Diabetes Forecast

How One Woman Uses Her Meter to Manage Her Type 2

Karen Murphy uses her meter to help improve her blood glucose management

By Matt McMillen , , ,

Terry Doran/Mittera

Name: Karen Murphy
Age: 47
Hometown: Sudbury, Massachusetts
Occupation: Registered nurse
Diabetes: Type 2 since 2015

When Karen Murphy was diagnosed with type 2 diabetes, she bought a blood glucose meter. Her endocrinologist at the Joslin Diabetes Center in Boston picked it out for her based on the selection of meters her health insurance plan covered. She has been using it every day since then, doing her best to follow her doctor’s recommended routine.

Blood glucose meters come in many sizes and shapes. Murphy’s device is quite small, about the size of a stopwatch, and it has a backlit screen that makes it easy for her to read. To measure her blood glucose level, she pricks her finger with a lancing device, drawing a tiny drop of blood. Murphy touches a test strip to the blood and inserts the strip into her meter, which automatically switches on. A few seconds later, she has her results.

Managing With a Meter

Murphy’s type 2 treatment includes weekly injections of dulaglutide (Trulicity), plus rapid-acting insulin when her blood glucose is high. On workday mornings, she wakes up at around 5 a.m. and checks her levels. If necessary, she calculates and injects a dose of insulin, based on guidelines from her endocrinologist. “How much I take depends on the meter reading, so I’m pretty dependent on it,” she says.

She uses premeal meter readings to determine when she needs to eat fewer carbohydrate-containing foods. If her reading is high before lunch, for example, she’ll take her insulin and cut her carbs or choose carbs with more fiber. “I’ll skip bread products and eat brown rice, but not too much,” she says. “Usually it’s fine.”

Meter readings also allow Murphy to evaluate her previous meal’s effect on her blood glucose. “If I’m high when I test right before lunch, that probably means my breakfast was too high in carbohydrates,” Murphy explains.

Occasionally, she supplements premeal checks with meter readings taken a couple of hours after she eats. This provides information about how a specific meal affects her blood glucose. “That helps me determine if I need to adjust my diet,” she says.

Murphy’s device allows her to add notes to each of her readings, a feature that she relies on to keep track of any unusual circumstances that may have affected her blood glucose level. “I can add comments, like whether I was sick or feeling hypoglycemic or hyperglycemic, and I can put in whether I was on vacation at the time,” she explains. “A month later, I won’t remember those things, so the flags and the comments will remind me.”

Making Connections

Murphy’s meter lacks Bluetooth, and that’s a feature that she wants when it’s time to upgrade her device. Meters with Bluetooth can be set up to transfer data wirelessly to a smartphone or to the cloud, so users can easily access and review their readings via apps on their phones or computers. Some meters can connect to cellular networks, which is useful when you don’t have access to Wi-Fi. Other meters use a cable plugged into a computer to transfer readings to data-management software. “I have my results on the actual meter, which is fine most of the time, but if I wanted to access my results really quickly, it would be helpful to have it on my phone,” Murphy says.

If she had a meter with Bluetooth, she could easily pass her results along to her health care team as needed. With her current device, Murphy shares her data only during checkups, when her doctor connects her meter to a computer via a cable. (Another option for some people who use meters without wireless capabilities is to send glucose logs at regular intervals between visits so providers can review blood glucose data more often.)

“My endocrinologist at Joslin, who I see every three to six months, downloads all my data since my last visit, so they can look for patterns or areas of concern,” says Murphy. 

On the Go

If she had it her way, her meter would send alerts to her phone, reminding her to check her blood glucose. “I forget sometimes, especially at work,” says Murphy, a nurse in the operating room at one of Boston Children’s Hospital’s satellite facilities, in Lexington, Massachusetts. “I get only 20 minutes for lunch. I sometimes run and eat, and testing slips my mind.”

Work is not her only challenge. She’s usually off by 3:30 p.m. during the week, after which driving duty begins. She shuttles her 14-year-old, Connor, to diving practice and volleyball and her 10-year-old, Kate, to acting classes and rehearsals. “Testing at dinnertime can be sporadic,” says Murphy.

She reaches for her meter the minute she starts to feel symptoms of out-of-range blood glucose. “If I feel shaky, I know I’m low,” she says. “When high, I feel thirsty and really fatigued, which makes it hard to concentrate.”

She has no complications of diabetes that require special adaptive features. People with vision problems, however, may benefit from talking devices or from those with higher-contrast or large-type screens. For those with arthritis, larger meters may be easier to handle. A diabetes educator or pharmacist can help narrow down the choices.

While she would like more advanced features to help her stick with her treatment plan, Murphy remains satisfied with her device after two and a half years with it. “It’s not that exciting,” she says, “but it works, and I haven’t had to change the battery yet.”

Managing Costs

If your insurance company doesn’t cover the meter that you would like and you can’t afford to pay for it out of pocket, talk to your health care provider. If the device will help you manage your diabetes better than other meters covered by your health insurance policy, your doctor can submit a “letter of medical necessity” that explains how you will benefit from this particular device.

Keep in mind: Many blood glucose meters don’t cost very much—you may even get one for free from your doctor—but the cost of test strips can add up fast if you have to pay out of pocket. Monthly costs depend on how many times you check your blood glucose. If you check often, consider a meter manufacturer that offers unlimited test strips for a flat fee. Or pick a meter that uses inexpensive strips. If your insurance covers the cost of test strips, you may be able to reduce your co-pay by purchasing them from a mail-order pharmacy approved by your insurance company.

  Download a full chart of blood glucose meters and their features.



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