Management and Measurement

As with many things in life, if you are hoping to manage something you better have a way of measuring it.  Whether it's watts of power on a bike, the food you take in - or in this case the management of my blood sugar.

It's been a bit over a month since I've switched from multiple daily injections of insulin which I calculated based on the blood-sugar reading of my Accuchek Nano Blood Glucose meter.  While I was using I was pretty good at holding steady at 100 mg/dL... according to that meter.

Then I switched to my OmniPod for my insulin pump.  The PDM (personal diabetes manager) works both as the controller for my pump, and also as a manual blood glucose monitor.  Right when I switched, the scientist in me knew well enough to check the consistency of the readings between meters.  

I would use the same drop of blood and test it on both meters.  Different meters have different margins of accuracy at different ranges.  Some are more accurate for measuring high values, etc.  I guess that's handy for those people who want precision in their poor control - not really my goal.

There has been a consistent off-set between these two meters.  The difference was usually as much as 25 points.  The Accuchek always read higher. That's a significant margin of error.  70 or 100 won't kill me, but 40 vs 70 is a big deal.  And it's tricky to guess which one was actually right.

Functionally what this means is that I wasn't sure whether all my work of the past month with the OmniPod in which I've been able to hold a steady monthly average of 105mg/dL, may have been in fact a less than stellar* 130mg/dL  (by my standards which are higher than most).

So after all this worry I finally got some blood labs done with a meter check.  They drew about 20mL out of my finger tip in the lab.  I was amazed at how well the lab tech milked that much blood so easily from a fingerstick - it actually hurt less than my stabber-jabber although upon further inspection her lancet cut a bigger slice.

The results came back.  The omnipod read 92 mg/dL.  The Accuchek read 124mg/dL.  The lab values were 100 mg/dL (BULLSEYE!).

Implications.  Accuchek should rebrand as in-accucheck.  The OmniPod is much more accurate and it will measure me as slightly lower than what my bloodsugar actually is.  So my avg of 105 might be more like 113 mg/dL.  

Looking back.  Makes sense why I was feeling gassed trying to workout with my Accucheck - similar to the fuel gauge on my Firebird which always showed 1/4 tank left when I really only had only enough to get me 20 miles.

Looking forward.  I'd like to target my actual blood values when resting to be 90 mg/dL - so I'll play around with lowering my set-point to the low 80's (which will be a real world value of 90).

What a relief.