Going to the Carnival…

The DSMA Blog Carnival, that is.  The prompt for July (OK, so I’m waiting until the last minute!) reads:

Blood glucose.  It’s front and center when it comes to diabetes.  It is how we get diagnosed and it is what we are trying to manage.  An important tool we use to manage our blood glucose is our meter and its strips.  But what happens if our meters aren’t giving reliable information?  Let’s explore that this month as we discuss a topic from the June 26th chat Fill in the Blank.  Weigh in on the following statement:

Test strip accuracy is important to me because______.

As type 1 diabetics we rely so much on numbers.  Our a1c, how many units of insulin we take, insulin sensitivity factor, Insulin to Carb ratio, but the number we rely on the most is our current blood glucose level.  This number is instrumental in telling us how we are going to proceed with our next diabetes decision – do I need a snack?  Insulin?  Should I wait a bit to eat dinner?  Am I at a safe level to exercise?

We test our blood glucose 4, 5, 10 or more times per day.  It is a constant “tattle tale” of how we are managing our diabetes.  Yes, our a1c gives us our overall diabetes “grade” for the past 3 months, but our blood glucose…that is the number we rely on to make these multiple daily decisions which, in turn, account the most for our overall care and management.

There has been a lot of talk lately about test strip accuracy (or inaccuracy if you want to look at it that way).  Our trusty little meters aren’t quite as great as we thought.  Some may read too high, some too low.  The general rule is that a meter is within about 20% accuracy.  This is a big deal.  Say my meter tells me my average BG is about 140.  I think I’m doing pretty darn good at this whole diabetes thing – this would translate to an a1c of about 6.5, not too shabby.  But what if my actual average is closer to 168 (an increase of 20%)?  That brings my a1c up to 7.5, which, not as great as 6.5, especially when you are planning a pregnancy and trying really, really hard to get your a1c to 7.0 or lower.

A person without diabetes may think, “What’s the big deal?  The difference between 140 and 168 isn’t THAT huge.”  But over time, as you can see above, it makes a pretty big difference.  If my meter is telling me 140, I’m giving myself less insulin than if I’m 168, thus remaining a little elevated.  And vice versa.  If my meter tells me I’m 168 but I’m actually 140, I may give myself too much insulin and thus cause a blood glucose drop later on.

Luckily, with the advent of CGMs, we have yet another tool to make our treatment decisions.  However, not every person with diabetes is able to benefit from this technology due to various reasons, so the core issue remains the same.  We need accurate meters and test strips.  Diabetes management is a series of small decisions that lead to an overall result.  Shouldn’t we have the best tools available to make the best decisions possible?