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Honey Syphon: It's about three and a half months now since I was diagnosed with diabetes and I am slowly learning how my body reacts to various things, such as food and exercise, so I can take control of the disease rather than letting it control me. One of the things I have had to learn to do is perform tests to show me the levels of glucose in my blood. There are two different ways to do this - urine testing, blood testing. These methods both have their advantages and disadvantages. Urine Testing If there is too much glucose in the blood stream, the body tries to flush it out by drawing water out of the cells and passing urine - that's why one of the symptoms is the need to rush to the loo very frequently. So if your blood glucose level is higher than normal, the urine will also have glucose in it, and this can be tested for. Once upon a time, the only way to test urine for high glucose was to taste it - it's sweet (hence the name, honey siphon). The things doctors do for their patients! Not so long ago, testing the urine involved complex procedures involving boiling it up with chemicals. Thankfully, it's all much easier now. One simply pees into a jar, then dips a specially-coated strip of plastic into the urine. Wait a short while and the strip changes color. Compare the color to a chart to get a reading of how much glucose is present in the urine. There are a number of disadvantages to this, over testing blood, which I will come to in a moment. But there is one big advantage, especially for the newly-diagnosed. The advantage is that you don't have to jab yourself with a needle in order to get some blood to test. Many people are frightened of needles; even those without a full-blown phobia are squeamish about the thought, or scared of the pain. So testing the urine is an attractive alternative. I was relieved when I was first diagnosed, and my doctor told me I should start by testing my urine. But then I discovered the down-sides. One of the disadvantages is gender-based. Men, I am sure, don't have any problems with peeing into a jar. They can see what they are doing and aim into a small receptacle. Women, on the other hand, don't have the visibility or the control to make this easy. Even without the aiming problem, actually holding something between your legs while sitting on a toilet seat involves uncomfortable contortions. As an alternative, one can simply hold the strip in the stream of urine as you pee, but this is also tricky and it's messy - you cannot avoid getting urine all over your hand. Once you have performed the test, you are left with a pee-stained strip and possibly the receptacle you peed into, which you have to dispose of somehow. If you aren't at home this can be a problem. Not all my friends have sanitary disposal bins in their lavatories! Testing urine in this way is also fairly inaccurate. It doesn't tell you what your blood glucose level is at the time of the test, but what it was anything up to four hours ago. This makes it hard to build up an accurate picture of what's going on with your body. Sometimes it's hard to match up the color of the strip with the color chart. Exactly what shade of blue is it? And imagine if you are color-blind - it must be impossible. The gradations are also large - when I was testing my urine, the system I used had four readings - Normal, Low, Medium and High. Most times my urine was High. So all it was telling me was that I had high glucose levels, which I already knew - not a lot of use! It's also no help if you have to worry about your blood glucose going lower than normal, which people on insulin or some kinds of medicine have to be aware of. So after testing my urine for about a month, and after being reassured by people who were already testing their blood that it didn't really hurt, I decided to switch. Blood Testing Blood testing works on the same basic principle as urine testing - you put a drop of blood onto a strip, and the strip changes color. You compare the color to a chart... well, that's the old way, but technology has made it all a whole lot easier. These days, you can buy meters that do a proper chemical analysis of the blood and display the exact amount of glucose present on a screen. There's no ambiguity trying to compare colors, it gives extreme accuracy, and some of the machines do clever things like store previous readings. The process goes like this (different meters work in slightly different ways but the principle is the same). The meter uses special strips, one end of which you insert into the meter. The other end has a special patch where you deposit a drop of blood. Even jabbing a needle into yourself to produce some blood is aided by a gadget - an auto-lancet, or finger-pricker as it is more commonly known. This has a mechanism that works a bit like a retractable pen, or biro - you press a button and the end shoots forward a precise distance, to prick your finger just enough to produce a drop of blood. You don't have to actual stick yourself with a needle, you press a button to make it happen and psychologically this is much easier. The gadget uses disposable needles which you use once and then discard, for hygiene reasons. The machine analyzes the blood you put on the strip and provides a reading. In the UK the reading is a number with one decimal place - for example, 7.6, 10.1 and so on. I'll explain what the numbers actually mean in a moment. The strips are disposable and just like the needles you only use them once. As with urine testing there is the problem of disposing of them when away from home, but somehow it's easier to cope with disposing of something with just a small drop of blood on it, than it is something smeared in urine. This is partly because urine testing is something done in privacy in the bathroom, and embarrassing to talk about, whereas blood testing can be done anywhere and I have no problem with doing it in front of an audience (in fact many of my friends find it fascinating to watch). I usually carry a small plastic bag around with me which I can put the disposables into until I can find a suitable bin. The machines themselves are not terribly expensive. The one I bought myself cost about £25 (approximately $40) although I have seen cheaper ones. The expense comes in the supplies needed. Each test requires a new needle and a new strip. The needles cost a few pennies each, but the strips... £25 for a box of 50 - when testing three or four times a day, that soon mounts up! I'll write some more about the cost of diabetes later. What the Readings Mean The readings my meter gives are in mmol. That stands for milli-mole (ie one thousandth of a mole) per litre of blood. A note for my US-readers - in the States you measure blood in milligrams per 100 millilitres of blood (mg% or mg per dl) and I have put those figures in brackets. The blood glucose level of a person who does not have diabetes varies from between 4 (72%) when they haven't eaten for a while, to 7 (126%) when they have eaten. It can go a bit lower if they haven't eaten for a long time, or a bit higher if the meal had a huge amount of carbohydrate, but it won't go over 10 (180%) , no matter how much they eat. Neither will it drop below 3 even if they don't eat for days. For someone with uncontrolled diabetes the level goes way above that - up to 20 or even 30 (360%-540%). The higher it is, the more dangerous the condition, and the more likelihood there is that side effects will develop. The aim for well-controlled diabetes is to keep the level below 10 at all times. Right now, I find my reading goes up to 11 or even 12 when I have had a big meal - and sometimes, for no apparent reason, even after a small meal. But it's early days for me yet and I don't let this worry me. I don't have to worry about my blood levels going too low. That's an issue for people who inject insulin, and for those taking some kinds of medication, but fortunately my tablets don't have that effect. If blood level does go too low, you experience something called a hypo (that means low) where the body starts to shut down because it doesn't have enough energy. The cure is to get some glucose into the body as fast as possible, by drinking a sugary drink or eating some glucose tablets. It sounds very unpleasant and frightening so I am glad I don't have to worry about this possibility. Taking Control I have to say that in some ways, I enjoy testing my blood. It's certainly easier than testing my urine. As a gadget-freak, I rather like using the meter. The model I bought is a beautifully designed piece of work - it is very simple to use, unlike other ones I have seen that offer so many functions they are more difficult than programming a VCR; it is small and compact so easy to carry around; the test strips are wrapped individually so I don't have to carry a large pack or bottle around with me; and it comes in a variety of very attractive bold colors so looks more like a mobile phone or a fashion accessory than a medical device. I also feel happier with the diabetes generally, now that I have such immediate feedback on what my body is doing. For the time being, I am checking my blood after each meal (about two hours after the meal) so I can see the effect the food has. This helps me to know whether what I am eating is the right thing or not (see my article on diet, coming up soon). I keep notes in a little book of the times of each meal, and the results of each test, with extra comments when I have an unusually big meal or anything else out of the ordinary happens. The doctor will want to see this when I go back for a check-up but it's primarily for my benefit, not his. I feel confident that I can control this disease. I don't have to rely on doctors to tell me what to do and not to do on a day-to-day basis. Everyone's body is different, and everyone's diabetes is different, so testing allows me to be more flexible and develop rules that work for me. The main problem is being organized enough to remember to test the blood two hours after every meal. Often I get absorbed in doing something and forget. I have taken to using an alarm clock set to go off when it's time. Eventually I will be able to stop testing so frequently. People I have talked to who are managing their diabetes properly tell me they only test their blood once a week. I expect it will take me several years to reach this stage. So meanwhile I will continue to jab holes in my fingers several times a day. Oh, and does it hurt? Actually, no - not really. There's a sharp sting that is gone before I notice it. The only time it really hurt is when I did some cooking not long after a test, and got lemon juice on the finger I had pricked. That's something to be avoided! |
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