Re: [IPk] RE: How many tests per day
At the International Diabetes Federation Congress in Paris a few weeks ago I
went to a Lifescan-sponsored symposium on blood glucose monitoring 'past,
present, and future' at which I heard a few great papers. One of them was
from Prof. Geremia Bolli (University of Perugia, Italy, I think), who said
that testing 8x/day should considered reasonable for any type 1, whether on
a pump or not. He said something I really agree with: there are no 'stable'
type 1s, but there are many well-controlled type 1s. Type 1 is dynamic. We
need to test frequently and make changes because it's not stable. If we all
did the exact same things and ate the exact same things every day, we would
probably not be 'stable' even then. For me, control is not about stability,
but about flexibility. It's not about rigidity, but about anticipating
changes that I can and correcting changes I haven't anticipated.
Additionally, Prof. Bolli stated strongly that isophane, Lente, and Regular
should no longer be considered suitable for most type 1s now that we have
analogues with much more predictable activity patterns on the market. He had
an interesting, and very sensible (I thought) perspective on pill-treated
type 2s: 4 tests in one day every month or so to see what patterns are like
and to make changes to a regimen, even if HbA1c is in the range of 7 or
below; as well as 1 bg test per day *at 5 p.m.*, not fasting. Makes sense,
though: if you're a type 2, it's important to know if your food and your
medication (whether oral or insulin) are working together properly through
the day. A type 2 could have appalling blood sugar levels from
post-breakfast until bedtime, but if the body does 'stuff' to fix things
while he or she's asleep a fasting bg could be just fine regardless of the
daytime lack of control.
IDDM 10 years; MiniMed pumper 7 years
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