By Jan Chait | February 17, 2009 5:53 pm
I feel the urge to write about meters. It all began last week when I got a phone call and — for a little while — thought I’d found you a deal.
The offer? A free meter and free strips. The company just wants people to be able to manage their diabetes, the caller said. Poor guy didn’t know who he’d called: A former newspaper reporter who has a tendency to ask a lot of questions.
No, there was no cost, he said. The meter and strips were paid for by the company. Media rep and phone number? Why, it was he, he said, giving me a name and phone number. (He was calling from Florida: The phone number he gave me had a West Virginia area code.)
Finally, I decided I would bite and gave him the information he needed to send me a free meter and strips. Then came the “catch.”
“What’s your Medicare ID number?” he asked.
“I’m not on Medicare.”
“It’s usually your social security number,” he responded. “Do you know that offhand?
“Yes,” I replied, “but I’m not going to give it to you.“
End of “free” meter and strips offer.
I reported him to my state’s attorney general’s office.
What would we do without our meters? My Type 2 diagnosis came after meters were beginning to become common, so I have no history of managing my blood glucose without one. Wait a minute: Yes, I do. The doctor who diagnosed me did not tell me to check my glucose. It was nine years before I got to a doctor who told me to check. At that point, my HbA1c was 17.4%. I’d hardly call that managing my blood glucose.
I was supposed to follow a “diabetic diet” to keep my glucose in range. Like that lasted more than about two weeks. I like it better today, when I can count carbohydrates and adjust my insulin dose based on what I eat and what my beginning number is.
But I digress. Let’s talk about accuracy. After all, if we don’t have a somewhat accurate number displayed on our meters, we could make a serious error — such as correcting for a high that doesn’t exist.
Several things can affect the accuracy of that number on your meter. Food on your hands probably is the first thing that comes to mind.
At the American Association of Diabetes Educators meeting in Washington, D.C., in August 2008, a certified diabetes educator (CDE) who does not have diabetes checked her blood glucose with nice, clean hands and registered 80 mg/dl after washing her hands with soap and water.
With lotion on her hands it was 87 mg/dl. With milk and with raspberries, 92 mg/dl; peanut butter got her a 94 mg/dl; red peppers, 117; sweet wine, 122; grapes, 447 (which went down to 132 mg/dl after wiping — but not washing — her hands).
Make sure you wash with soap and water, too, and not that hand gel stuff: One of her clients was getting higher readings during the week than on weekends. The difference? He used hand gel at work and soap and water at home on weekends.
Where you store your test strips can make a difference, too. Somewhere in my notes of interesting things I run across and store in my computer or write down (on everything from real paper to napkins and chewing gum wrappers) is the following from a few years ago that comes from a meeting of the American Diabetes Association:
In a study using Accu-Chek strips, researchers found that strips stored in a plastic bag or some other container instead of the vial they come in registered 122 mg/dl when a new strip was used. After one day of exposure it was 125 mg/dl. Fast forward to seven days, when a strip from the exposed batch showed 228 mg/dl. After 14 days, that number increased to 321 mg/dl.
That said, you might not want to store your strips in a baggie. The vials they come in are pretty airtight. They’d probably be good to keep matches in for camping.
And, finally, something you might not even know about can affect your numbers: Your hematocrit, or HCT.
So, you ask, what’s a hematocrit, how do I find out what mine is, and what’s the big deal, anyway?
Your hematocrit is the percentage of your blood that’s comprised of red blood cells. Each meter has a hematocrit range and, if your HCT is out of range for your meter, it could affect the results. Anemia and dehydration are two things that can affect HCT. Another is chronic obstructive lung disease (COPD). Too much squeezing can, too.
How can you tell what your HCT is? Ask your doctor. Chances are your physician has ordered a complete blood count, or CBC, at some point. Your hematocrit is a part of the CBC.
And how do you find out what your meter’s HCT range is? Look through the literature that comes with the meter, do an Internet search for [meter name] and “hematocrit,” or call the meter company. The number is usually on the back of the meter.
LifeScan says hematocrit levels of less than 30% may cause falsely high readings, and hematocrit levels of more than 55% can result in false lows.
While I was at the AADE meeting in Washington, D.C., in August, one meter company representative was anxious to tell me that the WaveSense Presto compensated for differences in hematocrit levels, even if they were out of range. (He brought it up, not me.)
Oh — one more thing. In case you didn’t know (I didn’t for a long time), your insurance will kick in for meters and strips. Just ask your health-care professional to write a prescription for them. Yes, I know they’re not prescription items, but you won’t get reimbursement if you don’t have a prescription.
While there’s no such thing as a free lunch (or meter — even with the free ones, you’ll pay for it in the cost of strips), you can get one by watching for coupons, asking your CDE, or even calling a meter company and begging. Whatever you do, however, don’t give out your social security number to strangers.
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