Studying for Lab Tests

In addition to all that I posted about my fortunes in connection with diabetes, I was also fortunate to get through school and college with very minimal effort on my part.

As a side note: Though some think it should be taken with a grain of salt being a community college, I breezed through most of my associate of applied science degree in nursing classes with a 4.0. I finally got a bit apathetic in my last semester and ended up somewhere around 3.85--still enough to finish at the top of my class (stiff competition, I know, but I also aced a bachelor's level Pathophysiology and Nursing assessment class).

Occasionally in the diabetic OC, you hear someone posit the advice to "give yourself a break sometimes." The idea is not to be so caught up in the nitty-gritty details--along with the wide fluctuations so common in diabetes--that you overstress yourself and burn out. My personal opinion is that this is usually spoken in the face of poor or unpredictable control. If what you're doing is giving you stable, excellent control, why do you need (or want) to "take a break" from it?

But, to prove that I am open-minded, I decided to follow this advice to an extent. There has also been a contentious debate which I've been mulling over which goes: Why does a non-compliant, type 2--on oral meds only--need to test often? What changes because of the frequent testing? Why are doctors prescribing and insurances pay (or pharmacies absorbing cost) for expensive meter strips if the diabetic doesn't follow any other of the doctor's advice? Of course, this question got all the compliant type 2s buzzing like bees! My own doctor is quite conservative when I ask for more strips than the four a day he allows me. The reason for frequent testing in a type 2 only on oral medication is to allow modifications of diet and exercise and possibly medication to prevent the poor control as well as gaining a background understanding of how the body will respond to all three factors under many different scenarios. If we only tested a fasting once a week, or an occasional post-meal reading, we could be missing a lot of harmful spiking (i.e., over 100-120 mg/dL) which even the A1c can miss.

But, on the other hand, I must say that other than testing different types of foods occasionally, and just recently making a change in exercise scheduling, I haven't done much modification at all. Most of my testing has been the automatic, because it's-what-I-do mode testing. I have a limited menu repertoire and tend to stick to it. So a couple days ago, before I had my labs drawn, I decided I would take a break from testing. A break from testing for me meant that I did a fasting, and then didn't test until just before exercise that afternoon. This was the time when I would usually see a rise in my blood glucose--probably my 4 hour spike from lunch, or my AM metformin or effects of previous day's exercise wearing off. Otherwise, I had no idea how my meals affected me that day.

It was sorta nice to not really act diabetic; but I, of course, didn't drop the whole diabetic outlook on life or control over my diet and exercise. Had I done that, and made it a pattern, I probably would have ended up with worse results than not studying much in my last semester of college. Taking a break from the diabetic curriculum can lead to disastrous complications. My break from testing didn't affect the next day's lab tests, except eating 6 eggs the day before instead of my usual 2 may have affected my less than desirable lipid panel. We'll see what the long-term shows on that.

It was nice to have a brief respite. I may well try it again. I was pretty confident that since my routine and diet were unchanged, I wouldn't be missing any blood sugar surprises. I must confess that I did feel guilty when I realized that my testing break would be affecting my data. How could I suppose that two random readings were an accurate reflection of the day's average? Oh well, I discovered the next day that my regular meter logging is definitely below my A1c anyway.

Epilogue: I more than made up for my break in the days after my labs were done. Being puzzled by the 5.3% A1c (106-111 average blood glucose) I got when my meter averages have been showing mid 80s to 90s consistently as average readings and because I got up much earlier than usual, I decided to test hourly and see if I was missing sustained higher levels of blood glucose. As a result, I did find that I spiked to the mid 90s on my meter at four hours after breakfast, so maybe that's what I've been missing. This wasn't a sustained spike that should have much impact on the A1c, however. I've done a similar experiment today, only I substituted my breakfast carbs from a can of mushrooms for a serving of spinach (as well as some low carb, home-made, sugar-free dark chocolate) and didn't see a spike all morning. I stayed in the low to mid 80's on my meter. Testing can be tiresome, but it also gives some valuable information. It's definitely a test worth studying and knowing the answers for.