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Have your kids ever got the 'you check too much' at the endo office speech?

Discussion in 'Parents of Children with Type 1' started by ecs1516, Jul 26, 2013.

  1. T-bird

    T-bird Approved members

    Aug 24, 2012
    My endo gave me that speech in the beginning when I was testing about 15 times a day. Now I test about 8 times a day.
  2. Debdebdebby13

    Debdebdebby13 Approved members

    Dec 15, 2011
    8-10 times per day on any given day, sometimes more, sometimes less. Her PDM right now say her daily average number of tests is 8. Our insurance only covers 8 strips/day so, unfortunately that sometimes dictates how much we test.
  3. sugarmonkey

    sugarmonkey Approved members

    Feb 16, 2008
    I would love it if my 16 year old tested that often. When he's not with me we're lucky to get 2-3 tests a day. If I'm there to remind him it's usually 8-10. His script is written for 10-12 to cover for any extras.
  4. Mimi

    Mimi Approved members

    Dec 19, 2008
    We got it once from an endo (pre-CGM). He walked in, congratulated us on the A1C and in the next breath said "Now let's talk about why you're testing so much."

    We don't see that endo anymore. :)
  5. Ott8965

    Ott8965 Approved members

    Jan 17, 2013
    We just moved to a new state and at our first appt. we got it. She said I needed to use the KISS acronym. Keep it simple! Sigh! Wish it were that easy ;)
  6. Michelle'sMom

    Michelle'sMom Approved members

    Aug 21, 2009
    No one at our endo's office had ever said anything about how often we check until last January. We had a new NP who insisted we should never have a reason to check more than 4 times per day. She even quoted my response in her notes in the medical file. I told her day to day management decisions were for us to make, & as long as we're responsible for our dd's care we'll determine how often we check.
  7. Pemb

    Pemb Approved members

    Jun 26, 2013
    We got that speech pre-dexcom. She was telling us that we really didn't need to test 10-12 times per day when the nurse came in and handed her papers with his a1c. The dr. looked at it and said, "Well, whatever you are doing, it is working. I guess I can't complain." She never mentioned it again.

    But really, more data is good! It gives a better picture of what is going on and makes fine tuning things so much easier.
  8. Turtle1605

    Turtle1605 Approved members

    Jan 6, 2012
    Let's see. Just testing...

    1. Upon Rising
    2. Before Breakfast
    3. Two Hours After Breakfast
    4. Before Lunch
    5. Two Hours After Lunch
    6. Before Dinner
    7. Two Hours After Dinner
    8. Before Bed
    9. Once in the Middle of the Night

    That equals 9 tests. If you are lucky enough to combine the "upon rising" and "before breakfast" tests and one of the "two hours after meal" tests and "before meal" tests, that may eliminate 2 of them. But, then...throw in a gym class, some football practice and the stubborn 285 number you are trying to get to come down...you are still at 9+ and that's on a good and "normal" day. So, no...I don't think you are testing too much. ;)
  9. Ali

    Ali Approved members

    Aug 1, 2006
    I agree 100% with Turle1605. The basic number of tests without exercise or any lows or highs is 8. Add middle of the night and it is 9 and exercise 10 to 12 and a low or high another few. :confused::confused:ali
  10. Darryl

    Darryl Approved members

    May 8, 2008
    Frequent testing allows you to react to changes in the direction of BG before it strays too far out of range. Testing every 12x/day (every two hours) doesn't really tell you the direction of the BG. What if you test at 3 PM and it's 100? What do you do? It might be 100 going up or going down. To know the direction BG is heading you would need to test every 15 minutes at most, or 96 times per day. So if you are not using a CGM, testing 8-12x per day seems completely reasonable, and I don't know why an endo would suggest to test less often than that. We check 3x/day to cal the CGM but when the CGM is occasionally out of service, we test every 1 or 2 hours including overnight.
  11. DavidN

    DavidN Approved members

    Sep 7, 2012
    This makes sense to me for someone not using a CGM. But with a CGM, we knock out #2, #3, #5, and #7, leaving 5 regular tests. More of course if the CGM is "out of whack" or when confirming and correcting lows.

    So my question to those with CGM's checking 10-12 times a day, where do the extra checks come from? Do you more or less follow the PP list despite having the CGM? Do the extra tests come from treating lows? I'm just curious as I think I'll learn something important here from more experienced parents.

  12. ecs1516

    ecs1516 Approved members

    Dec 11, 2007
    Because our Dex has been off before. He adds those extra checks before driving, Cross Country, when the Dex is off he checks twice to see which one is right. COnfirming how low in a low. If high then getting exat number to do correction. We were told by office to not treat highs off CGM number
    It also depends how the CGM has been working. If it has been working well then may go by CGM for driving. New Dex G4 last night and it was a roller coaster.His actual BG was level. Could not make up its mind on if high or low. It is doing better this morning.Take that back. The CGM is off by 100 right now. This is an unexpired G4. It said he was 100 more than he really was. Usually they are good sensors but not always.
    Last edited: Jul 31, 2013
  13. tammy82

    tammy82 Approved members

    Oct 23, 2006
    We were never told we check too much. It depends on the situation also as to how many times you check. We do around 8+ and if she is very active such as going to a waterpark or amusement park it is much more, I would check her hourly to be sure everything is fine before doing rides.
  14. skyblufig

    skyblufig Approved members

    Jan 31, 2013
    Everything I read and am told would indicate that, in general, the more you test, the better idea you have of how to manage the T1D, so... test away. We recently had to get our NP to call in a change in our Rx for test strips from "6-7 times daily" to "8-10 times daily" so that our insurance would cough up more strips per month, but that was just an insurance thing.

    OT, when this happened, we had to buy 2 vials of test strips out of pocket. Holy smokes! $60 a pop! :eek: Interestingly, our former Rx of 200 (4 vials), with a discount card, costs us $15. The new Rx of 300 vials? Still $15. Makes me a little nauseous how much money T1D would cost without insurance. What do people do? Just not test?! :(
  15. shannong

    shannong Approved members

    Sep 15, 2012
    I agree. Without a CGM, how can any doctor say you are testing too much? I test my son 15-20 times a day. We do not have a CGM.
  16. Mom2henry

    Mom2henry Approved members

    May 16, 2010
    Only you know what it right

    We check an average of 10 times a day. Every time we go to the Endo he says that we check too much. He is not a fan of checking at night as a rule, (agrees there are times when it is warranted), and feels a bit smug about it. Unfortunately for me, my DH feels similarly so it adds fuel to the fire. But I keep it as is. I am the only parent who manages D so I am not requiring anyone to do what they do not want to.
  17. Nancy in VA

    Nancy in VA Approved members

    Jul 16, 2007
    I was told once I was checking too much - I think I was averaging over 15 times a day. We looked at the pattern of when I was checking and asked ourselves what we were doing with the information. For example, we were always checking 2 hours after breakfast but she was rarely, if ever, low, and if high, we never corrected because we knew she spiked and then came down. That check was worthless.

    We had a couple of other checks like that - routine ones that weren't doing anything but telling us something we weren't going to do anything with anyway.

    The Endo was working for us to understand that checking just to know the number you weren't going to do anything with anyway wasn't a productive use of our mental energies. She freely admits that our CDE LOVES the ton of numbers and loves to analyze them (like I do) and that's why she and her CDE make a great team - the Endo's job is to help us see the forest for the trees, while the CDE is looking at the trees. Its all about balance. Managing diabetes is a marathon, not a sprint, and coming up with practices that are conducive to good mental health, as much as physical health, was important. I appreciated the conversation and did some adjustments and reduced our testing. Without a CGM, I think we were at about 10-11, with the CGM, its definitely fewer (wake up, before lunch, before dinner, ~11pm, anytime the CGM alarms with something we need to address). So, that's 4 regular ones and then responsive ones. We check for each low alarm and for the high alarms after 2.5 hours after eating - we will snooze if it high alarms before that and not check unless she's still over 180 at the 2.5 hour mark.

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