Why are my numbers different?

Q. Why are my numbers different?  

I see people on line and some of the numbers look like the numbers on my meter, but others look sort of like my A1C looks, only a bit "off."

What gives?

A. Where do you live?

In the United States, our blood glucose meters use the measurement of mg/dl.  That stands for milligrams (of glucose) per deciliter (of blood.)

In Canada (and other pasts of the world) the meters use a mmol/l measurement.  That stands for millimole* (of glucose) to a full liter (of blood.)

Here is a link to a chart that includes mg/dl and mmol/l and A1C conversion.


 *A millimole is 1/1000 of a mole, which is a measurement for the mass/area of molecules)

To to that off...

We also have the AlC number.

The A1C test is a test that is done at a lab (there are at-home tests, but not very accurate and I have not had luck using them) and the test shows the average of all your blood glucose over the last three months.

Glucose binds itself to the hemoglobin in your blood and the hemoglobin cells last about three months, so by taking the average of how much glucose has attached to your hemoglobin cells, we see a reflection of your true average.

Q. Why is an A1C better than just averaging out my meter numbers?

We tend to use our glucose meters on a schedule (either by certain parts of the day, or based on when we eat) AND/OR if we're feeling a bit wonky (either high or low.)

So we miss those high numbers or low numbers that happen when we don't test, or while we're sleeping (*that's why my A1C was higher than my meter average - I don't test during the "Dawn Phenomenon.")

Our meter numbers are really good for planning our eating and exercise, but the A1C is good for knowing our glucose "status" and adjusting medication.

If there's anything I missed, let me know and I'll add it!

Eat To Your Meter

I use a lot of test strips - until I have a really good handle on this, I want to know how different foods affect me.

For your diabetes to be "controlled" you MUST control those after-meal spikes. ("Spike" - when your blood glucose rapidly increased to a high number within an hour of eating.)

That means testing each of them, and that means "eating to my meter."

Here is a really good article about it, and has a lot of "why" - I'll copy and paste the "how," but please read the whole article.

NOTE: If I'm testing a new food, I do the one-hour test so that I know how much the food changes my blood glucose at this highest point.

So, here is how you “eat to your meter.”  Take a blood glucose reading before a meal.  Eat your meal.  If you are NOT diabetic, test your blood glucose 1 hour after a meal (if diabetic, test 1 1/2 hours after a meal.  If you are diabetic and commonly experience blood glucose levels over 200, then test 2 hours after a meal).

If you experience more than a 25-30 point spike in your blood glucose between your pre and post meal readings, then identify the carbohydrate (grain, starch, legume or fruit) on your plate.  THAT FOOD IS NOT YOUR FRIEND!  (Article: “Should I Eat Fruit?  How About Grains, Starches and Legumes?”  HERE.)

What do you do if you find a food that spikes you over the target range?  Well, next time, try cutting the portion of that food to a very small amount.  For instance, I would personally have a significant blood glucose spike from 10 strawberries, bur very little spike from 3 strawberries.  So, I have learned my limit with this particular food.

If you still have a significant blood glucose spike from the food after consuming only a very small portion, then, in my opinion, this food has to be eliminated from your diet.  Why?  Because your body cannot process this food without significant blood glucose rise.  If you continue to eat foods that cause a significant rise in blood glucose, you will eventually need medication (or MORE medication) to help you process these foods.  To me, no food is worth more medicine and the side effects that come along with it.

Now, when you find a food that causes very little blood glucose spike, put it on a “safe” list.  After a few weeks of testing like this, you will have built up a nice sized safe list, and you will have eliminated obvious trigger foods.  Concentrate your meals around your “safe” foods.  Once I have determined which foods are “safe”, I personally, no longer test for those foods.

I did this several years ago and built a “safe” list for myself.  I have chosen stricter targets for myself, choosing to keep my post-meal blood glucose <100.  I literally have dozens of items on my “safe” list that cause less than a 5-10 point spike in my blood glucose.  Many of the foods I eat have almost NO glycemic impact.  Here is an example of one of my pre-meal, 1-hour and 2-hour post-meal blood glucose from a food on my “safe” list.

What I learned in Al Anon

For a time, through a difficult space of time with a very dear loved one, I went to Al-Anon meetings.  I wanted somebody to tell me how to handle this.

But they wouldn't.

"We can only tell you our experiences, but cannot and will not tell you how to handle yours."

Over time, I began to understand.

1- Everybody and every situation is different.  

How one person responds may be very different from how another person responds.  That difference might be the difference between success or failure.

Over time, as I listened to stories, I realized that my loved one would have responded very differently and it would not have gone well.   It was only by taking a bit here and a bit there that I was able to figure out how to move forward with my life.

How it relates to my dx

You read a lot of "try this" and "try that."  Worse, you hear a lot of "you HAVE to..."

You read a lot of "you need to get off meds" and "meds are poison."  

Not every thing works for every person, and by trying to make the glass slipper fit every foot, it becomes an exercise in frustration.

2 - You have to "make it your own"

If you only go by what somebody else tells you is the way it has to be done, you never have the chance to "make it your own."

How it relates to my dx

You hear a lot of "you HAVE to..."

You know what?  That may be true.  But until I internalize that information, it's the will fighting against the desire.

The more I was told (or told myself) that I COULD NOT have something, the more I wanted it.  The more somebody else told me that there was something I HAD to do...the longer it took me to get to that point.

Now, as I relate to others, I help others find substitutes, work-arounds, etc.

I give them space to "make it their own."

3 - Baby steps count, too.

With my loved one, there were a lot of missteps.  Lost opportunities.

But a step forward is still a step forward.

How it relates to my dx

A step forward is still a step forward.  In myself, and in others.

Recognizing baby steps in others is worth celebrating.

They may not "get it" when they're told that the only right way is the way they're being told.

But if their steps are in the right direction, let's celebrate that.

1- What works for me may not work for others
2 - What works for others may not work for me
3 - Give others the space to figure it out in their own time
4 - Celebrate the baby steps.