Blood Sugar/hypoglycemia Questions

[ajw4790]

Hi!

I recently went to the Endocrinologist again. I have been going for hypoglycemia/POTS/Neuropathy. So, far not much progress has been made. They ordered some tests before and I have another round to do. I also am supposed to do a more detailed and frequent tracking of my BS over a period of days and document it. It may be needed for proof of an issue later on.

Anyways... My Questions: How often are you supposed to change the lancet in the trigger thingy? Also, do almost any lancets work in a machine or does each brand require their own. I have seen so many generic brands, I think you can use any in a machine right?

Where do you test? Because sometimes my fingers will gush blood, but other times they don't... I think at those times I am having less blood flow to my fingers. So, with blood pooling is there a best place to test? Or any tricks?

Also, has anyone heard of or had this testing done???? I guess it is a 72 hour inpatient observation of your blood sugar etc. I am not sure of the exact name of the protocal, or what all is involved? But, wanted to see if anyone has any info?

Thanks!!!!!

[juliegee]

I'm certainly not an expert, so any out there chime in! I think the directions say to change the lancet every time or at least every third time. It's really important to change it every time if more than one person uses the machine. Since it's only me, I rarely change it- just when it seems dull. I think the lancets are specific to the brand. As far as getting blood; it's a crap shoot for me. I set my lancet at it's longest and often have trouble getting blood. I take my BS when I'm quite hypo, so I have little or no blood in my fingers at that point; it's all diverted to major organs. I always test on the side of the tip of my fingers. I've heard the pain/nerves are worse in the middle.

I've heard of the 72 hour test. They wait till you have an episode then draw lots of blood for DXing purposes. My brother, who also has POTS/NCS did that and nothing was found. GTT's are pretty limited. The 72 hour test is limited as well as you are essentially exposed to no stressors (except the lack of food.) There is really no substitute for real life. That being said, I bet the 72 hour test would yield better info than a 3 or 5 hour GTT.

Let us know what you and your endo decide.

Julie

[Sophia3]

once I showed high blood sugar for me 125 fasting and I am usually low blood sugar or normal...was very bad as kid and we NOW KNOW it was early ANS stuff...I even had a couple grand mal seizures and had to eat frequent snacks

Anyway my ANS doc, and endocrinologist gave me a home testing kit and I watched what I ate but messed up the testing a few times, trick to learning it. I finally realized I could've used the same NEEDLES and the match sticks to check blood are VERY EXPENSIVE...anyway, my blood sugar levels were all normal...but I never had the nerve to do a VERY HIGH GLYCEMIC MEAL that my doc suggested initially...eat lots of pancakes and syrup with no protein or fat! Yikes... I have always gotten sick from more than ONE small pancake...but since I had steady numbers after about 10 sticks my doctor was ok with that.

Also if upright for too long (like ride to my doc's office) my cortisol has been high a time or two...so orthostatic INTOLERANCE can trigger a cascade of false tests so I ALWAYS LIE DOWN for blood work now. ALWAYS.

Are you talking about being in the hospital for some observation? I wasnt sure what your medical test question was. They still do Glucose tolerance tests but I know for pituitary problems (often do NOT show up in blood work) INSULIN Tolerance tests used to be done...even the late, great Dr. Streeten was a fan of this test (he was father of Dysautonomia)

And while that might give VALUABLE answers to my situation, my doctor was afraid it would put me in a coma or make me very ill so we never did it...sometimes the risks are not worth it.

But he said fasting and a HUGE MEAL of pancakes with all the syrup you can force yourself to eat, is better than drinking the sugar syrup in a GTT. Those always made ME ill as a kid and young adult...so I wish you luck in whatever you are doing.

Oh, and I would also re use the needles until they are DULL. all that stuff is expensive...especially the match stick things. I have a diabetic friend that lent me a couple when I got error readings....I dropped blood on the match stick instead of letting the match stick thingie 'soak up the blood drop' slowly from my finger.

I had my local pharmacist help me with the first stick and that's when we learned NOT to let the blood plop onto the match stick.

THis is way more information than you needed isn't it?? sorry

[flop]

Usually you need to use the right lancet in a finger-pricker device as they are different shapes. The staff at the pharmacy should be able to advise you (in the UK you have to get them on prescription so the dr specifies the brand). I only tested my blood sugar occasionally a few years ago when I was on high doses of prednisolone. I used to use each lancet about 4 or 5 times then change it. As you should only use the lancet on one person it is okay to reuse a couple of times, however they loose their sharpness and don't work so well / hurt more after a few uses. If you don't use the machine daily I would always use a new lancet.

The best place to get blood from is the sides of the finger-pad, then squeeze your finger to gently milk a drop of blood from the wound. You should only need a small amount of blood to do the test. Having cold fingers can be a problem so washing them in warm water can help bring blood to the fingertips. Another trick is to let your arm hang down so that blood is taken to the fingers by gravity. DON'T prick the centre of the finger pad - it hurts like crazy as there are lots of nerve endings there and it doesn't bleed as well as the sides.

Do you know anything about the test that you want info on? Does it have a name?

Flop

[ajw4790]

Hi!

Thank you so much for all your answers!!! It helps!!!

As far as the test... what I was told by the attending that popped in for like two minutes... was that I needed a comprehensive diary of BS levels (esp. when symptomatic) and that this is needed to prove the necessity of the test.

Then if they decide there is a need for the test, it is then scheduled, and I would be admitted to the hospital for 72 hours for observation. I believe at least most of the time fasting is involved. I am not sure if anything is administered? Then, I guess they test over the time period your reactions. So, I assume mainly blood tests. As far as a name? Not sure, didn't give it one... They said it would be a test where I was admitted for 72 and would fast.

I looked online and didn't find anything in the short time I looked.

If anyone has any more info it would be appreciated!

Thanks!!!!

[flop]

I think that I have found the test that your doctor was talking about. This link is to part of a book, read the bit entitled "Supervised Prolonged Fasting".

Flop

[Guest Sandy Sims]

Since you brought it up.

Norms for insulin on my labs ran from 1.9 to 23

My insulin level started at 15.64 fasting with a fasting glucose of 97

(normal scale fasting glucose for this lab stopped exactly AT 97-- normals scale for insulin ran 1.9-23 normal

--so no red flag with those, right?

But what follows shows why I say ~~

FASTING NUMBERS MAY MEAN NOTHING! GLUCOSE NUMBERS ALONE MAY MEAN NOTHING!

GET INSULIN LEVELS AT ALL BLOOD DRAWS!

Then my glucose went to

159 at the 1/2 hour draw,

137 at one hour,

107 at two hours--none of that being remarkable--the 159 is at best a tiny bit high.

HOWEVER--and best you sit for this.

Insulin readings ran

15.64 fasting --this is normal --and exactly mid range normal even? (1.9-23 normal)

107.68 at 30 minutes!

121.35 at one hour! (almost 10 times normals shown!!)

73.92 at two hours!

Pretty wicked, eh?

Thing is this test should've been run longer--as insulin dropped-- later my blood sugar at home rebounded and hit 191.

My glucose levels I now know are all over the map due to insulin overdrive

and adrenal surges,but highs to lows move quickly and in unpredicable ways.

These blood glucose drops and peaks wrecked my BP and pulse rate HUGE!

Fixing this--for me has fixed the other for the most part. Sometimes my glucose spike can be as long as 3 hours after a meal--

or as quick as 30 minutes--lows can hit as fast as 31/2 hours after a meal--seeing the drop high to low coming on VERY fast--

or lows can hold off for 4 or 5 hours if I'm in bed sleeping. (excercise/stress brings on lows MUCH faster)

On the other side of syndrome X

Lipids?

Cholesterol 256--HDL 42--LDL 184 Tricylcerides 152-- The hdl-ldl ratio being more than a 5-1 ratio!

Common cause for this? Diabetes.

Another one?

Vitamin D def!!!

http://www.lipidsonline.org/news/article.cfm?aid=4988

Vitamin D may do you as much good as lipid lowering drugs--with far fewer side effects.

I tried vitorin (spell?) and got VERY ill with the first dose. My cardio now no longer prescribes any of these drugs due to recent research

showing they may actually increase cardiac risks? He actually told me I'd be better off to just "live with the numbers?"

I thought he was nuts. But now I don't think so. I think I just need to get my vitamin D.

http://moblogs.wordpress.com/2007/08/25 ... nificance/

This guy is just spit balling--but he has put together quite a few links in this article.

So now you know what I found and why I say what I do about having these tests.

Hope it helps!

XOXOXO

SandyXOX

Sandy

DX: Orthostatic Hypotension, MVP, Scoliosis, Osteoporosis, Vit D & b-12def, Dysautonomia, Autonomic Neuropathy--Sympathethic, High Norephenephrine &Cortisol, reactive hypogylcemia, Dysmetabolic Syn X, Kidney function lossSandy

[Guest Sandy Sims]

Stuff from diabetes school taught at my local hospital--doc sent me--insurance pays for this! Ditto for ALL testing supplies--just ask for an RX and call ANY local diabetes supplies place they'll file it for you!

Today I didn't take my morning metformin 1/2 a pill to get some high numbers on the machine read out to show the local doc who did NOT prescribe the extra 1/2 dose to be sure he'd OK it.

B4 lunch I was 123--not bad--45 minutes later 136 (usualy I spike fast--AND I ate a lean cuisine small entree --all veggie--with low fat cheese--small amt--BUT added 15-20 grams of coarse potato chips--a fast carb). This all looked normal to me so I went on about my day and forgot about it.

But two hours later I started feeling groggy--BP dropped.

For me this means check again. It was 173. OOPS!

Over 140 means check every 30 minutes at least til it drops they taught me in school since for me highs mean lows on the other side i need to stop.

30 minutes later was 181. YIKES!

Two highs means test every 15 minutes until it drops.

15 minutes later was 193. OMG time!

BP crashed--pulse also slows when my sugar is high (tho high when it's low due to adrenal surge with lows) So I started moving around some to try to burn some of it off--maybe staggering is more like it? (danger zone is over 200)

15 minutes later it's 131--60 point drop in 15 minutes?

So then I'm looking for food NOW to catch the low on the other side I KNOW is coming and FAST! All bran crackers and lowfat cream cheese --i.e-protien and slow carbs. while I get dinner ready AND my night metformin a bit early.

Anyway, this is how it works if you do what my dietician told me to do--test, TESt, TEST each time you try a new carb that isn't a slow carb. Maybe for you it is--or isn't. I have tested 191 with no symptoms. But I now know this just means a low is coming!! Better is to see it coming and stop it B4 adrenals have to kick in!!!

Right now my adrenals REALLY think they're supposed to kick in--I need to re-train them they don't have to by keeping my sugar very stable until they get better. I've been told this will take about 6 months to turn them off except for REAL emergencies. Right now they kick in at 75--just because they do--this has gone on too long.

Also, I'm supposed to test with symptoms more carefully right now as I have an infection and am on antibiotics. Prior to the infection I'd dropped to once or twice a day testing at times I knew I tended to run high--was doing fine--120's to 130's to 90's for lows--perfect-- had pretty much gotten most things figured in the first couple of weeks. But I've run thru 100 test strips this month!! At a buck each you DO need to get a prescription for these!

BTW I ran a similar one dose metformin test last week b4 I got an infection ANND took supplements--topped out in 150 range--but then got all swollen and a kidney infection so am thinking I need to better talk to a doc about this now. There is not really a whole lot of for sure stuff out there on taurine and l-carnitine for diabetes or kidney issues--tho initial research looks promising for both.

Info to know?

A meter older than one year may not be working. If you register your meter they'll send you a free new one each year. People sell old or damaged (heat during shipping kills them) strips often. That little bottle of juice that came with your meter is to test one strip from each new bottle with--instead of blood. Each bottle has a range this test should fall in printed on the side. If not testing in range TAKE THEM BACK! They're dead!!

Also strips expire 30-60 days after being opened--NOT the much longer times on the bottle--that's for unopened and kept at least in A/c--refrigerator is better for unopened strips (not opened ones--just A/c for them--don't want them wet.).

Lancets--seems all I've gotten work well in ANY machine--but take the machine and check if unsure. I use them 3 or 4 times--or til I get bruised and know they're dull. Lancets aren't as expensive as strips!

Meters don't like heat--or being wet.

I now have three meters? Sound odd?

I bought the first one--got a second one free in class--it was dead early on and testing 40 points lower than my original one--called both the manufacturer from 1-800 number on the machine and my diabetes supplies place--BOTH sent me a new one free. Lots of places will GLADLY send you a free meter kit! It's the strips that cost--$1 each--so get a prescription saying you CAN test several times a day so insurance will pay for them. The supplies places are great--they called the doctor--got my RX for me--send my stuff as needed--and file all insurance for me.

METERS ONLY WARANTEE READINGS TO A 20 POINT "RANGE." They also are not designed to test lows as well--some don't get below 60. THIS MEANS A 70 WITH SYMPTOMS IS A DO SOMETHING NOW DEAL! Also means it's not a bad idea to let two people send you a free meter so it readings don't match how you feel you CAN test one against the other.

For $20 you can get a plug and software to dump your meter into your computer and print nice graphs--my docs nurse says, "he likes these--it's a one minute thing to see!" This also helps me to know what time of day I'm getting highs and lows so I don't have to test so much after a week or two.

OK, that's the jest of a three day dibates class and 4 dietician appts.

Hope it helps!

XOXOXOX

Sandy