Okay . . . Here I am again . . .
Had a fairly long discussion with Bev (the Nurse-practioner in charge of the DEC at my local hospital) and the short answer is . . . drum role please . . .
we are all right.
Now, for the longer answer . . . hope you've got lots of reading time . . .
Since the advent of the GI (glycemic index), Canada has been looking at the impact of carbs on BGL in a far more specific way because the GI research is constantly bringing to light how different carbs are -- not only between simple and complex carbs, but also down to the level of different foods within a similar category. Apparently, if the truth were know, CDA would like all patients to test their sugar levels every hour throughout the entire day for the very best control, but realize almost (almost
) nobody will do it (got a giggle from her -- at least she does understand reality, even though she doesn't preach it). So the NS CDA decided to put emphasis on the preprandial and the one hour vs three hour postprandial levels. This is not even consistent all across Canada and definitely does not apply in the US, where the ADA has been more reluctant to adopt the GI findings.
Here is a little example she gave me to explain what she was taught to look for -- in that perfect hourly-testing-world and after that perfectly balanced, but probably non-existent meal, (the translation from Canadian numbers to US numbers is mine and the starting point is just random, i.e., not meant to be indicative of perfection) . . .
Immediately prior to eating . . . . . . . . 6.0 (108)
one hour after starting to eat . . . . . .10.0 (180)
two hours after starting to eat . . . . . 8.5 (153)
three hours after starting to eat . . . . 7.5 (135)
four hours after starting to eat . . . . . 6.0 (108)
five hours after starting to eat . . . . . 5.5 ( 99)
Five hours is the longest time recommended between meals and (again in that perfect world), it would be preferable if we all ate every four hours including the middle of the night (she did laugh at that point). Oh, yeah, the timing is measured from the time you swallow the first bite and no matter what the meal is, the timing assumes it will take you from 20 to 30 minutes to complete the eating process (another giggle, here).
Bev also reminded me that bedtime snacks are very important for most diabetics and particularly those using insulin. For me in particular (since I'm prone to those hypos), she recommends my bedtime reading is best at 9 to 10. If lower than 9.0 (162), I should lower my bedtime insulin by a couple of units.
Once again . . . there is no totally definitive answer . . . listen to your own doctor or diabetes educator. But I don't think it hurts to learn everything you can about this kind of 'stuff'.
So . . . question for this evening . . . how often do you test?
BTW, I test at least twice a day, often three and sometimes four. I know lots of Type II's do test more often and I also know that most Type I's have to test more often in order to regulate their insulin dosing precision.
See you later everybody . . .