The point of all treatment for Type 1 diabetes - whether it's diet or insulin - is to keep the level of glucose in your bloodstream as close as possible to normal. The nearer you get to achieving this, the better you will feel, especially in the long term.
What do the results of a blood glucose test tell you?
When you do a blood (or a urine) test you are measuring how effective your previous dose of insulin has been. In other words, doing a test just before lunch will tell you the effects of your morning injection of fast-acting insulin while a pre-breakfast test will tell you how effective the previous night-time dose of insulin has been.
As a matter of routine you are suppose to check your blood glucose levels at least three times a day and more often if you are ill or changing your insulin regimen. A blood glucose test will tell you quickly and easily whether your glucose level is getting too low (Hypo) or too high and you can take action as necessary. Among the young people we talked to there is a variation regarding the number of blood tests they do per day. In this summary young people talked about their reasons for checking their blood glucose levels more often than recommended, for doing them regularly or less often or not at all.
Doing regular blood glucose tests
Some of the young people we talked to have always tested their blood glucose regularly and this pattern hasn't change since diagnosis. Their main attitude is that it is something that they have to do; that they have no choice if they want to control their diabetes well. Those who inject insulin every time they eat know that it is very important to check their glucose levels to determine how much insulin they need. They tend not to find anything difficult or unpleasant about doing the glucose test. A few of them keep a diary to record their glucose results. A lot of the young people we talked to said that they find it more difficult to do a finger prick than to do an insulin injection. Some young people talked about what they do in order to avoid discomfort and damage to their fingers.
Many young people indicated that the number of glucose tests they do in a day changes depending on how they feel. Some young people said that they do more daily tests than what it is expected because they find it difficult to tell if they are going low or high. One teenager said that he tests 1 to 12 times per day depending on how he feels. Last year he was experiencing lots of hypos and is trying hard to avoid them.
Sometimes young people have to look closely at what their blood sugars are doing. Sometimes you need to do lots and lots of blood tests to find out whether or not your current insulin regimen is working properly. One young woman had a period in which she was doing very frequent glucose tests to find out if her insulin regimen was the right one for her. Young people who do strenuous sports like rugby or football said that they need an accurate picture of their blood glucose levels because when playing or training they use large amounts of sugar in short periods of time. Young people also said that they increased the number of blood glucose tests they were doing daily while their diet was being supervised by their doctor. (See also 'Talking about - Diet and diabetes.)
Doing less blood glucose tests than before
Some of the young people we talked to said that now they don't test as often as they did a few years ago mainly because they have lived with diabetes for several years and understand how much insulin they need for a particular type of food. Also because their diabetes is well controlled and their glucose tests are not telling them anything they don't already know. Others said that testing is time consuming and a nuisance to do them particularly at school or when you are going around with friends. Those who have lived with Type 1diabetes for years indicated that they do not need to 'prick' their fingers to know if they are going low or high; that they have learned to recognised the warning symptoms. Others only did blood glucose test regularly when they were changing from one insulin regimen to another in order to check that the transition was going smoothly. A few admitted that they do not do their glucose tests everyday but 'they are working' towards it.
Feeling like a human "pin cushion"
Many young people said that until recently they were not doing their glucose tests regularly or not at all. Some of those diagnosed as children indicated that they usually stopped doing them in their early teens because they 'rebelled' against it; their fingers began to hurt every time they pricked them; or just simply they 'hated' doing them. Some teenagers described it as feeling like a 'human pin cushion' while others found it difficult to do a test at school.
Many of the young people we talked to have started doing daily glucose tests again because as they put it they simply 'grew up' and want to live a healthy life. They also said that the new testing machines have made testing easier. A few young people however, have already developed complications due to poorly controlled diabetes in the past. One such young person, diagnosed at the age of three said that until a year ago she never did a test, the few glucose tests she had were done by her mother, she had a phobia of the testing machine. Last year she was told that she has several diabetes-related complications including scleroderma diabeticorum which basically means thickening of the skin and happened because she used to run high blood sugars over prolonged periods of time. (See also ' Talking about - Managing diabetes as a teenager', 'Hypos' and 'Highs'.)
A few young people have stopped doing glucose tests altogether despite being aware of the risk of complications. One young woman said that 'she got out of the habit of doing them' She relies on her HbA1c test which is done every six months at the hospital to check how well she is doing. In fact, several young people relied or are relying on their HbA1c's tests alone to assess how well they are controlling their diabetes.
One young man who has poorly controlled diabetes indicated that he finds it very difficult to do his glucose tests despite the fact that sometimes he doesn't feel well at all. Says that his GP encourages him to try and do glucose tests. He hasn't seen a diabetes specialist team for the last two years.
Awareness of long term complications
In general, young people who are doing or aiming to do at least two glucose tests a day do so because they are thinking about long term complications and their own personal goals. They do not want their diabetes to spoil their future plans. Some young women indicated that they would like to have children in the future and for that they need to be healthy. Others indicated that they want to travel or live abroad. They regard glucose tests has a very important and integral part of controlling their diabetes well not just for now but for their future. As one woman said “I want to be healthy in my old age”.