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RE: [IP] Testing...How Often is Too Often??



They actually told me to test before meals, 2-3 hours after, and at 1am,
3am, and 5am.  I was testing 10-14 before because I was still calculating my
carb ratio amount when I started on the pump.  I was getting low alot and
needed to check.  The increased checking on the pump has been from the more
frequent testing in the middle of the night, and lows I have been
experiencing between meals.  These are being fixed by tweaking the basals.
Thus I have been testing between meals.  It all adds up.  

Also, on shots NPH and Humalog, I would peak from the Humalog at about 2.5
hours.  Since starting the pump I have been seeing it at 1hr.  So I have
added in the one hour test also.  I have caught quite a few lows earlier
then I would if testing only at 3hrs.

For example.  Yesterday morning at breakfast I was 128, and at 1hr. I was
125.  On shots with the same breakfast I would be 310 or so.  So I wanted to
determine if the patterns.  

I also have hypoglycemic "detection" problems.  I wouldn't say unawareness
because if someone asked me if I was running low I would stop and think for
a second and say.."yep."  I just don't seem to stop until they are lower
these days.  I haven't figured out why, other then psychologically I have
convinced myself I can function longer at lower numbers before needing to
correct?  That or I am too lazy.  By testing more often I can catch them and
make myself correct.  

Lastly, I will admit it has almost become a game of seeing what they are.
This time last year I was taking 3 shots a day and testing maybe that many
times in a week.  I got sick of how I was feeling and decided it was time to
figure out why these things are happening.  When I started noticing patterns
I started to correct them.  In June I started carb counting and saw a new
doctor in September who got me carb counting much more efficiently.  Still
working on the details.  Before starting the pump this week I had dropped my
entire daily insulin intake below what I was taking just in my morning shot
and that didn't involve changing my diet.  Scary huh?  Now with the pump I
am taking about the same insulin daily as I was in my morning shot last
week.  So yes I am testing alot but I am still tweaking things as I go.
Because my carb ratios weren't set before starting the pump I have to
problem shoot both at once. :)

Sorry so long, but there are reasons to test so often.  
Yes once things settle I will be testing less.  But I don't have a 
problem testing so often and either does my doctor.  In fact she is
very impressed.  The CDE even asked me for numbers that I didn't need 
to have but did.  It is making the tweaking much easier.

-- Sherry

-----Original Message-----
From: Kornfeld, Avner [mailto:email @ redacted]
Sent: Thursday, December 09, 1999 8:47 AM
To: 'email @ redacted'
Subject: RE: [IP] Testing...How Often is Too Often??


Sherry,

One of the benefits of the pump is ability to set up a better basal profile.
When you will optimize your basals number of BG tests will be reduced. My
average is 6 per 24 hours. I do not see any reason to do 10-14 or 20. If you
do that, your basals and may be your boluses are not set right. It takes
time to settle those basals. I did it after ~2-3 months.

Avner

-----Original Message-----
From: Sherry Webb Nolan [mailto:email @ redacted]
Sent: Thursday, December 09, 1999 3:26 PM
To: 'email @ redacted'
Subject: RE: [IP] Testing...How Often is Too Often??


I just started the pump on Monday and have tested about 20 times a day
since. ;)  But on MDI I was easily doing 10-14 a day.  The insurance company
hasn't said anything...yet.  Although the doctors office wrote the script
wrong and I only got 900 strips for 3 months instead of 1200. :)

-- Sherry

-----Original Message-----
From: Jennifer G. [mailto:email @ redacted]
Sent: Thursday, December 09, 1999 12:08 AM
To: email @ redacted
Subject: [IP] Testing...How Often is Too Often??


Hi all!

I wanted to get the opinion of other people who are using the pump.  Do you 
find that once you went on the pump, your need for blood testing increased, 
decreased or was there no change?  I've been on the pump for almost a year 
now, and have found that I'm testing much more frequently than I ever have 
before.  Part of the problem is that I've had Type 1 for over 20 years now 
and have developed hypoglycemic unawareness.  The other concern I have (and 
part of why I test frequently) is that I am very sensitive to Humalog, which

is what I'm using with the pump.  2 units will lower my glucose by about 
100.

Basically, I test before meals and 1-1.5 hours after meals.  If my target 
sugar after meals is high, I take another dose and test 1-1.5 hours after 
that.  I always test before driving and before and after doing any type of 
planned exercise.  I test again before bedtime and when I wake up.  And of 
course, if I have a low I take 15 grams of carbs and test again in 15 
minutes to check that I'm headed in an upward direction :)

I've heard 5-10 times per day is the norm, but I often add up my daily tests

and find I've exceeded that range.  My insurance company is trying to give 
me the old "diabetics test 4 times per day" business.  In my opinion, that 
sort of thinking is on par with "diabetics need only take two doses of 
insulin per day."  :P

So, can anyone give me the benefit of their experience and let me know if 
I'm being excessive?  My endo seems to have no problem prescribing me with 
the strips...it's just the insurance company balking at it.

Last bit of info: my last HbA1C was 6.5.

Thanks!

Jennifer



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