Diseases and Remedies

I have Type 2 diabetes and am treated with insulin. I am not very keen on testing my blood and sometimes feel guilty about this. How often do I really need to test?

When you first went on insulin you probably had support from family and workmates and close contact with a practice nurse. It can be depressing when the initial interest fades and you have to come to terms with the fact that the routine of diabetes will never go away. This is a time when people may stop doing regular blood tests. We have interviewed a number of people who have given up testing and these are the most common reasons they give.

• Testing is messy and bloody.
• I haven’t got time/can’t be bothered to test my blood.
• There is no need to test if you feel all right.
• Testing my blood brings it home to me that I have diabetes.
• It is inconvenient/embarrassing to test in public or at work.
• Insulin injections are essential, blood tests are not.
• A bad test makes me feel even more depressed about my diabetes.

These are the opinions of people living with diabetes and they must be respected. However, we believe that, if you need insulin, you will only achieve good control by doing blood tests since there is no other way of knowing exactly where you are with your diabetes. There is no hard and fast rule about how often you should test and you should be guided by what information you hope to gain from doing a blood test. You should obviously test if it is important to know your glucose level, for example when checking your safety to drive, confirming a hypo or if you feel unwell, or in preparation for exercise. On other occasions, you may simply want to check that your blood sugar level is within the target range.

In the past 12 months I have had to increase my insulin dosage several times, but have been unable to get a blood test result that was near normal. I have had diabetes for 25 years and until last year I have always been well controlled. What has gone wrong?

Here are a few reasons why your blood glucose levels may have crept up and why you need more insulin after many years of good control:

• less exercise, meaning that more insulin is needed for your food intake;
• an increase in the amount of food you eat;
• increased stress or emotional upsets;
• any illness that lingers on, leading to a need for more insulin;
• technical problems with injections such as the appearance of lumps from repeated doses of insulin into the same site;
• increase in weight and middle-age spread;
• treatment with certain drugs, especially steroids.

Apart from these identified reasons, some people do find that the dose of insulin that they need may vary by quite large amounts with no obvious explanation.

Can stress influence blood glucose readings?

Yes, but the response varies from one person to another. In some people stress tends to make the blood glucose rise whereas in other people it may increase the risk of hypoglycaemia.