I am a newly diagnosed DM2. For some reason I got the idea that I am to test my blood glucose just before beginning a meal and an hour later. Should I be doing it just before beginning and an hour after finishing (or whatever time after finishing meals I determine that my BG peaks) instead of an hour after starting that meal?
- 587184
I wear a cgm, take metforman at dinner, 5 shots of insulin (three fast acting and two long lasting) and use jardiance. Just make sure you follow your doctor's guidance. I hope yours doesn't get as bad as mine.
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- ChulaiGuy65536144536144
That was fast response time. My doctor only asks that I measure two times a day; before breakfast and before dinner. I want to get a handle on how well I am bringing down my BG level and have heard that I should be watching after meal levels. I realize that depending on the person and their circumstances docs may ask them to test differently. I am just trying to figure out when the post meal is to be taken whatever the time lapse may be. Do I measure from when I take the pre meal level or from when I finish eating.
- Road-house82908290
I test in the am before eating for a fasting reading. Then, I test again 2 hrs after my evening meal to see how I'm handling the glucose load of my evening meal.
My understanding from my doctor is to test 2 hours after the meal you eat. Depending what I'm eating it could be after any meal I usually don't normally have. As an example if I'm going to have something for dinner that I've tested for a many times before and I do well I'll try to test in the morning or after lunch. After awhile you know what effects you and what doesn't. That's just me your results may differ. And you also have to have a wife that must know what I want the next day for meals the day before.
With the exception of an additional 1/2 hour before testing, this is exactly how we (takes my wife and I working as a team) manage my DMII. I take 500 mg metformin with breakfast and supper. My A1C is consistently 5.8-6.1 and my after meal numbers range between 110-130, occasionally spiking higher but rarely over 150. My dietician recommends 45-60 carb grams per meal and I pretty much eat what I want but know that I have to stay within those carb limits. I understand that this is more information than you asked for but I all too well remember being new at this and finding conflicting information everywhere, even on the American Diabetes Association website. If I could urge you to do one thing to help you manage this disease it would be make an appointment with a registered dietitian for you and your wife.jim1392 wrote: ↑Dec 17, 2020My understanding from my doctor is to test 2 hours after the meal you eat. Depending what I'm eating it could be after any meal I usually don't normally have. As an example if I'm going to have something for dinner that I've tested for a many times before and I do well I'll try to test in the morning or after lunch. After awhile you know what effects you and what doesn't. That's just me your results may differ. And you also have to have a wife that must know what I want the next day for meals the day before.
Prednisone will shoot your numbers through the roof, if your doctor prescribes it make sure you ask him or her about that aspect, I had to learn that the hard way.
Looks like we both are on the same plan with the Metformin, breakfast and supper. I also found out the hard way with the Prednisone after taking it for a problem I had.Ray wrote: ↑Dec 17, 2020With the exception of an additional 1/2 hour before testing, this is exactly how we (takes my wife and I working as a team) manage my DMII. I take 500 mg metformin with breakfast and supper. My A1C is consistently 5.8-6.1 and my after meal numbers range between 110-130, occasionally spiking higher but rarely over 150. My dietician recommends 45-60 carb grams per meal and I pretty much eat what I want but know that I have to stay within those carb limits. I understand that this is more information than you asked for but I all too well remember being new at this and finding conflicting information everywhere, even on the American Diabetes Association website. If I could urge you to do one thing to help you manage this disease it would be make an appointment with a registered dietitian for you and your wife.jim1392 wrote: ↑Dec 17, 2020My understanding from my doctor is to test 2 hours after the meal you eat. Depending what I'm eating it could be after any meal I usually don't normally have. As an example if I'm going to have something for dinner that I've tested for a many times before and I do well I'll try to test in the morning or after lunch. After awhile you know what effects you and what doesn't. That's just me your results may differ. And you also have to have a wife that must know what I want the next day for meals the day before.
Prednisone will shoot your numbers through the roof, if your doctor prescribes it make sure you ask him or her about that aspect, I had to learn that the hard way.
- ChulaiGuy65536144536144
Thanks again. I think my Primary Care Physician is a lump. I asked for a referral to a nutritionist and he told me I can sign up for a class. Someone else explained how it can be important to sit down with a nutritionist who looks at your individual medical picture, including all the meds you are on, and explains how you should proceed. I think my doc is just a box ticker.
Anyway, the specific info I was seeking was from what point in time to I determine when to take a post-pandrial blood reading. For example, if it is taken after a 2 hour wait, is that 2hours measured from when the meal began or ended.
Anyway, the specific info I was seeking was from what point in time to I determine when to take a post-pandrial blood reading. For example, if it is taken after a 2 hour wait, is that 2hours measured from when the meal began or ended.
- ChulaiGuy65536144536144
Thanks Ray. That was what I was trying to clarify. I began thinking I measured from the time I took the before meal BG. Then as I got into this stuff it didn't make sense and I saw where everyone talks about "after meal" or "post-prandrial" BG levels. I am now going to be taking those reading from when the meal is concluded.
In follow up on the above, it seems that measuring from the end of meals results in significantly higher glucose levels; especially at breakfast. Perhaps due to the dawn effect, my post meal blood glucose is 20 to 30 points higher than what I had been measuring.
I understand the VAMC will do this for you.ChulaiGuy65 wrote: ↑Dec 17, 2020I asked for a referral to a nutritionist and he told me I can sign up for a class. Someone else explained how it can be important to sit down with a nutritionist who looks at your individual medical picture, including all the meds you are on, and explains how you should proceed. I think my doc is just a box ticker.
That is not surprising as your meal will trigger an insulin response. Even non-diabetics get a jump in blood glucose after a meal.ChulaiGuy65 wrote:In follow up on the above, it seems that measuring from the end of meals results in significantly higher glucose levels; especially at breakfast. Perhaps due to the dawn effect, my post meal blood glucose is 20 to 30 points higher than what I had been measuring.
You might consider talking to your diabetologist about continuous glucose monitors. They can be pretty useful for this period of time where you are learning how to externally regulate your blood sugar.
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Shoot, southern Arizona VA will not even give you testing supplies or meter unless you are insulin dependent. I get mine from the MCAS pharmacy.
I see an endocrine specialist for type II and his recommendation is taking your blood sugar first thing in the morning before eating or drinking and then 2 hours after the start of a meal. He believes in testing at least 3 times a day for anyone with diabetes as it teaches you what types of food will send your blood sugar up. I could not do anywhere near 45 carbs in a meal or my blood sugar would be in the 200's
When I called Medicare they said you also had to be Type 1 to get one.Badeye wrote: ↑Dec 20, 2020It is my understanding that the VA will not approve a continuous glucose monitor for s DMII patient. I was told that I would have to pay for it.
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Medicare only supplies me for testing that equals 1 test per day. Lucky enough since I've been a type II since 2011 I pretty well know what triggers my spikes. I mostly use them when I'm eating something new or I don't feel right.
Medicare should cover blood sugar test strips more often if your doctor documents why it is medically necessary.
https://www.aarpmedicareplans.com/medic ... trips.html
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https://www.aarpmedicareplans.com/medic ... trips.html
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Nick,Nick wrote:Medicare should cover blood sugar test strips more often if your doctor documents why it is medically necessary.
https://www.aarpmedicareplans.com/medic ... trips.html
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The information you referred to is for a Medicare advantage plan, not standard Medicare. Still what you said is correct. Your doctor needs to determine how often you need to test. For example, I am DMII and my endocrinologist wants me to test before breakfast daily. Each case is different. Also if you get an infection a high blood sugar makes treating/curing it difficult. I have been treated for a bone infection now for over three years.
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The policy is standard across medicare coverages.
"Beneficiaries with diabetes who use insulin may be able to get up to 300 test strips and 300 lancets every three months. Beneficiaries with diabetes who don't use insulin may be able to get up to 100 test strips and 100 lancets every three months. If your doctor says it is medically necessary, you can get additional quantities of testing supplies. Additional documentation is required."
https://www.diabetes.org/resources/heal ... e/medicare
Also see
Article SE1008, Medicare Coverage of Blood Glucose
http://www.cms.gov/Outreach-and-Education/Medicare-
Learning-Network-MLN/MLNGenInfo/index.html.
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"Beneficiaries with diabetes who use insulin may be able to get up to 300 test strips and 300 lancets every three months. Beneficiaries with diabetes who don't use insulin may be able to get up to 100 test strips and 100 lancets every three months. If your doctor says it is medically necessary, you can get additional quantities of testing supplies. Additional documentation is required."
https://www.diabetes.org/resources/heal ... e/medicare
Also see
Article SE1008, Medicare Coverage of Blood Glucose
http://www.cms.gov/Outreach-and-Education/Medicare-
Learning-Network-MLN/MLNGenInfo/index.html.
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- ChulaiGuy65536144536144
All I know is that I have a medicare advantage plan with Kaiser; Kaiser Pemanente Senior Advantage Plus. When I was diagnosed by my Primary Care Physician I asked for a montor and he prescribed one and told me to test before morning and evening meals. When the RX was filled it was for 200 test strips, a meter, 200 lancets, and control solution. If I wanted alcohol wipes or a sharps disposal bin I had to pay for them.
I have not tried to get any testing supplies from VAMC. I have not tried to see if my Kaiser doctor would prescribe more strips and if it did, would they be paid by Medicare. However I have read the statement of benefits and it says that there is no copay for diabetes testing supplies, but limits apply. I don't know what be the limits.
I have not tried to get any testing supplies from VAMC. I have not tried to see if my Kaiser doctor would prescribe more strips and if it did, would they be paid by Medicare. However I have read the statement of benefits and it says that there is no copay for diabetes testing supplies, but limits apply. I don't know what be the limits.
The VA issued me one.Badeye wrote: ↑Dec 20, 2020It is my understanding that the VA will not approve a continuous glucose monitor for s DMII patient. I was told that I would have to pay for it.
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- 587184
I have a CGM and I am Type II. I was lucky enough to get approved for Dexcom else it would have been Libra II
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- ChipMorrison7576275762
I have been a Diabetic type II for 17 years. I started out testing upwards of four times a day. Today I test in the AM prior to breakfast. I have given up eating lunch and sometimes test around that time of day. My BG is lowest at that point. My AM test is moderate, about 140 but of late have ranged lower because I have lost almost 70 pounds since i quit eating lunch. I have gone from 243 to 177 today. I take two 500 MG Metformin when I get up, one with my evening meal and two at night prior to going to bed. I also take a Januvia once a day. Recently I was in the hospital to have my gall bladder removed. They would not give me Metformin and I ended up getting every once in a while shot of insulin. I complained when my BG got 170 and there after they gave me insulin when I reached the 170 level. But in a 10 day period I got four shots,. When I got out of the hospital I had lost another 10 pounds (terrible food, high carb food as a "heart diet."). Since the operation I have maintained weight below 180, more like 177 now days. I am a Agent Orange/Boots on the Ground Viet Nam vet.
- ChulaiGuy65536144536144
Good going on the weight loss, Chip. I am down to 187 from 210. As for BG, it is up one day and down the other, but for now their are cardiology things going on that have my attention. One morning its 88 and the next a 134, but diet doesn't seem to be the cause. of the BG swings.
Pain level for me can account numerical swings in the BG, could for you as well?
Is that a temp thing with the prednisone? I have to take that anytime I have a lung flareup, did not realize it could hurt your sugar numbersRay wrote: ↑Dec 17, 2020With the exception of an additional 1/2 hour before testing, this is exactly how we (takes my wife and I working as a team) manage my DMII. I take 500 mg metformin with breakfast and supper. My A1C is consistently 5.8-6.1 and my after meal numbers range between 110-130, occasionally spiking higher but rarely over 150. My dietician recommends 45-60 carb grams per meal and I pretty much eat what I want but know that I have to stay within those carb limits. I understand that this is more information than you asked for but I all too well remember being new at this and finding conflicting information everywhere, even on the American Diabetes Association website. If I could urge you to do one thing to help you manage this disease it would be make an appointment with a registered dietitian for you and your wife.jim1392 wrote: ↑Dec 17, 2020My understanding from my doctor is to test 2 hours after the meal you eat. Depending what I'm eating it could be after any meal I usually don't normally have. As an example if I'm going to have something for dinner that I've tested for a many times before and I do well I'll try to test in the morning or after lunch. After awhile you know what effects you and what doesn't. That's just me your results may differ. And you also have to have a wife that must know what I want the next day for meals the day before.
Prednisone will shoot your numbers through the roof, if your doctor prescribes it make sure you ask him or her about that aspect, I had to learn that the hard way.
The numbers increased during the ramp up and down cycle of the steroid. I literally ate nothing but protein and no carb veggies for the time period to keep my BG numbers in check.
Tks, yeah, that's one other big thing about steroids/prednisone, gives you nonstop munchies.Ray wrote: ↑Jan 18, 2021The numbers increased during the ramp up and down cycle of the steroid. I literally ate nothing but protein and no carb veggies for the time period to keep my BG numbers in check.
ChulaiGuy65 wrote: ↑Dec 16, 2020I am a newly diagnosed DM2. For some reason I got the idea that I am to test my blood glucose just before beginning a meal and an hour later. Should I be doing it just before beginning and an hour after finishing (or whatever time after finishing meals I determine that my BG peaks) instead of an hour after starting that meal?
When I was first diagnosed with T2D just over 10 years ago, I tested at the one-hour point with every "new" menu. In other words, I used the meter to help me eliminate any foods that caused a spike which exceeded my limits - "Eat to the Meter". This was after trying metformin (per my Endo), which my system couldn't tolerate. Since then, my A1C 10-year average is 5.6, with a highest of 6.0. Oh, and add lots of physical activity/exercise as well. So, ultimately, my diet is low-carb and low to mid glycemic with almost no processed foods. Restrictive? Yes. But I suffer the severe side-effects of all pharma so I have no other choice. I figure, I ate whatever I wanted for the first 50 years... ;-)shelley7 wrote: ↑Dec 21, 2020I see an endocrine specialist for type II and his recommendation is taking your blood sugar first thing in the morning before eating or drinking and then 2 hours after the start of a meal. He believes in testing at least 3 times a day for anyone with diabetes as it teaches you what types of food will send your blood sugar up. I could not do anywhere near 45 carbs in a meal or my blood sugar would be in the 200's
Nowadays, I always do a fasting test (before breakfast) and do several random tests throughout the week.
- ChipMorrison7576275762
I do my initial test after getting up in the AM. I used multiple tests to determine what to eat and not eat. I no longer do multiple tests. Then I went on a diet of no lunch and lost 65 pounds. I stabilized at 180 pounds. Then I had Gall Bladder removed and while in the hospital lost some more weight. I am now running about 172 or 173 pounds and my A1C is down to 5.8 and my morning blood sugar tests run around 110 with an occasional spike up to 125. I am now in the "pre diabetic" range. But I am still a diabetic and I still take my Metformin and Januvia every day. It is all a matter of maintaining control.
I had some of the same problems with metaformin based drugs. Now using Trulicity with no bad side effects.33-Forever wrote:ChulaiGuy65 wrote: ↑Dec 16, 2020I am a newly diagnosed DM2. For some reason I got the idea that I am to test my blood glucose just before beginning a meal and an hour later. Should I be doing it just before beginning and an hour after finishing (or whatever time after finishing meals I determine that my BG peaks) instead of an hour after starting that meal?When I was first diagnosed with T2D just over 10 years ago, I tested at the one-hour point with every "new" menu. In other words, I used the meter to help me eliminate any foods that caused a spike which exceeded my limits - "Eat to the Meter". This was after trying metformin (per my Endo), which my system couldn't tolerate. Since then, my A1C 10-year average is 5.6, with a highest of 6.0. Oh, and add lots of physical activity/exercise as well. So, ultimately, my diet is low-carb and low to mid glycemic with almost no processed foods. Restrictive? Yes. But I suffer the severe side-effects of all pharma so I have no other choice. I figure, I ate whatever I wanted for the first 50 years... ;-)shelley7 wrote: ↑Dec 21, 2020I see an endocrine specialist for type II and his recommendation is taking your blood sugar first thing in the morning before eating or drinking and then 2 hours after the start of a meal. He believes in testing at least 3 times a day for anyone with diabetes as it teaches you what types of food will send your blood sugar up. I could not do anywhere near 45 carbs in a meal or my blood sugar would be in the 200's
Nowadays, I always do a fasting test (before breakfast) and do several random tests throughout the week.
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