From Dallas, Texas, USA:
I was diagnosed with diabetes at age 42. Family history has two generations of diabetes diagnosed within the same time frame (between 40-50), with father and both of his parents dying of cardovascular complications within 10 years (five years in the case of father). Thus, I am aggressive in treatment, but see a Primary Care physician rather than a specialist.
I am his first pump patient. We are disagreeing about what is a reasonable amount of testing. I feel I should be testing in the morning, before meals, two hours after meals, before, sometimes during exercise, and after and before driving -- note that these time periods often overlap. Also, testing whenever I feel funny, or if I need to adjust things with the pump -- new set, etc. According to the meters I download I'm averaging just over eight times a day. He thinks I should be testing only four times a day. Who is right and why?
Also, what hA1c value should I be trying for? He seems a bit disappointed that I am consistently just under 7.0 (6.8-6.9). I would like to go lower, but I don't feel I can if I am trying to meet his testing expectations.
I do not think that the number of blood sugars you are doing is excessive. This is especially true having started an insulin pump in the recent past. With time, I would anticipate that you would be able to predict what some of the values are and would not have to monitor so often. I would not criticize you for doing more than a usual amount, especially if it allows you to make good decisions regarding your management. The goal for control is an HbA1C < 7%. Hypoglycemia would be the limiting factor. A normal value would be great but not at the risk of recurrent lows. I would say you try to lower as much as possible toward normal until lows become a problem. Currently, your HbA1C levels are good. Trying to improve them will require some caution so as not to increase the frequency and the risk of low blood sugars.
Original posting 12 Feb 2004
Posted to Blood Tests and Insulin Injections
Last Updated: Tuesday April 06, 2010 15:09:52
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