Diabetes Self-Management Blog

It’s Monday but, with the Labor Day holiday and the children here, it feels like Sunday. Not that I had much of a holiday weekend: I had work to do. Well, not "work" work, like where you actually make money, but the type where, for example, you do the synagogue’s monthly bulletin.

Just as I finished that and breathed a sigh of relief, the Sisterhood president called. “I have those pictures for the calendar,” she said. Calendar? Oh, yeah. I did say I’d do a calendar featuring old photos for a Sisterhood fundraiser. (It sounded like a good idea at the time.)

In the meantime, religious school starts next week and I’m not only the director; I teach a class, too. And have a meeting with the new kindergarten teacher tomorrow. And need to take my granddaughter to the bank to open up a savings account. And my cleaning lady quit, so I have a potential new one coming over…well, in between when I need to have this blog entry in and dash out to meet the kindergarten teacher.

And the cleaning lady is probably going to run out of the house screaming, because (1) I’m not neat, (2) my husband isn’t neat, and (3) those two teenagers who seem to hang out here more than they do at their own house certainly aren’t neat. And like I have time to clear a path before the poor, unsuspecting potential vict…er, cleaning lady…gets here to look the place over?

So is it any wonder that, when I went to code my new backup blood glucose meter, I messed up?

Because I wear a continuous glucose monitor (CGM), I need to check my blood glucose with a certain kind of meter that “talks” to the CGM. When the company that makes the meter offered a freebie that is smaller and uses the same strips, I took them up on it. I can’t use the new meter to calibrate my CGM, but it’s tiny enough that I can slip it easily into my pocket and carry it along with me when I go out.

But it has one tiny little problem: It looks the same whether it’s right-side-up or upside-down. Wouldn’t you know my strips had a code of “6,” and I entered the number while the meter was upside-down? I figured it out right after I checked my blood glucose, at which point I turned the meter around the right way and re-entered the code. Just for fun, I checked my blood glucose again: It was 40 points lower than the result I’d gotten when the meter was miscoded. Had I given myself insulin to bring my blood glucose down, I would have dropped into hypoglycemia-land.

Unless you have a self-coding meter, you need to code it yourself, making sure that the code on the meter matches the one on the vial of strips you’re using. However, says Charles H. Raine III, M.D., research has shown that 16% of people fail to code their meters properly.

Raine, a diabetologist in Orangeburg, South Carolina, is the lead author in a study involving miscoded meters which showed that the probability of insulin error reached as high as 50% if doses were based on the results from a miscoded meter.

Why do meters need to be coded to match the strips? Because the chemicals that make up the reagent that measures your glucose level aren’t mixed in one never-ending vat; they’re made in batches. And, no matter how hard you work to make the batches match up perfectly, it just ain’t gonna happen. There’s going to be some variability in the chemicals, the manufacturing process—even in the weather.

When you change the code, it causes a slight change in the mathematical formula that reads the glucose and allows the strip and the meter to…well, attain karma.

While I’ve always made sure my meter was properly coded, I never thought it would be a potentially serious matter if I didn’t. Until the day I couldn’t tell up from down or top from bottom and realized what could have happened had I not discovered my error.

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