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Looking Back: How Often Should I Change My Lancet? (A “Grost.)

source: Type 1 Diabetes Memes

I’m on the road today, visiting with the Patient Revolution team, so I’m looking back at a post from the past.  But it’s not just any post … it’s a grost.  (A gross post.)  How often do you change your lancet?  I will admit that I don’t do it as often as I should, but I’ve been really trying to do it more regularly.  In efforts to keep my fingertips from hating me.

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(Taking a cue from Glu today because when this post rolled through my feed, I was like, “Hmmm.  A lot now, but before?  NEVER!!”)

Every single time there’s a new meme about changing the lancet in a finger pricker device (nope, that is not the technical term), I laugh because they are all true in that “whoops” sort of way.

Upstairs in the bathroom closet, I have boxes and boxes of lancets for all kinds of different poker devices (again, not the technical term).  All different sizes and shapes and gauges … years and years worth of lancets for half a dozen different devices.  (Except The Guillotine.  That thing was retired decades ago, thank goodness.)  And the reason I have so many lancets stashed?  I went years without regularly changing my lancet.

Gross.  I know.  And I’ve seen that photo of what a needle looks like before use, after one use, and after six uses and yes, it grosses me right the hell out.  But for a long, long time, I changed my lancet once a month.  Maybe once a week, depending.  And I only changed it if it didn’t procure a good blood droplet or if it went into my fingertip and got “stuck.”  (You know what I mean … when you press the button and the lancet deploys, only it lodges itself into your fingertip and has a weird suction feeling when it pulls out?  Horribly horrible.)  Lancet swapping-out was a shameful non-priority for a long time.

Two things made me start changing my lancet regularly:

ONE.  A friend told me about how she’d heard a story about a person with diabetes whose fingertips were downright gangrenous because they didn’t change their lancet.  “Ew, really?”  “Really.”  And even though I stand firmly on the “hope vs. fear” motivation concept, this story about mostly-dead fingertips made me want to throw up.  Then I started searching the Internet for information on needle reuse and the photos made me want to apologize profusely to all my digits.  I had no idea how nasty and serrated the needle edges became after just one use.  I thought about all the times I had injected syringes through my jeans in high school.  I thought about how a box of lancets could last me two years.  I thought about how gross I was.  Gross, gross, groooooosssssss.

TWO.  And then I explored lancing device options.  I had heard really good things about the Accu-Chek Multiclix (mostly from Sara, because she frigging loves hers), and the device was snazzy because it comes with a drum of lancets that automagically swap out, but the size of the thing was too big for the case I kept my meter in.  Switching to the One Touch Delica was the winner, for me, because the lancet gauge is so thin that I’m forced to change it regularly because otherwise, I don’t bleed.  (It becomes that dance of pull back the device, press the button, nothing happens, repeat 10x, change lancet and curse.)  Like it or not, I have to change my lancet regularly or the device becomes useless.

Now I change my lancet once a day.  Every day.  And every time I kill a box of lancets, I feel accomplished because in the last four years, I’ve gone through at least two dozen boxes.

In the 20+ years prior?  Probably the same number of lancet boxes.

Rewind.

Put test strip into glucose meter.

Prick finger.

Apply blood.

(Yawn as the meter counts down because it’s six in the morning and what’s sleep?)

Look at screen.

Blink.

Pull strip out of the meter.

Toss it into the meter back with all the other dead strips.

Zip up meter bag.

Brush teeth.

As toothpaste foam starts to drool out of my face, promptly forget what the meter result actually was.

Toothbrush hanging out of my mouth, turn meter back on and scroll back through the memory.

See result.

There it is.

Finally register result in brain.

Repeat every single day.

It’s Just a Blood Sugar Check.

Checking my blood sugar takes less than 30 seconds.  Truly – upcapping the bottle of test strips, inserting the strip, pricking my finger tip, squeezing blood onto the absorption pad on the test strip, waiting the five second countdown of my meter to see the result up on the screen, and then taking the strip out and turning off the meter.

Thirty seconds.

Great.  No big deal.  Easy-peasy, and other rhyming phrases.

Let’s add in the responsive elements.  First, I anticipate the result.

Have you ever had go force yourself to check your blood sugar because you don’t want to see the result?  You know you’re high, so you want to avoid confirming it because seeing that number adds to the emotional failure quotient.  Have you ever forgone checking your blood sugar because you know you’re low, choosing fast-acting glucose sources over the 30 second confirmation routine?  The process of checking blood sugar isn’t just the installation of strip, pricking of finger.  There’s oftentimes an emotional hurdle that needs to be leapt over first, forcing me to attempt to view data as data instead of data as self-worth.

Then I perform the glucose check.

Then I respond mentally.  What is that number?  Do I have insulin on board?  Have I exercised in the last hour or two?  Am I planning on exercising?  Do I need to correct the number, either with food or insulin or exercise, to bring it into range?  Am I okay to leave it alone?

Normal questions like, “Am I hungry?” come to mind oddly late in this hierarchy.

But before the mental response, I respond emotionally.  A blood glucose result of any kind stirs up emotions, even when I try to immediately squash them.  There’s pride built into a 100 mg/dL.  Anxiety built into a 50 mg/dL.  Guilt baked right the fuck into a 300 mg/dL.  This is what keeps me from viewing my data as simply “data,” because every number represents something I’ve done or didn’t do … and I need to remind myself more that the thing I’m honestly not doing is making insulin.  The rest is a basket of beady variables that spill out unpredictably.

Checking my blood sugar is important because it gives me a view of where I’m at and helps me set the pace for where I’m going.  But it’s never “just a blood sugar check.”  It’s more than that.  There’s so much mental and emotional real estate dedicated to a 30 second process.

 

How Often?

“How often do you think about diabetes on an average day?”

“Not sure,” I said, checking my blood glucose twice so I could calibrate my continuous glucose monitor, mentally calculating the lunch insulin bolus I needed to take cover my food without making me low for my run later this afternoon. Looking at the five strips left in the bottle, I realized I needed to refill my kit. And to also reorder supplies.

“Probably a lot.”

Verio Sync: Second Impressions.

[Second Disclosure Verse, Same as the First:  I have received the Verio Sync meter for review prior to the full US launch. I was not asked to write this review.  Opinions shared, for better or for worse, are mine.  Typos, too.]

It’s been about five weeks since I started using the Verio Sync, and after getting over the initial “eh, the screen isn’t as nice as the Verio IQ,” the transition was smooth.  The meter performs similarly to the Verio IQ, but it does have some potent perks.

Ahem.  Potent perks:

  • The battery life on the Sync is better than that of the IQ.  I think.  I actually haven’t seen the “low battery” icon yet on the Sync (except when the meter starts up after sticking a strip in, so I at least know the meter has a low battery icon).  With the IQ, I was charging it every five days or so, and it only lasted that long when I would manually shut the meter down after testing (holding the button down until the meter screen went blank).  The Sync turns off automatically much faster.  For now, I charge the Sync when I charge my Dexcom, which is every five or six days.
  • The syncing feature of the Sync doesn’t drain my iPhone battery as much as I’d thought, because I don’t leave the Bluetooth feature on my phone enabled all the time.  I enable Bluetooth as needed, uploading the results once or twice a day instead of every time I test.  This helps conserve battery on all fronts.
  • As a PWD who has always struggled with logging blood sugars, the app for this meter is awesome.  Not because it does anything truly remarkable (it doesn’t fly, and it doesn’t make me fly), but it does what it’s supposed to do:  automagically sucks my blood sugar results from the meter and loads them into the app.  For someone like me, who struggles with making the time to download meter results, this is extremely useful.  At a glance, I can see how things have been going, and it’s powerful motivation for me to either continue on the same path or to change the course of it … blood sugar-wise.  (See also:  things have been good the past few weeks, so lots of green on the graph.  But back in mid-December, there was more red up there than I’d like.  Something about keeping the green as the dominant color serves as incentive.  In other news, a bell just rang and now I’m craving a snack.)
  • I also saw some of my first pattern alerts crop up, which were more common with the Verio IQ.  Tagging doesn’t seem to be tied to “I ate” or “I didn’t eat” but more to time of day, seeing as how manually tagging blood sugars is a feature that was removed for the Sync.  (Again, this didn’t affect me much because after about four months with the IQ, I turned off the tagging feature.  It frustrated me that I could only be a “full apple” [before meal] or a “bitten apple” [after meal].  I needed a third icon for simply “not eating.”)

  • Another powerful bit of information for me is the ability to see my 14 day averages portioned out by time of day.  Again, being able to score at-a-glance information about when my blood sugars are in range, out of range, and free range (read: bonkers) is very useful and helps me make tweaks as needed.
  • I do not like swapping one feature for another, though.  The Ping meter had the ability to send results straight to my insulin pump, and I was to remote bolus using the meter.  The Verio IQ and the Sync do not.  And as I mentioned before, the Sync seems like an aesthetic step back when compared to the IQ.  I really wish glucose meters, as they are improved, didn’t take features away as they moved forward.

But, as previously mentioned, it seems accurate.  So far, it’s matched very well with the results I’ve seen from my Dexcom G4 sensor, and it’s also lined up neatly with the results I’ve seen from hospital-grade lab work (A1C draws).  Bells and whistles are nice, but accuracy and dependability reign absolutely supreme in this house.

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