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March 21, 2005

Blood Tests and Insulin Injections, Other

Question from Pittsburgh, Pennsylvania, USA:

I have had type 1 diabetes for 16 years, with my A1cs almost always being below 8.0 over this time. I am very conscientious to check my blood sugars between 10 to 12 times per day and give insulin according to my correction scale and carbohydrate ratio. I use a One Touch Ultra Smart meter which gives me a lot of memory that records hundreds of past tests, as well as recording my average blood sugars for the past seven, 14, 30, 60 and 90 days. I use these values to eyeball whether my blood sugars are in check. I am a sophomore college student and the tedious habit of recording my blood sugars four times a day on a record sheet seems unnecessary at this point, but my doctor still wants me to do it. If all my tests are in the meter and my A1c is good (last was a 7.1), do I really need to record these values? Since I test so often, the four times required on the sheet (breakfast, lunch, dinner and bed) are not really representative of my blood sugars throughout the day.

Answer:

The goal of record keeping blood glucose readings is to allow you to learn. Most people don’t learn just by looking at meters, even clever ones like the Ultra Smart meter. You may be the exception and you could convince your doctor/nurses by giving them analyses of your past few weeks’ blood glucose data when you visit them. Another option would be to get the free download One Touch Diabetes Management Software from LifeScan and computer download to do a more thorough job than the meter itself will do. The whole idea, of course, remains how you analyze what you are doing since many people do a great job monitoring but never analyze their own results. Go back and chat with your diabetes team and see if you can re-define what you need to do, what they want you to do and come to some position that meets everyone’s goals.

SB
Additional comments from Dr. David Schwartz:

Your points are extremely well taken and I certainly agree with Dr. Brink. But I would add another pearl from practical experience: Sometimes there is hardware/software problems that interfere or prevent meter downloads. Having your logbook is a good back up plan. If you download yourself, as Dr. Brink suggests, that would seem to cover most all contingencies — unless you have your own computer meltdown.

DS