San Francisco Bay Area resident Patrick Totty writes about his experiences living with type 2 diabetesSee all posts »
The Pattern Detectors, Part 2: Establishing a Test Pattern
Here is a series of steps I mentioned in my last blog for learning about your blood glucose patterns and how they are affected by diet, exercise, medications, and your own unique physiology.
Learn how to test yourself.
This means knowing how to draw blood for your meter to test. It also means learning to live with the minor pain that comes from pricking your fingers several times per day.
Modern technology can’t eliminate all of the pain of self-testing, but it has removed most of it. Track which of your fingers gives the most blood for the least effort, and experiment with depth settings on your lancet until you find the one that draws the most blood for the least sting.
Test yourself several times a day at set intervals.
You have to establish a pattern to detect a pattern. You can vary when you test and how much as you learn more about yourself and type 2, but four times daily is a good start:
- Fasting. After your nighttime sleep and before your breakfast. This is what your blood sugar level is like after several hours of no food. It gives you a baseline against which you can compare other figures.
- Two hours after breakfast. This lets you see how much your blood sugar spikes after a meal. Keep in mind that everybody’s blood sugar levels—diabetics’ and non-diabetics’—spike after a meal.
- Before dinner. This figure gives you a rough idea of what your levels are at the end of an active day.
- Two hours after dinner. The same as with breakfast, this figure lets you see how much you typically spike and gives you a rough idea of what level you’ll be going to bed with.
At this point, your main concern is to establish a habit of testing at set times and recording the results. Finding a pattern comes later.
Once you have a baseline of tests, begin introducing variables.
Assuming you’ve already begun taking medications, the two most basic variables you can control are food and exercise. For example, you can track differences between high-protein breakfasts of eggs and bacon and high-carb breakfasts of grains and fruit.
If you take a walk or bike ride after breakfast, you may want to see how it affects your post-breakfast reading. For some people, exercise drives down post-meal blood glucose levels, while for others it has a negligible effect. Again, you’re simply looking for your pattern, so this isn’t the point where you want to fret that vigorous exercise doesn’t lower your levels the way you want them to.
Taking variations into account means you may have to commit to more testing throughout the day.
You may want to add a post-lunch reading, or a mid-afternoon pre- or post-exercise reading.
Another variation is work. On-the-job stresses and exertions are different from what you experience on a holiday or weekend, so you have to look for a pattern there, too.
As you chart your pattern, your map, “My Day With Diabetes,” at first will look like one of those generic Google maps of California: a big outline with a few notable features listed. “My day’s” equivalents to San Francisco, Los Angeles, and the Sierra Nevada will be fasting, breakfast, workout, lunch, afternoon, post-dinner, etc.
With either map, as you focus more closely, the more valuable it becomes. You begin to see highways, parks, landmarks, major roads/blood sugar highs and lows, exercise frequency, food types. Both maps go from being big blanks to rich, detailed collections of information.
Take notes as you go along.
They may be questions, such as, “Unexpected high spike after breakfast. Extra two cups of coffee caused it?” or notations, “Ate small dinner, but had big spike.”
What you’re doing is honing your powers of observation and your willingness to theorize. Both help you stay engaged in learning about your type 2.
In the next installment, I’ll discuss how long you should pursue finding your pattern and what to do if it eludes you.