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From Abby: Absolutely Not Medical Advice.

Like we said before, this is NOT medical advice.  Not even close.  But Abby has some opinions that are influenced by her years with type 1 diabetes, her nursing degree, and all the stuff she hears people saying about diabetes, and she wants to share those opinions here.  
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I love me some accuracy. I fully appreciate and take advantage of the photo opportunity that is a matching finger stick and Dexcom reading. That being said, I want people to remember something about the 20% frustration factor. Think about the fact that labs are little tiny experiments, whether a finger stick glucose reading or a lab draw for yearly cholesterol - it is measuring a small (like, really really small) sample of fluid and figuring out how many of that "thing" is in that sample. You try making technology that requires a micro-amount of capillary blood that will give you the same reading every time. The bigger problem here is that when you think about it there is NO WAY that the glucose concentration in your pinky finger is the same as in your antecubital as in your ear lobe. It's impossible! How could it be the same throughout your body?

What helps? Using the same meter all the time, using unexpired strips, getting a new meter every two - three years, and only base your medication dosing on that meter. When you think about it, if your particular meter reads 100 mg/dL, but your venous blood is 120 it's fine because you're going to do the same thing every single time with that meter reading of 100, which will result in a consistent A1c that will match. See? Stop using 48 different meters and getting mad because they are 8 points off from each other. The key to science is consistency, and diabetes is science.

Note: if you feel low, and your meter reads an in-range number, get back to basics. Wash your hands, chose a new finger, and test again with an ample sample. Test strips are mass manufactured and they are not perfect all the time.  Also, remember than any blood glucose reading is more accurate than a urine strip that gives a vague reading of "in between brown and greenish but more on the brown side" on it.  There has been progress!

Myth #4: My hydration status does not effect my diabetes. Water is not insulin.
Okay, this is sort of kind of true and not true. Fact: Water is not insulin. Fact: Hydration has a HUGE effect on diabetes. Like, arguably the biggest effect of anything short of pasta. I actually heard a doctor say in a lecture a few weeks ago "I've seen people admitted with HHS (the type 2 version of DKA) whose blood sugar went from 1500 mg/dL to 800 mg/dL after two liters of fluids and no medication." Want more evidence of hydration influence? Think about the symptoms you have when you are dehydrated - thirsty, dizzy, nauseous, headache ... sound familiar? If not, you've never felt a high blood sugar. More fluid dilutes your blood, which lowers the ratio of glucose to blood, which is also known as mg/dL - which is how you measure your finger stick glucose on your tiny little meter. So, it's safe to say, that if you are dehydrated your "blood sugar" will increase. Thirsty yet?

(Please note that water is not a substitute for medication. Ever. In any sense of the idea. Ever. Do not drink a bottle of water and think you don't need insulin or your pills. It's not true. It never will be true. What you can do, is if you have a stubborn high that you're afraid of rage bolusing into a low, drink some extra water and wait a little bit - it might not do anything, but a little extra water never hurt anyone right?*)

*If you have kidney, heart, or any other sort of medical issue PLEASE PLEASE follow your doctor's plans for fluids. I am aware that many people have a strict fluid intake limit. Again, this is Absolutely Not Medical Advice. Ever. Seriously.

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I'm guilty of comparing meters during BG tests (what can I say, I love to be frustrated?). But you make a valid point that I've been wondering in the past few days - it does make sense to stick with one meter for consistency! However I do have a problem with getting accurate results from that one meter. Yesterday for instance I tested at 83 mg/dL on my Verio IQ but 65 on my PDM. I don't usually feel my lows so I can't go based on how I feel. Had I not tested with the PDM additionally, I wouldn't have wondered if I was low or going low and may have went about my way unexpecting. That scares me.

I was so excited when I saw the title of this post! I really love this weekly dia-myth-busting stuff! :) Keep it up

Thanks for posting the advice! However, Diabetes by definition is "NOT" an Exact Science ~ as stated by professional medical journals and my multiple Endo-Doctors. Consistency and Type I Diabetes is an oxymoron.

Great call on the Hydration issue vs Blood Sugar! :) I have noticed that if I am High (above approx. 200, and I am Hydrated - I will have to go tho the bathroom about every 15 minutes. As diabetics we need to be aware of how quickly we do in fact become dehydrated when High :(

Completely agree on the accurate meters. The other day I had a reading of 20.1 mmol and thought hmm I usually feel really ill if im that high
One minute later - same meter 11.7
I still didn't feel ok and tested on a new meter and was 6.5
Íts a crazy world we live in so thanks for saying all the things we already knew (or should have known)

I know I've been shouting to the rafters lately about meter accuracy and I'm probably one of several voices on your last nerve, but it's awfully frustrating to acclimate yourself to one product line and want to try the latest and greatest new device only to have a total existential crisis when your numbers don't match what you thought they should be.

FDA says companies don't ask for tighter restrictions and that the onus is on the meter companies. So if we don't advocate for better, who will? They can do better than +/-20%. They can.

As much as I share the opinion that you should pick a meter and stick with it, I am not comfortable in a world where my friends change their meter codes to second guess the company so that the numbers seem more realistic. And that's where we are now. And somebody might get hurt. (I'm talking about freestyle code 16 vs 17.)

We are also in a world where, because our pumps use precise calculations, I'm dosing a different amount of insulin - a potent hormone - for a 120 than a 125. And yet, the meter could be telling me I'm anywhere from 90 to 150 and I'm supposed to answer for the resultant highs and lows when I face my medical team who wants to know "why were you low/high here?"

It's an advocacy issue I feel pretty strongly about. Yes, it's better than nothing and it's better than urine testing and it has its flaws because it's home labwork done many times a day under uncontrollable conditions...but it is frustrating nonetheless that we can't get better than what we have.

I can't agree more with you on getting a new meter every 2 years or so! Because of a malfunctioning older meter, I ended up in a coma, alone on my living room floor for 36 hours before being found. A month in the hospital was REALLY tough, and I'm sorry to say, I have never fully recovered. But I'm alive, by some miracle, and I cannot stress enough how important it is to replace an "old" meter!!!

it does make sense to stick with one meter for consistency! However I do have a problem with getting accurate results from that one meter.

And please stop getting mad when your CGM and your meter are like 10-15 points away from each other. You know that they aren't measuring the same thing at the same time, right?

I love these posts!

Ahhh I hate meter accuracy! Tested on a Bayer Contour... 74... had a feeling it was off so retested... 224?!?! I had to consult my Ping, which is more accurate. 221. Thanks...

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