Kristen and Maggie discuss why you should be checking your blood sugar with type 2 diabetes, tips & tricks to make checking your blood sugar easier, and what to do with the data you receive.

Note: We cannot provide medical advice. Please contact your doctor directly for specific questions about your care.

Topics

• Should you check your blood sugar with type 2 diabetes?
• Tips & tricks for checking your blood sugar
• Reviewing your data with an expert

References

• Ketogenic diets

Transcript

Scott K. Johnson - Hey, welcome viewers, it's great to see you. Thanks for tuning in to another episode of Coaches Corner. We would love to know where you're watching from let us know in the comments. You know, one small way that mySugr is giving back is by hosting these short conversations with our diabetes coaches to talk about staying healthy in body and mind. And we really appreciate you sharing some time with us. Now I do have to give the standard disclaimer. We cannot provide medical advice so please contact your doctor directly for specific questions about your care. Today we're getting clear with mySugr Coaches Kristen and Maggie about type two diabetes and checking blood sugars. All right, hi Kristen, hi Maggie! Great to have you back again today and today we're talking about type two diabetes and monitoring blood sugars and let's face it, there's a lot of different information out there and we'll get into that but with that being said let's jump right into it. So if I have type two diabetes, should I check my blood sugar and if so why?

Kristen Bourque - That's a great question Scott and, you know, the short answer of it is yes. You know, we as educators and also of course your health care staff as a whole find monitoring your blood sugar is such a valuable tool. So we wouldn't have you do it just for nothing I promise but it tells us a story essentially. You know, you only see your doctor every what? Three months, six months potentially. And especially right now maybe a little bit less often. So it gives us a really great kind of idea of where your blood sugar is at and again it helps us to make decisions based on those numbers, you know. so essentially I always kind of describe it as a tool. It's a tool for you to use to kind of gage kind of where you're at. Whether it's, you know, after you check your blood sugar after you eat a meal to see if the amount of carbohydrate was sufficient. So, it really helps to kind of give us an idea of where we should be at in our diabetes care.

Scott K. Johnson - Great and around checking blood sugars, are there certain times or, you know, it's one thing to just check blood sugars when we think about it but can we be a little bit more strategic around when we're checking blood sugars?

Maggie Evans - That's a great question Scott. So, I think for most people when we check blood sugar is really individualized. It's really going to depend upon kind of what you work out with not only your educator but with your doctor, kind of what data, what information, we're trying to collect to really kind of target your care. So, you may already have a suggested timetable for when we want you to check your blood sugar. For a lot of people, standard one would be like your fasting. Right when you wake up in the morning, your fasting blood sugar. Could be the two hour after meal blood sugars. Typically just finding those periods of time to target are really helpful and yet again your doctor can help you figure that out, your educator, your coaches can help you with that too. I always like to kind of encourage people to tack on that habit of checking blood sugar with something that you're already doing. So if it's like, "Man I wake up in the morning "and I always forget to do my fasting blood sugar." What's something you always do every morning? Do you press the button on that coffee pot? Do you brush your teeth every morning? Put your meter there and then that's going to be that automatic trigger, "Oh yes, I need to check my blood sugar." So you can kind of find those ways to give yourself those reminders if it's kind of hard for you to remember to check frequently.

Scott K. Johnson - Great, great points. Can we talk a little bit about targets and it's one thing to do the monitoring and see the values that come up on the screen, it's another thing to know what those values mean and know how to interpret them and what I should be shooting for or aiming for, right?

Kristen Bourque - I think a lot of people with diabetes get confused because they will monitor their blood sugar and kind of just move on with their day, so I think it's really important that users understand, you know, these are kind of the numbers I'm aiming for and then kind of have again, you know, essentially, going back to what I said earlier, to have a learning tool to have an idea of where we're at. So, generally there, again, we kind of recommend the American Diabetes Association guidelines. Of course, like Maggie said, is your doctor may have specific guidelines for you because these can be individualized depending on the patient and the length of diabetes and such things. But, so in general if we're talking about our fasting blood sugars, so that's first thing in the morning, no food or drink aside from water, ideally the goal should be 80 to 130. Now, as Maggie mentioned, going back to if we were to monitor after meals, so we generally recommend one to two hours after your first bite of your meal, a goal of less than 180. So again, both of these tools, depending on when your decide to monitor, kind of give us a really good idea of, again, managing your care, so from an educator perspective, and also again helps you as the user to know, "Okay, this number was maybe high or low," or to, again, learn from those things as I mentioned before. We also do want to mention low blood sugar's considered a blood sugar less than 70, so that's also very important to, a number to pay attention to. A lot of times a low blood sugar will come with symptoms such as you know, shaky, dizzy, light headed, things like that. But, it's also important to, you know, recognize if you do have those symptoms to always monitor your blood sugar first to determine that that's also, or how to treat it I should say.

Scott K. Johnson - Great, all right. When it comes to actually doing the blood sugar check, what are some tips for doing that? I know that it can be one thing for people who have grown up with diabetes or have been doing diabetes for a very long time we kind of take for granted, "Just do a blood sugar check." But it's a whole nother story when you're just diagnosed, the doctor hands you a prescription for strips and a meter and then you're off on your own and you go and you get your meter, or your receive your starter kit from mySugr, what-have-you, you're faced with all this new equipment and this stuff and you have to figure it out, right? And it's, I just want to kind of acknowledge that it's not a normal thing to do these checks, right. What are some tips and tricks that we can share with people that might be helpful for them?

Maggie Evans - I love this concept, kind of getting back to the basics, right? I think for all of us who work in diabetes it's always, you know we're so, it's so common to us, "Yeah just go do a blood sugar check." But really kind of recognizing, getting back to the basics and being solid with those I think is very important. When we're thinking of checking, I think the first thing to consider is where am I going to check, right? Most common for a lot of people are the fingers. That tends to be the easiest place, most common place to check. What we tend to recommend though is not checking on the finger pad, that's going to be very painful there's a lot of little nerve receptors there and it tends to be a little bit more rough so we might not get as good of a drop of blood. So if you just go to the side of your finger, right along there, it's a little more delicate and it won't hurt as much either. So that's something to consider there. Also making sure that you're rotating the sites, right? We don't want to go always to that left finger, pointer finger, every single blood sugar check, 'cause that's just going to get really painful after a while so always just making sure throughout the day, throughout the week, that you're rotating which fingers that you're checking on. And then considering your lancing device.

So with mySugr you get the lancing device and you have the ability to pick on the dial how deep you want your needle to go. And so generally when I'm working with people one on one, I kind of use the scale of, if you're going to pick a one, you don't do much with your hands, maybe you have very delicate skin, it's going to be a lighter poke, and then if you go all the way up to, I think it's eight on those lancing devices, that'd be like, I'm in construction, I work with my hands a lot, my fingers are tough, they can take a lot more, and that's going to be a lot deeper of a poke. So generally for the average person anywhere from like one to three or four might be a good place to start in terms of kind of picking that depth for that finger stick poke. The other thing too is considering changing your lancets. I know it's really, kind of a common thing or it's easier just to leave the same lancet in there, why do I have to change it out? But as you use it it's going to get more and more dull and it's going to be a lot harder for it to poke the skin so it just makes it a little bit more painful overtime. So just make sure that you're routinely changing those out to make sure that you have a nice fresh lancet as well. Logging it in your app which it will automatically do with the meters that we provide, but making sure that it's logged into the app so you can continue to review your blood sugars. Like we said before, it's data, it's information, it's that tool that we need to kind of help determine targeting care for the future, so it's really helpful just to make sure that it's uploading in there. And then just review that data frequently. So review that with your coach or with your doctor. Just making sure that everyone on your care team has access to that and that we're reviewing that with you to kind of determine the next steps for your care.

Scott K. Johnson - Those are great tips and pointers. I also am a big advocate of leaning on those in my health care team to help me review my data so those of you out there living with diabetes you are the expert of living with diabetes but that doesn't mean you also have to be an expert in reviewing your data. Of course, it's nice if you can and you do but you have people on your team that can help you with that, like your coaches and your health care team who are clinically trained to help spot patterns and trends and make recommendations on things you can do to help with that so I really like this because it's almost like I can outsource a piece of my diabetes to those who can help me with that. So, if I've got a question or need a little bit of help I can use the coaches in mySugr, if I've got coaching through mySugr, send them a question and go on about my day and then when they've had a chance to review all my data and have some answers or suggestions or maybe even more questions for me, I get a notification and then I got that dialogue going back and fourth, it's really a nice feature and it helps me not have to bare 100% of the burden of my diabetes on my own and it's really a nice thing that I've got help on my team so take advantage of that, there's help out there for you. So, great round up of tips and information and tricks so, thank you and then we'll be back again very soon with some more helpful information. But before I do that, and I don't want to stop us if there's any more information that we want to add.

Maggie Evans - I always just say, kind of going back to what you were saying Scott, is take the pressure off yourself, put the pressure on us, right. We as your coaches, we're here to help you and provide that care and so let us take on that burden of checking your blood sugars and analyzing that data to really help give you those tips and tools to help you manage your care. That's what we're here for, that's what we're trained for, and what we love to do. So, we love that pressure so give it to us.

Kristen Bourque - And Scott, I also wanted to mention too, and Maggie brought up a great point about this is that, for us it's very natural to talk about this because that's our job, right, but if you're especially newly diagnosed, the idea of checking your blood sugar can be very intimidating, and also some people struggle with fear of needles and things so, also again, going back to relying on your health care team, your coaches, for support in that way too because that is a very common thing to struggle with too so yeah, you know we got your back and you know reach out to us if there's even something like that 'cause it's very common.

Scott K. Johnson- Great. Great, great, great. Awesome, all right. We will be back again soon with more helpful information. Thank you Kristen and Maggie. Talk to you soon.

All right, there we go. Kathi, you had a great question about using the Abbott Libre and how it can sometimes read slightly different. So the FreeStyle Libre from Abbott it's a, what they consider a flash glucose monitor. So it's something a little device that you wear on your arm, it has a little sensor that goes in and then you scan it with a reader or your smartphone and it gives you some historical data on what your glucose values are. Now the reason that it can read a little bit different than what your traditional finger stick or blood sugar reading is, is that it's measuring a slightly different fluid in your body. That fluid is called interstitial fluid. And it has a very close relationship with blood sugar but it's different and so it can lag behind a little bit from the traditional glucose in your blood. So, I would say, you know, Kathi if you're getting those values that are 10 or 20 points apart, that's generally pretty good and it's not something to worry about. And it's definitely giving you more data, more information to work with, it's close enough. If it starts being, you know, dramatically different then that's something where you want to call the 800 number for the support group that manufactures that and ask them are there things that you can do for troubleshooting and at what point is it far enough apart that you should be concerned or swap out a new sensor, that type of thing. So, yeah with that I hope that that was helpful. That discussion with Maggie and Kristen. If you have additional questions or want us to dive a little bit deeper, go ahead and leave us the questions. We're happy to follow up and address them in an upcoming episode. And as far as upcoming episodes on Wednesday, we tackle the question, "Is there such a thing as a diabetic meal plan?" I hope that you'll join us. Until then, stay well and we will see you next time. Bye.