This is Not a Test

“Easy, quick, and virtually painless!” Do ads for new types of blood glucose meters ever make you roll your eyes? We all know that incredible advances have been made in blood glucose monitoring over the years, but even so, you may find that many folks don’t check their glucose as often as they should. While there may be several perfectly logical reasons to check your blood glucose frequently, there are also a variety of factors that keep people from testing as much as they should.

  • Testing, testing, 1, 2, 3. Consider the term “blood glucose testing.” Testing. Test. It’s like that middle school history class you forgot to study for. No one wants to fail a blood glucose test – (and we know you can’t exactly study for it!). You know your target range, so a result that is outside of your target may feel like a failure.
  • Another Inconvenient Truth. Glucose monitoring can be inconvenient. Whether you are on an airplane, dining at the Four Seasons, or in a business meeting, there are times when you just don’t think to use your glucose meter. To make matters worse, if any of the people around you notices, their reactions may range from discomfort to curiosity or they may start telling a story about their great-great-granddaddy Earl who had diabetes and died – at the age of 98.

  • Up, up and away. Many people feel as though their glucose numbers are always high – so why bother monitoring it? High numbers can be discouraging, especially when you haven’t done anything wrong. To add injury to insult, your health care team may casually glance at the numbers and shrug them off as though the results are unimportant – or say things to remind you how poor your control has been.
  • Ouch! Forgive me for stating the obvious, but there is another reason why people don’t like testing their blood glucose: it hurts. Maybe not in an agonizing way, but it can be uncomfortable nonetheless.

With all these great reasons not to monitor your blood glucose regularly, how do you move toward a more proactive approach?

“Think of the gas gauge in your car. When it nears empty, do you avoid looking at it? Do you yell at yourself for being so stupid as to allow it to get this low? Do you feel like a failure because you’ve allowed this to happen? Do you resent your car because now you must stop for gas?” asks William H. Polonsky, PhD, CDE, Associate Clinical Professor at the University of California, San Diego and author of the book Diabetes Burnout: What to do when you can’t take it anymore.

“Probably not. You don’t tend to think of the amount of gas in your tank as ‘good’ or ‘bad;’ the gauge is just providing information that allows you to make the best possible decisions. And this is exactly the mindset to use with your blood glucose meter.”

Personally, I think this is a brilliant analogy to help shift your mindset about checking your blood glucose and ease up on blaming yourself for numbers that are out of your target range. Here are a few ideas to help you re-think blood glucose monitoring:

  • Make friends with your glucose meter. It may seem odd to talk about having a “relationship” with a meter, but some people name the navigation systems in their cars and most of us certainly have a love/hate relationship with our cell phones, so why not buddy up to your glucose meter? You are in control of this relationship, so set the ground rules and be sure to remind your meter that this is one test you can’t fail.
  • Change your vocabulary. Maudene Nelson, RD, CDE, reminded me of this when I spoke with her last week: Replace the word “test” with “check.” It may seem like semantics with you, but I feel much more confident about checking in on something than I do about testing myself in it.
  • Charles Dickens had Great Expectations – we would like Reasonable Expectations, please. I’ve already said that you can’t fail a glucose test, but what should your target range be? Talk with your health care team to decide what is acceptable for you at this point – you may find some flexibility. Instead of only feeling good about yourself when you have a good result, be proud of yourself for taking the time and making the effort to monitor your blood glucose. If people who support your diabetes management aren’t reasonable in their expectations, give them some educational materials, bring them to your next appointment with your health care team, or be sure to explain that this is a step in the process toward checking more often and gaining more control.
  • Learn how to use blood glucose information. Have you and your health care provider made a plan for when your blood glucose is too high or too low? Do you know how high is high and how low is low? Be sure to ask these questions next time you talk with your health care team. If the plan doesn’t work, you haven’t failed – it’s just time for a new plan!
  • Make a monitoring schedule that works for your routine. Perhaps the easiest way to do this is to link glucose monitoring to your normal routine and habits. Before you walk into that business meeting, you will probably pick up a pen and paper, so set your meter by your pens to remember to check your blood glucose before the meeting, or bring the meter with you. Before you board a plane, remind yourself to check your blood glucose when the flight attendant offers you a drink (and keep your meter within reach!). Most of us wake up in the morning, eat a few meals throughout the day, and go to bed at night. These are some of the most basic and regular routines, so talk to your health care provider about how you may incorporate glucose monitoring into these daily activities.

Above all, be patient with yourself. I know this is often my biggest challenge. If you want to be more proactive in your blood glucose monitoring, remember that change takes time – but one missed check doesn’t mean you have to start from the beginning.

Believe it or not, there might be a bright side to pricking your finger and testing your blood glucose: It’s better than 60 years ago when people had to perform chemistry tests on their urine (my bathroom counter doesn’t have space for test tubes), or 30 years ago when they had to collect urine for test strip sampling (I guess you’d be good at, um, providing a sample on demand).

Need a little extra support? Sometimes it’s good to share what you’re doing (or trying to do) with others who may be working on the same thing.  Check out our online community and join the conversation.

That’s right, I’m giving you a thumbs up. You can do this!

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11 Responses to This is Not a Test

  1. warriorbard says:

    I think the #1 reason why many folks don’t test more often is because of the cost of the strips. Insurance does not always cover them, or if it does you have to pay out of pocket and then submit for reimbursement – subject to your deductible, of course. And/or limit the number you are allowed. Plus, not everyone even has insurance.

  2. sc says:

    Maybe it would be nice if the attitude towards ‘how to deal’ with the curiosity of those around a patient testing his/her BG could change by means of not thinking of it any different from someone wearing glasses and thus reacting the patient himself/herself accordingly! I mean, patients should change and in turn “force” the others to change.

  3. Linda Gleckler says:

    I agree with the biggest roadblock being the cost of the strips and whether insurance covers the cost or not. Getting my test strips is always the biggest challenge. Otherwise, I am very willing to do the testing as it helps me maintain control.

  4. lori says:

    I can attest to the fact that majority of diabetics don’t test is due to the cost of the test strips. You can get a machine free anywhere but it only comes with 5 test strips. I am a Dialysis RN with a type I diabetic daughter and even for us with insurance it becomes difficult to pay for testing strips. Insurance companies should really look into providing them at reduced costs because the end results of “not” testing results in frequent hospitalizations, amputations, kidney failure etc. which will cost these insurance companies major money as opposed to making test strips more affordable. One bottle of 50 strips =$65 is ridiculous. That is a price without insurance. so for someone testing 4-5 times a day that becomes super expensive. I can see why the prediction for doubling the number of dialysis pts in the US in the next 10 yrs could be so true.

  5. Thanks Dayle,

    I love Dr. Polonsky — and his gas tank on a car analogy is great!

  6. I think electronic test kits are not that precise but can be used to check if sugar levels are high or low.

  7. Karen Williams says:

    I am about to purchase my first monitor and have no idea which one is best for me. I know I want something simple and something I can carry in my purse. I know my insurance will pay the allowable , which I’m not sure what that is until I purchase it, also next year I am on medicare, please advise.

  8. Shannon Mitchell says:

    I dont’ bother daily testing anymore. My quarterly A1C gives me all the data I need.

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