Articles, Blog

Monitoring blood glucose with mySugr

October 24, 2019

– Welcome, mySugr was
founded for one reason: to simplify life for people with diabetes. Our app and care services work together to provide a powerful
health management solution. We are a digital health company for people with diabetes made by
people with diabetes. Welcome to mySugr. And today we are going to be talking about monitoring blood glucose, right, so we’ll cover some brief introductions. Is monitoring important? When should I check? What am I aiming for? And then we’ll do some walk-throughs of connecting one of the Accu-Chek meters to the app and then also a manual entry if you don’t have a connected meter. So with that, let’s
move into introductions. I’m joined by Molly Wagman. – Hi, I’m Molly. I live with type one diabetes, and I am a Certified Diabetes Educator. I’m the clinical lead here for mySugr. – And my name is Scott Johnson. I’m the patient success manager here, and I also live with diabetes. So diving right into it, does monitoring blood sugar help? What’s so important about it? – Yes, yes, it’s absolutely important, because if you’re not monitoring, then you don’t know what’s happening. – Yeah. – So if you’re not
checking your blood glucose at a regular basis, and we can talk also about the good times to be checking to get the most information from it. But if you’re not checking
on a regular basis, then there’s no way to know how well your medication is
working, or the activities that you’re doing are working. – Yeah, yeah, so there’s
a lot that happens in day to day life living with diabetes and monitoring blood sugar. Checking blood sugars
is one of the best ways to know whether what
you’re doing is helping or hurting, or is it working? Allows you to have some good conversations with you care team. All that kind of stuff. So, yes, it definitely does help. So you mentioned some strategic times around checking blood sugar. Let’s dive into that a little bit. – Yeah, so the best time to check is when you want to evaluate a certain situation. So a classic situation is meal times. So it’s best to check
right before the meal. So you have your starting point, and then about one to
two hours after the meal to see how that food affected you or if your medication is
appropriate for that meal. I do want to stress, though, that is is just information, right. It’s not a grade on how well
you’re doing. (laughing) But it’s helpful information to help you make decisions and
tell the whole story of your diabetes. – Yeah, that’s great. I’m so glad that you mentioned that, because it’s so easy to,
you do your pre-meal check, and then you check again after. And if it’s not what you were expecting, it’s easy to start beating
yourself up about that. So a great reminder that
it’s just information to help you know what to do next and what you might want
to do different around that meal or situation. So meals are one thing that we can kind of troubleshoot with that, but are there some other situations? – Absolutely, exercise. I know you’ve been training
for a very long bike ride coming up, so do you
want to talk about times that you’ve been checking during exercise? – Sure, yeah. So I definitely, I check before exercise, even hours before
exercise, so I can kind of, with another check or two between then and when I’m starting, I can
see where I’m trending, right? And then that also gives me
some super powerful information to use as I’m kind of reviewing my management strategy during exercise. So it’s collecting the
data and helping me know what do I need to adjust in
my food, exercise, medication. Kind of what’s the perfect recipe? – Yeah, exactly. So it’s absolutely necessary
if you’re taking insulin to be checking, like you said before, even sometimes hours before
to see how you’re trending. But even if you’re not taking insulin, seeing how the exercise affects your blood sugar is really powerful. – Yeah, absolutely. I’ve also noticed through
doing some paired testing that different types of
meals affect me different. Different situations,
stress, or lack of sleep, like it’s a really, really powerful tool to help you put together
some great information to help you make better decisions and make adjustments
with what you’re doing. – Yeah, totally. – Yeah, so let’s talk
about what am I aiming for? There’s all these numbers coming at me. – Yeah, well I can tell you that the American Diabetes Association, the ADA, recommends for
most people with diabetes for their fasting or
pre-meal blood glucose values to be between 80 and 130. And then one to two hours after the meal and before bed, less than 180. – Okay.
– So that’s for most people with diabetes, but
everyone is an individual, so it’s best to work with your care team, your doctor, or your diabetes educator to find out what is your
target blood glucose value. – Yeah, ’cause there could be situations where your doctor or care team might have you shooting for a different target. – Yeah, exactly.
– And that’s good to know. All right, wonderful. So let’s talk about my meter has a memory. Why go through the extra steps of logging into a tool like mySugr? – Well, yes, the meter has a memory, but there’s really only way to look at it, and that’s at the numbers
and scrolling back in the history. When you’re able to log
it into a true logbook and reporting system like mySugr, then you can see it in graph form, and you can see it in a way
where the days are aligned with each other. You’re looking at it as a whole, not as single, individual
blood glucose values. So you can see the whole picture. – Yeah, and it also allows
you to tell more of the story. – Exactly, the story.
– Right, so each piece of your diabetes data has a story to it. And when you’ve got just the number, you’re not really sure what that story is, so using a tool like mySugr can help add some more context – Exactly.
– to all that diabetes data. Well, with that in mind,
let’s actually dive into what it looks like to log with mySugr. So I’m going to jump
into connecting a meter, and then we’ll backtrack a
bit and do a manual entry. So what I’ve got here is
an Accu-Chek Guide Me, and we’re going to take our phone and go right into the mySugr app. Hit the connections menu. You’ll see all of the available devices that you can connect with. Tap Guide Me. Tap Connect Now. It’s going to give you some
instructions on the screen. So I’m basically just
following the instructions, turning the meter on, selecting the meter, and then there’s a little PIN code on the back of it. Get that typed in here. All right, and now we are
successfully connected. And I can see that connection there. So I’m going to go back out, and one of the cool things
I want to show you is, going back into the connection screen, you can actually see when the
last time it synchronized. See that? 11 seconds ago. So that’s perfect. And connecting a meter like that, it’s just that easy. So now, when I check my
blood sugar using the meter, I take the meter, do my check,
put it back in my pocket, and it automatically will
send that information over to mySugr, which is
really, really helpful. So I encourage you to use the connected device whenever possible. So next let’s take a look
at what it looks like to manually enter a blood sugar. So I’ll just do a little
bit of rearranging here. All right, there we go. So we’ve got the main home screen here, and let’s say I don’t
have a connected meter, but I want to add some data to my logbook. There’s a plus sign there which brings up the new entry screen,
and here we’ve got a lot of the basics. So you can kind of see it’s
highlighting the blood glucose. I’m going to type in a value there, and we’ve got some insulin fields. So maybe I’m going to have a little snack, and I’m going to take
a little bit of insulin along with a correction. So when we were talking about the context and telling the story, that’s where these tags come into play. So adding some additional information lets me tell more of the story
around this 154 blood sugar and food I’m taking. So I’m going to tap on Snack, and there it goes in. I also added a correction. And those are just a couple of things that you can add to the reporting and to your records. And you can see that
there’s a ton of stuff here. And these are super
helpful when you’re looking at a report, that you can
look at what tags were used and see a little bit more
about what’s going on, right? – Exactly, and monitoring is much more than just the numbers from
the blood glucose meter. – Yeah.
– And adding the different details, like Scott was saying, building that story around it, is absolutely necessary,
because if you’re looking in the past, and trying to
spot patterns and trends, and you don’t have any
context around the numbers, you don’t know where to
make changes if you need to. So, for example, if you
even just add the amount of carbohydrates or details
about your meals at meal time, then you know for sure that maybe that it was the meal maybe
to high in carbohydrates. – Sure. – That made the blood
sugar go a little bit above your target. But if there’s no information there, then did you even eat that time? – Right. – Were you just checking
’cause you were curious, so you don’t want to have
to rely on your memory. – Super hard, and I hate that question when I’m reviewing my reports
at the doctor’s office, or with my coach, and they say, – Were you just checking
because you were curious, ’cause I can’t, it’s come and gone, but if I’ve got it in my logbook, I can look back on it. So this first screen has a limited set of information there, but you can, because I can’t, it’s come and gone, down at the bottom, you can open that up and add a ton of extra information. So one use that I use this
for is adding a picture of my meal, right? So let’s have a picture
of a nice Diet Coke there, and let’s just pretend that
was a sandwich or something, and I’m going to enter
in a wrong carb value, right, seven grams. So now, when I’m talking
with my coach or my provider, we can look at that picture and look at my carb estimate, and have a discussion around maybe I need to improve my carb counting, or do some things
different around my meal. So being able to add that
additional information is super helpful. Another thing that’s
really nice is being able to add a description of the meal, right, so that’s one thing there. We also have the ability to enter in just some notes. I’m traveling and off my game. Whatever the case may be. You can add these notes in, and then those’ll show
up in the reporting, – Yeah.
– and you can also search for them. You know, another nice
thing to look at here in the available devices
is a blood pressure monitor and then those will show
up in the reporting, Can you talk a little
bit about why looking at some of those pieces of data is also important and helpful? – Absolutely, especially with diabetes, we know that monitoring your weight and your blood pressure
are super important and can help with your overall help. But if weight loss is a goal for you, then monitoring your weight is a good way to just keep track and see
how changes are happening over time, and also see how
your blood sugars are changing over time with that weight change. – Yeah. – And if you’ve been diagnosed
with high blood pressure or hypertension, then monitoring at home is incredibly important because oftentimes when
you’re in the doctor’s office it might be a little bit higher than it might be at home, so
getting those readings at a consistent time at home
is actually the best way to monitor your blood pressure. And when you have it connected to the app, and you have all of your diabetes data in one place, it makes it so easy to make the whole evaluation. – Yeah, that’s great. Another thing I want to cover
briefly is the estimated A1C. So here you can see in this screenshot it’s showing 6.2. You can get this estimated A1C value by giving the mySugr logbook enough checks to work with, and one great
thing about that is that through this I have an idea
of what my actual lab-drawn or finger-poke A1C will be before I sit down with my doctor. So I often can get emotional, or I don’t like the surprise, and with the estimated A1C
I don’t have that surprise. – Exactly, yeah, I feel the same way too. That’s one of my favorite features. And none of us like
surprises when we’re walking into the endocrinology or the
doctor’s office. (laughing) – Right, yeah, absolutely. To get that estimated A1C, you do have to give the mySugr app enough data to work with, so you can look
at that a couple of ways. You can look at it as three checks per day over seven days, or play
around with the frequency, or – Yeah. – tell me a little bit more about that. – Even in three days, if you’re
doing seven tests per day, it’ll show up. However, if you skip a day,
so if on that fourth day you don’t do seven finger
checks, blood sugar checks, then it will go away, but at least you’ll have that at the beginning. But in general you need
at least three per day for a minimum of seven
days for that to populate. – Yeah, and the reason behind
that is we need to give you an accurate estimation,
– Yeah. – so there’s got to be
enough data to work with. All right, with that, let’s jump into some Q&A time here. Now the way that this
works is you can send your questions in via the Q&A tool there. They are not visible
to any other attendees, so you don’t have to worry about that. You can also mark them as anonymous if you don’t want Molly
or I to see your name along with that, all right? So we’ve had a number of questions come in during the broadcast,
and the first one says, “Poking my finger really hurts. “Is there anything I can do?” – Yes, there are a few things
that you can do, hopefully. So a lot of times when
I hear that checking your finger is painful is
that the lancing device, so that’s the little poker, is set on too high of a depth of poke. So that’s the first thing to look at. So the higher the number, the deeper that the needle
will go into your finger. So if it’s hurting you, then just crank that down a little bit. And another tip to try is first think about how hard you’re
pushing into your finger. – Sure. – So if you’re really pushin’ in there, then maybe just ease up
on that a little bit. And then the third thing to try, and this is the most
common thing that I see, is actually don’t poke on
the pad of your finger, right in the middle.
– Yeah. – You want to go more towards the side, – So if you’re really pushing in there, They’re all in our fingertips. Our fingertips are very sensitive. So if you go closer towards the side, it won’t hurt as much. – Makes sense. – Yeah, do you have any more tips. – I am guilty of not changing
my lancet often enough. (laughing) – Me too. – And so that makes sense. A brand new, sharp lancet is
going to hurt a little bit less than one that’s been reused
and may be a little bit dull. – Yeah. – So, yeah, that’s a hard habit to remember.
– That’s a good tip. – Yeah, all right. Let’s look at the next question. So, “My blood sugar
goes up in the morning, “even when I don’t eat anything. “What’s going on?” – Yeah, another common thing that I hear and I see a lot, so this
actually happens in everybody, whether you have diabetes or not. Blood sugar will typically rise in the early morning hours due to these different hormones like growth hormone, cortisol, adrenaline. These help us wake up and
get us ready for the day. – Okay. – So our liver stores and
secretes glucose for us to keep our blood sugar steady. And these hormones actually tell our liver to secrete some more glucose
to fuel us for the day and to get us ready. So if you are noticing that
your blood sugars are higher in the morning, to see if
this is truly what’s called, this one’s called the dawn phenomenon, you can check your blood sugar before bed, in the middle of the night,
and then when you wake up. So if it increases drastically from that middle-of-the-night
check to first thing in the morning, it’s dawn phenomenon. And it’s totally normal. And it’s really up to you with how much that rise is if there’s something that you want to do about it. – Yeah. A good bit of information to have with you when you talk with your
coach or your care team. – Exactly. – So that’s great. All right, thank you. That’s something that I struggle
with a bit too is those, my body doesn’t want to
get up and get moving in the morning, so it’s tough. – Yeah. – All right, let’s take another one. “I’m having trouble connecting my meter. “What should I do?” So this is assuming that you’re using one of the Accu-Chek connected meters that’s in the menu there. We have a world-class support team, so they are available
through the menu on your app through help and support. They’re also available
at support at with an email. You can even book an appointment online to set some time together over phone or video to help you get through that. And I would do a total disservice if I tried to dig in too
much to that question, so I’m going to maybe cheat a little bit and send you off to our support team They’re also available
at [email protected] All right, let’s take one more. “My blood glucose goes
up a lot after I eat. “I’m checking 90 minutes after my meal. “Thoughts?” – So first I want to clarify
what a lot is to you, because that might be
20 points for someone. A lot might be 150 points for someone. So we would expect
there to be a little bit of a rise after the meal. We wouldn’t expect it to
stay completely steady. So typically around 30
to 50 points is okay to see it rise about 90
minutes after the meal. And then, especially if it comes down two, three hours after the
meal, then that’s okay. We would expect that. But, if you’re finding that it’s going up much higher than that
and you’re not comfortable with how high it’s going after you eat, make sure that you’re
monitoring your food. So you’re entering your
food into your log, so you can see what the, if
there’s higher carbohydrates. The carbohydrates are the main foods that are going to cause a
rise in that blood sugar, so you might want to play with
the amount of carbohydrates. Or if you’re taking a
medication like insulin at meal times that are going
to help lower your blood sugar from your food, then that might need some adjustment as well. You may need a little bit more. – Yes, so again it sounds
like just being able to collect that data, tell the story of those numbers, and
then use that information to make some decisions
or have a more empowered conversation with your
coach or health team. – Exactly, yeah. – Wonderful. Well that is about all
we’ve got time for today. Thank you so much for
joining, and stay tuned for the next one. Bye. – Bye.

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