Why I Love to Test My Blood Sugar, and Why You Should, Too.
4 rules to make you a testing expert
By Wil Dubois
OK, before we get started today, I want you to take this quiz with me:
Why should you test your blood sugar?
a) Because my doctor told me to.
b) Because my wife told me to.
c) Because I read that people with diabetes have to.
d) Test? What's testing?
e) None of the above.
The correct answer is (e), none of the above. Although most people actually test for one of the other reasons, we need to talk about the real reason you should test!
Oh. Wait a minute. Sorry. I forgot to give you the second part of the quiz: Do you think about your numbers, or do you just record them? Or worse yet, do you just let the meter remember them for you? This matters because, used right, your meter has the power to transform you from a mild-mannered patient to a diabetes superhero.
So that's what I'm going to show you today. I'm going to show you how to use your meter "right." No, no, no. I don't mean technique. I'm not talking about how to lance your finger, how big a blood drop you need, how to calibrate your machine, or any of the other nuts and bolts stuff. That's diabetes kindergarten. We're in diabetes grad school now. I'm talking about brain stuff. Mindset. The intelligent use of a meter vs. the stupid use of a meter. And because my job around here is to simplify diabetes, I've got four simple rules to help you become a blood sugar-testing genius.
Rule # 1—A bad number is just good information
All too often I hear people say their blood sugar number is bad. Really? Did it break any laws? Cheat on its income tax? Abuse its children? Vote for… you know… the wrong political party? What, exactly, does a number need to do to turn bad?
Sure, a blood sugar number can be out of range. It can be high. It can be low. It can be dangerous, even. But bad? I don't think so. Because "bad" numbers are just good information. A problem to be fixed, nothing more. And if a number is not where it should be, or not where it needs to be, knowing about it is a very, very, very good thing. I think you should celebrate "bad" numbers. Rejoice in them when you find them. Opportunity just came knocking, because you can't fix a problem until you find it.
Rule # 2—Judge a number by the company it keeps
Your mother was right. You can judge a man by the company he keeps. And the same is true for blood sugar numbers. In fact, I'll go one step farther and say the ONLY way to judge a number is by the company it keeps.
Example: Is 340 mg/dL (18.89 mmol/L) bad company to keep? Maybe. Or maybe not. Standing on the street corner covered in tattoos and wearing a black leather jacket, 340 looks pretty menacing. But we need to see who 340 is hanging out with to really judge it. Oh, and we need to think about what time of day it is, too. If you wake up and find 340 in bed with you first thing in the morning… well, that's not so good. (And just how much did you drink last night, anyway??) But if it's four hours after scarfing down two pieces of birthday cake—with extra ice cream, naturally—and your blood sugar was 482 mg/dL (26.78 mmol/L) a while ago, then things are improving a great deal and I'd argue that the 340 is actually a pretty darn good number.
Here, let's try on another scenario for size. How do you feel about 109 mg/dL (06.06 mmol/L)? Is it a boy scout or a juvenile delinquent? Remember, you can't judge a blood sugar number by its value alone. You have to judge it by its context, by the company it keeps. That 109 would be great in some circumstances, like first thing in the morning. But what if you're an insulin user who just took a whopping big shot only an hour ago? Looks like the boy scout just whipped out a switchblade and is demanding your wallet.
The bottom line is that numbers need context to have any meaning whatsoever. And beyond considering context by time of day, or when we took our meds, we can also create context by using a technique called Testing in Pairs.
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There was a test strip that X used. There was blood on edge of the test strip that X used. The test strip that X used had sat on the desk. The desk is now tainted by the blood on the test strip that X used. There was work on the desk. The work is now tainted from the desk that held the test strip that X used. The work was picked up by Y. Y's hands are now contaminated by X's blood from the test strip that lie on his desk when Y's work was...