Chapter 12 - Blood Glucose Monitor

There's a night and day difference between using a blood-glucoseˆ monitoringˆ and the old method of urine tests with a Clinitestˆ kit.

Prior to blood-glucoseˆ monitoringˆ I would test my urine to see if I was passing sugar. If so, it would mean my blood-glucoseˆ level was higher than it should be. The body is an amazing "computer". When a person's blood sugar level gets to a certain level, the brain tells the pancreasˆ to secrete enough insulinˆ to handle the sugar or glucoseˆ or glycogenˆ . Once the lower boundary is reached the brain tells the pancreasˆ to stop its insulin secretion. For a diabetic, the brain is telling the pancreasˆ to secrete insulin but the pancreasˆ just can't do it. This is diabetes mellitus in very simple laymen terms. The insulin allows the body to use the glucoseˆ properly. Without insulin the blood stream contains this unused glucoseˆ and the body attempts to get rid of it. By means of two other organs, the liver and kidneys, this glucoseˆ is filtered and finally passed out of the body. Prolonged high blood-glucoseˆ causes a strain on these organs as well as contributing to other complications such as retinopathy.

For years I tested urine to find out how my control was. Because urine is a body waste, the test results are delinquent by up to four hours. When there is no other means for testing you put up with what you have. Because there was nothing else, Clinitestˆ was great. If the result were negative you were not passing any sugar in the urine. Tests could range from negative to four-plus(4+), each giving a different color that could be compared to a color chart. If I was four-plus(4+) I also tested for ketonesˆ . If ketones were present, my doctor would normally send me for a fasting blood sugarˆ . Every few months I would have a blood sugar testing that would determine how much glucoseˆ was being "retained" by the blood stream rather than being properly used by the body. There is a test called an A1Cˆ or HbA1Cˆ or glycosolated hemoglobinˆ that counts how much glucoseˆ has remained unused in the blood stream within the last three or four months. The ratio standards for an insulin dependent diabetic with a good A1Cˆ is now 6.5 or less.

Several years ago I was introduced to a self- blood-glucoseˆ monitoringˆ kit. Finding several articles about them on the internet I requested a referral from my endocrinologist. She vouched for several companies and I selected LifeScan®. My first monitor was the "OneTouch Profile". Using a small drop of blood obtained from the fingertips an accurate blood-glucoseˆ level result would be reported in forty-five seconds. These blood sugar levels are current and they appear in a digital readout. While I was still injecting insulin I would be able to determine the amount of insulin to inject to obtain my desired blood sugar level. Now that I'm using an insulin pump, I believe taking frequent blood sugars is even more important. When first starting pump therapy I wanted to know what my best basal rate was for any given time period. Splitting twenty- four hours into four hour chunks, I tested every hour within a chunk for a week to determine what my best possible basal rate (remember basal rates and boluses from previous chapter) was for that particular chunk of time. I now have seven different basal rates within each twenty-four hour period. Tests prior to meals allow me to do simple arithmetic to determine how much insulin to take for my bolus. Without the monitor these adjustments would be impossible to make.

Nearly a year passed before I started using LifeScan®'s new "FastTake" meter. Smaller than the "Profile" and packaged in a small case with velcro straps to fasten the kit onto my belt, I was now able to get results within fifteen seconds. The kit contained the meter, a lancet device, a bottle of twenty-five test strips, a supply of lancets and a control agent used to verify accuracy. With the kit, I could carry everything I needed on my person. Not only that, but I didn't even look out of place. Nearly everyone is carrying a cellphone on their belts now. I've simply exchanged an insulin pump and a meter for the cellphone.

Just recently I obtained LifeScan®'s latest and greatest, the "OneTouch Ultra" (see photo above). My test results are now reported in five seconds. I'm actually getting spoiled. The "Ultra" has the capability of using different sites for obtaining the blood sample as well. Now instead of just the fingertips, I can use my forearms. However, I would be remiss if I didn't mention that a recent article by the American Diabetes Association (ADA) suggests that persons using an insulin pump not use alternate site testing. Fingertip testing is still the most accurate.

For those of us who have used these meters for quite some time, we have discovered many products available to help keep the finger tips soft and supple. I personally use an aloe-vera product called "Fingers" by MedTronics MiniMed®.

Romans 12:1,2 KJV I beseech you therefore, brethren, by the mercies of God, that ye present your bodies a living sacrifice, holy, acceptable unto God, which is your reasonable service. And be not conformed to this world: but be ye transformed by the renewing of your mind, that ye may prove what is that good, and acceptable, and perfect, will of God.