Tuesday, May 30, 2017

Nessa Front

Vanessa
Latest Blog Posts

I Will Do It In A Minute

Blood glucose testing, one of the most important behaviours involved in ensuring effective diabetes management, yet one of the biggest burdens about having the condition. BG testing is the main method that informs us as to how much glucose we have in our blood, with a target goal between 4-7mmol. But we can all relate to how hard reaching that goal consistently can be (imagine trying to hit the middle of a dart board!), but that is for another blog……what we want to focus on in this blog is actually DOING IT, checking our blood sugars a specific number of times consistently per day, to ensure we are keeping a track of our BG levels and aiming for that golden A1c we have always dreamed about.
So people assume “They are diabetic so they have to check their BG levels consistently”. Yes we do, however some people chose not to and do not test enough to ensure effective self-management, in fact many studies and journal articles have highlighted this, especially in adolescents and those diagnosed later in life. Why might this be? Let’s look at it from a behaviourist’s perspective (Vanessa being a behaviour change specialist):

  1. Unwanted readings: We have all been there when we check our BG levels and a double digit number appears, we instantly feel a flood of emotions (guilt, anger, frustration, confusion etc.), which then leads to us not wanting to check it again. This reading acts as a punisher to the behaviour of ‘testing’, reducing the likelihood of the behaviour reoccurring. Plus we would probably prefer not to know what our BG levels are, especially during bouts of uncontrollable readings due to hormones or stress.
  2. Pain: Let’s be honest, us diabetics are hard as nails when it comes to exhibiting pain on ourselves. However, for some, especially young children, newly diagnosed individuals or those with needle phobias, a little pin prick can be a BIG punisher, again leading to avoidance of testing.
  3. Nuisance: When you have had Diabetes for a long time, like ourselves, you get used to juggling a meter, lancet pen and test strips all in one hand whilst carrying your shopping bag in the other (Vanessa – The number of times I whipped out my meter and tested my BG levels in the middle of a concert whilst dancing!).
  4. However, for some, having to test on a regular basis can seem like a burden, especially if they are rushing around and have no time…… But Remember Always Take Time!.

So, how can we alter our behaviour to ensure that we regularly check our BG levels throughout the day. Here are a few tips to increase the frequency:

  • Set yourself specific times to check your BG levels and set alarms/timers/buzzers to prompt you to check at each of your chosen times
  • Take data on your readings and fill HIGHLIGHTED boxes so that you are aware that you need to fill in the empty spaces
  • Ensure you take your meter everywhere with you
  • Reinforce Yourself – Set a goal of how many times you want to check it per day, and if you meet it, reward yourself!

Get a second person on board, every time you check your BG levels, text it to your partner/friend/parents so that others are involved in the process and can motivate you further.

Connect with another diabetic online to increase your motivation and together share your BG test results when testing

But what is great about the 21st century…..CGM’s! These little devices are a life saver with regards to evaluating information about BG levels, WITHOUT PIERCING OUR FINGERS! However, not everybody has access to one due to the overall expense (as always!). Could you imagine how much easier diabetes management would be if everyone had a CGM!? Over the past couple of years, the Freestyle Libre (FL) has come about, which we have both used ourselves.

From experience, there are a few pros and cons to the FL, one con (which we are sure most of you will relate to) includes the stickiness of the tape on the sensor, which has fallen off many arms over the years. Nothing like seeing £50 be flushed down the drain! However, these can be replaced on request. In terms of pros…well all we can say is that the ability to visually see what your blood sugar has been, where it is now and where it is heading is life changing, especially for a diabetic. We also found that, linking back to adherence of testing, scanning the FL sensor is SO much easier and much less hassle than pricking our fingers and drawing blood. Having that constant knowledge of what our BG readings are, to us is so important. In fact, when our sensors run out (as unfortunately each sensor only lasts 2 weeks boo!!!) we find that we actually test our BG levels more with our regular meters, as we become so used to having constant feedback on what our levels are.

Vanessa – I actually wanted to conduct a study on how the FL improves adherence to BG testing, but unfortunately didn’t pass ethical approval due to the fact it involved piercing of the skin! Ahhh!

Let’s hope one day that some sort of CGM will become readily available to us all on the NHS, or at a cheaper price. This will make dancing at a festival a lot easier!