The key to management of type 1 diabetes is to maintain a balance between doses of insulin, carbohydrate intake and the amount of exercise taken. The aim is to maintain one's blood glucose level within safe boundaries and avoid the rather nasty and potentially life limiting side effects of poor diabetic control.*
Knowing your blood glucose level is important and the measurement methods have certainly developed over the years.
When I was first diagnosed in the early 1970s home blood glucose testing was primitive, to say the least.**
Basically a diabetic's urine was tested to see whether it contained any traces of glucose. This wasn't a test of blood glucose, but of urine glucose levels. If your blood glucose control was poor then glucose was passed through your kidneys and out in to your pee.
The test involved putting 5 drops of pee and ten drops of water in to a test tube and adding a reagent tablet. An exothermic reaction occurred and after a lot of fizzing a coloured liquid remained. This was compared with a colour chart to give an estimate of glucose levels. As I said, crude and hardly the most straightforward activity when out and about.
To this day I can still remember that blue and green were good results, orange was most definitely not.
I understand that this reagent kit was eventually replaced by a plastic stick that was simply dipped in your pee, but I don't recall every having that made available for use at home.
If we jump forward to the late 1980's a significant change took place.
I had moved down to London for a new job and signed on at my local hospital's Diabetic Clinic. I was asked about testing and I mentioned the use of Ames urine glucose reagent tablets. The Consultant scoffed that "those were for old ladies" and handed me a cardboard box containing a palm sized meter, a finger pricking device, a tube of test strips and a lengthy instruction manual.
This was a personal blood glucose measuring device. I simply inserted a test strip in to the meter, pricked the end of one finger and squeezed to release a small drop of blood. The drop of blood was then placed on the test strip and within a few seconds my blood glucose level was shown on an LCD display.
I was now able to actually test my blood glucose rather than urine glucose and this could be done relatively discretely whenever and wherever I wanted or needed.
I've been testing my blood several times a day ever since until today ...
This morning I had an appointment with my Diabetes Specialist Nurse and, having attended the prerequisite training, she has authorised me to use the Freestyle Libra monitoring system.
This is a waterproof circular disk that adheres to my arm it has a microfibre sensor that protrudes under my skin, constantly reading my blood glucose levels. The disk has a near field rfid chip and passes data to an app on my phone whenever I pass my phone over the disk. The disk stays in place for 14 days before it needs to be replaced.
I've only had the Libra disk a few hours and it is a revelation. At a glance I can now not only see my blood glucose level, but also whether it is steady or trending up or down.
Only time will tell how I get on with this new technology and the most important aspect is whether my overall control improves. We shall see.
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* You really don't want to know, but if you insist ... loss of sight, impotence, kidney failure, loss of sensation in extremities which can lead to gangrene, amputations and often death.** Hospitals could test blood glucose, but the test involved a blood sample being taken and then taken up to the Labs for processing. This was usually done a couple of times a year at one's Diabetic review with a Consultant.
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