclined to think that if your friend is not 
testing, that it is highly likely, given the circumstances, that her 
sugars are well out of control. My experience in the time that I have 
been counselling folks here, is that the ones who don't test, are the 
ones whose sugars are invariably out of control.

The consolation prise for your friend is that if she can test regularly, 
and if she is given proper counselling, I believe that she could learn 
to listen to her body and hence the fact that testing might eventually 
have to be done less frequently.

It goes without saying that I am making the catagoric assumption that 
the person concerned, is adhering to some sort of diabetic compliant 
diet, at least.

-- 
Michael Park
"I will bring the blind by a way they did not know; I will lead them in paths they have not known. I will make darkness light before them, and crooked places straight. These things I will do for them, and not forsake them." (Isaiah 42:16 NKJV).

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