Glucose meter
Electronic glucose meters will be your best friend when you get diagnosed. Before you make any correction, either with carbs, or with insulin, you need to test. That’s not only going to tell you if something is really wrong, but also how much you need to correct. But, before we get into analyzing the actual reading, how do we use our wonderful device?
- Frst, we carefully remove a single testing strip from our container
- We insert the strip into the glucose meter, which wakes up
- We take a lancet device to prick a finger and create a drop of blood on the skin
- Don’t prick your fingertips! There’s no need, they are the most sensitive part of your finger, and if you get scar tissue there you’ll lose feeling in your fingers. Instead, poke, the side of your finger, pictured below. It’s just as effective at getting blood, but hurts less, and avoids scar tissue in important places.
- We dip the strip in the blood, wait a few seconds, et voila! You get a reading!
In the process, there are many ways to produce a bad reading. I will mention a few. You’ll find that we T1Ds do things quite differently from what a non-T1D educator tells you.
- I try to keep my hands clean at all times because I know that I may need to poke at any time. But I don’t sanitize my skin before poking, unless I have a reason to believe it is an issue.
- If I sanitize with alcohol before poking, I always wipe the first drop and slightly milk the finger to get more, because the alcohol can dilute the reading
- Very important: probably the biggest cause of false reading is because of sugar on your hands. Make sure to keep your hands free of food: finger foods create false readings (particularly if they are sweet). Remember that sanitation doesn’t remove sugar or other substances from the finger, so rinsing or washing is better for a clean reading!
- I am very careful to only handle the strip from the middle, where there is no terminal. Touching either end of the strip might falsify the reading (touching the insert end of the strip may decrease the conductivity of the strip where it touches the glucose meter).
- I adjust the depth of my poke (some lancets allow you to adjust the depth) so as to get enough blood without milking, but not too much (I don’t want to go needlessly deep to avoid scar tissue). Too much milking of the finger can falsify the reading (typically towards a lower one).
- I hardly ever change my lancet. On T1D forums we sometimes discuss how often we change them: some of us do that once a month, some never… When I was on Multiple Daily Injections (MDI) with no Continuous Glucose Monitor (CGM), I would change it once per week. There are parts that are bulky and difficult to deal with when traveling (such as the Dexcom G6 injector, which is enormous), but the spare lancets and the lancet devices are not.
Glucose meters are not created equal. Unfortunately, your insurance company probably restricts you to one or two. In another chapter I’ll discuss the important features of a glucose meter, and how they compare in the real world.
I use enormous numbers of strips every month: some days 10 or 20. I have a CGM now, but CGMs test interstitial fluid, not blood, and are typically 15 minutes behind—they also suffer from some other estimation problems. They rarely work in the middle of an athletic effort, at least for me. So, in many situations, I hand-test a lot. Don’t let anyone convince you that you only need 2, or 4, or 6 strips per day. You need what you need, and you really need it.
I should add: don’t take my discussion on CGMs as an argument against them. CGMs are the most useful tool in my arsenal. Without a CGM, I wouldn’t be able to have the type of control I have today; I would have a much worse A1c, and I would have a much more dangerous life. I live my life with my Dexcom along with me, and I wouldn’t be able to pursue it without it.
So sometimes, it’s hard to know when to test. You can’t test every 15 minutes of every day, but it’s also not healthy to only test before mealtimes. Without a CGM, we have to take responsible and educated guesses as to when we might be out of range, and test, to see if we need to correct with carbs or insulin. In addition to simply making informed guesses, look out for the warning signs of highs and lows:
Growing up T1D 