Questions for the Almighty Blogosphere
Please know, that in my mind the OC knows everything.
With that being said, I have a couple questions I would like to ask. This is the kind of stuff that rolls around my brain sometimes.
1) I eat two things. One item is very quick to digest, the other is very slow. What happens? Does it digest at a mixed speed - like the quick is speeding up the slow and the slow is slowing down the quick? Or does it digest in the order it was eaten?
I would think that it kind of all gets mixed up in my stomach. The slow stuff slowing down the digestion of the faster stuff. But what about when you eat something like ice cream, go low, eat some glucose tabs, and have your BG come back up? Shouldn't the ice cream slow the glucose tabs?
2) This question comes from one of my favorite co-workers. What is with having to calibrate your glucose meters? I mean, I have done it for always. As long as I can remember. And I know that if you don't have it calibrated correctly, that the results can be inaccurate.
But why? Is it something about the chemical process? What is it about the process that requires us to put in the code, or the chip, or the calibration strip?
With that being said, I have a couple questions I would like to ask. This is the kind of stuff that rolls around my brain sometimes.
1) I eat two things. One item is very quick to digest, the other is very slow. What happens? Does it digest at a mixed speed - like the quick is speeding up the slow and the slow is slowing down the quick? Or does it digest in the order it was eaten?
I would think that it kind of all gets mixed up in my stomach. The slow stuff slowing down the digestion of the faster stuff. But what about when you eat something like ice cream, go low, eat some glucose tabs, and have your BG come back up? Shouldn't the ice cream slow the glucose tabs?
2) This question comes from one of my favorite co-workers. What is with having to calibrate your glucose meters? I mean, I have done it for always. As long as I can remember. And I know that if you don't have it calibrated correctly, that the results can be inaccurate.
But why? Is it something about the chemical process? What is it about the process that requires us to put in the code, or the chip, or the calibration strip?
posted by Scott K. Johnson | 6:56 PM
14 Comments:
To answer your first question, when you eat a fast acting sugar (like your glucose tabs) at the same time as something like icecream, (or pizza, etc), it does tend to slow absorbtion of everything down. That's why if you're treating a low, you should have just plain old sugar first- no fat or protien to interfere until 15 min later. I always use a dual wave bolus ( 50% now and 50% later usually) for large boluses for meals like pizza, pasta, or anything high in protien and fat that slows carb absorbtion down. Chinese food is a little higher in carbs, so that I use a 70/30 split- and the second half is usually over half an hour to an hour. This takes some trial and error, but it might help you with some of your lows related to the Novolog. Even if you do a square wave for a large bolus when your BG is at target premeal for 1/2 hr, it might help head off a low. Protein gets digested in the stomach, so high protein meals will slow absorbtion of carbs because they get absorbed from the small intestine. I hope this helps you understand... I can't draw a graph on here as to what it would look like:)
Good question #2 is... I have always wondered myself. Has anyone ever actually read the literature they stick in with the box of strips? Maybe the answer lies within.
All I can figure is that they produce the strips in big "batches". Each batch is somehow unique from the others and therefore needs special treatment(diff. codes). Just a random theory/thought... I'd love to get a definitive answer on that one. Come on OC!
I think the answer given above is correct about the batch to batch variability.
Still, you would think that they could work out the production process so that variability is minimized.
Bayer now has a couple of meters out that do not require coding. Not sure about the precision.
Concerning your first question slowly digested food does slow down the digestion of fast foods. If I have a hypo and drink coke it will take longer for the coke to raise my bg if my stomach has food than if it were empty. Concerning question two - I don't know. Abbott will soon have a new Freestyle that does not need calibrating. I don't think this new Freestyle measures ketones though, so I am stuck with their Precision Exceed. I think it is amazing that there is only one blood glucose monitor that also checks for ketones in the blood.
1. Ah, the digestion question. I've been told that if you eat something fatty along with something sweet, the fatty bits will slow down the absorption of the sweet part. Thus, my mother never let me treat a low with a Snicker's bar, despite my relentless begging.
2. No idea, but I've forgotten to calibrate my Ultra Smart, realized it, calibrated, tested again, and received almost the same result. I think the meter companies are just trying to gnaw on my nerves. :)
I saw a kid's science show that compared the rate of digestion for different foods. It was an experiment to see what happens to gum when you swallow it.
There were several clear containers filled with the same acid as what's in the stomach.
The scientist put a hamburger in one of the containers (it consisted of lettuce, a bun, and the meat). After a half hour, they showed the container with the hamburger in it and the bun was totally gone, but the lettuce was disintegrating, and the meat was still intact. A few hours later, the meat was falling apart.
I hope that answered your question to #1.
P.S. After a day, nothing happened to the gum.
Hi Scott,
I don't have a definitive answer to either question, but I'm glad you're asking them :)
For the meter question, I used a meter for a while that did not require calibration (actually, the literature said that it does "automatic coding" - I'm pretty sure it was an Accu-Check)...
When I switched to the One Touch line of meters, I wondered why Accu-Check made a product that did not require calibration, but One Touch didn't. Who knows...
I have no knowledge to add.
Just wanted to say hi.
Hi!
Oh gracious, these people are so damn smart, knowledgeable and informed. One of the things I love about the OC.
NOthing to add to the answers except it takes me back to the mid 70's, when they told you to "eat a candybar" if you felt low. First, I never knew if I was truly low, because there was no bg monitoring. And, if you did a urine test, you could have spilled sugar a half hour earlier and then be crashing and you'd think you were still high...............my goodness, it's amazing those of us from that era are still here.
Maybe the sour chalk glucose tabs aren't so bad after all.
Hope you're enjoying the nice weather this weekend, Scott.
You always have such good questions. I have absolutely no answer for you but the people above seem to have had good ones.=) I hope you are having a great week.
These questions are hard ::thinking cap is on:: Maybe they can be answered when there is a cure?
um, I can't remember the last time I calibrated my meter... I always thought it was more for the user to check to make sure the strips were in the correct range. They always have been. I guess I might calibrate if I thought something was wrong with the meter. But I don't know if I have any of that calibration juice. I use an OneTouch Ultra.
(I don't recommend doing this, I guess.)
To address your first question, I don't necessarily have definitive answers, but I have my suspicions. When you eat, food is basically chewed and the tiny bits end up in your digestive track. There, everything is digested collectively, and having more slowly digested carbs or fats in with more rapidly digested foods can slow the process down, although I believe it depends on the individual and what they eat. For example, I have seldom found that small amounts of fats (such as cheese) slow my metabolism at all ... a ham & cheese sandwhich hits my blood glucose levels as fast as a ham-only sandwich, but it may have more to do with the quantity rather than the ingredients. This suggests to me that there may be a "pecking order" for different foods based on volume -- I also believe the same applies to competition for the cell receptors that insulin binds to, so some hormones have a higher priority and we therefore require more insulin to address this.
As for the second question on test strips, I would say Scott M is 100% correct. That seems to be the case, although as others noted, they really should have the variability reduced with a well-refined manufacturing process to at least limit the range ... why do calibration codes on some meters/strips range from 1 to 50?
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