Ten strips a day

Ten strips a day. Those are my directions: “Test 10 times a day as directed”.

I shouldn’t complain.  Ten strips a day isn’t really bad.  Some people have insurance plans that cover a lot less.  Some don’t even have insurance (that should all change in the United States in a couple of years!).  And as we all know, strips are too expensive!

But everyone who has a prescription has a prescribed “per-day” amount.  And, in most cases, that is a perfect amount for a perfect day.  Maybe the doctor says to test before meals, before bed, and before exercise.  Five a day.  Or maybe the prescribed order also states to test before driving, two hours after meals, upon waking up, and once overnight.

Dr. P., a person with Type-2 and winner of last month’s Best of the ‘Betes Advocacy award, was told to only use one strip a day.  She tried arguing for three.

Whatever the test strip allotment may be, it is almost always based on the expectation that everything goes perfectly right.  But when does anything with diabetes goes perfectly right?  If you said “never”, you win.

• When I went swimming in my parents’ pool over the weekend, I disconnected my non-waterproof pump (I hear you Shannon!).  With the increased exercise and temporary zero-basal rates, I couldn’t really tell what was happening, so I ended up using more strips than usual.

Intentionally getting an Error 5 for the purpose of a blog post? Well, that’s my own damn fault.

• In fact, any time I test and my blood sugar is low, the so-called “experts” tell met to treat it, wait, and test again. Another strip burned.
• Conversely, if I test and my blood sugar is high, it might lead lead to a ketone test which also shows up positive.  The remedy: take wild-ass-guess amount of insulin by syringe, then test again.  Often.  Because there’s no telling when the insulin delivery stopped, or when (or how strong) it will start up again.  More strips burned.
• Occasionally, the mistake is more innocent.  There’s some sort of juicy sweet residue on my fingers and the result is not realistic.  Wash hands, and test again.  Another strip burned.
• If the result is just plain not believable, even within the 20% tolerance, test again.  If the number is significantly different, then test a third time, to figure out which of the first two were right.  Two more strips burned.
• Error 05?  That’ll cost you.
• What if the CGM is asking to be calibrated?  Or if you’re just following directions and using the meter’s control solution? (really!?)

The point is, those allotments are acceptable if you’re trying to collect data for your doctor.  But if you’re really planning on doing something based on the numbers, then the amount of strips needed per day is bound to change.  Sometimes more, sometimes less.  Don’t just read the number, react to the number.

Fortunately for me, I’ve been somehow able to refill my three-month supply a bit before the three months is up.  Otherwise I’d be on the phone with my doctor begging him to write a new prescription for more strips.

But directing a patient to test a specific number of times a day?  That’s ludicrous.  I’d much rather see the prescription read “as needed”.  It’s gotta change.  And I guess this message is what advocacy is all about.