on-going mostly unedited stream of thoughts

why I prick my fingers 5x a day

Some time in 2018 I bought a glucose meter. I cannot remember exactly why – I was probably worried I was diabetic because I was frequently getting serious food comas after eating. By “serious” I mean the level of drowsiness was so overwhelming that I could not keep my eyes open no matter how hard I tried. I think I bought a glucose meter for a peace of mind, to assure myself that I was actually fine.

Like many people I was afraid of getting my finger pricked, but curiousity won so I braced myself. We imagine it is like a pricking our fingers with a needle but a good lancet is so fine and quick that the sensation lasts for less than a second. I remember panicking when I saw my first result – in the pre-diabetic range. Then I realised I did it after my regular 2-in-1 instant coffee (yes I love this actually), so I panicked less. But the result next morning didn’t seem ideal either.

home glucose meters vs blood-drawn tests

Glucose meters are home devices and are considered “accurate” when they are 15-20% within range, 90% of the time. Which means they are actually not accurate at all, because 20% can mean 5 mmol/l or 6 mmol/l. 5 is considered normal and 6 is considered pre-diabetic. But it is useful for monitoring trends, and there are meters which are known to be more accurate than the others. We could also get a HbA1c test at which checks for blood sugar control during the past 3 months.

Months later I plucked up the courage – this time real long needles are used – to go for a blood screening. I was also reaching a plateau with my migraines and wanted to see if there are any biomarkers that are abnormal. My HbA1c test then was 5.5. The doctor was like, “see, nothing is wrong” but the prediabetic range now starts from 5.6. I thought 5.5 meant that my blood glucose was also 5.5 mmol/L which is not ideal at all but still acceptable, but years later I found out 5.5 of a HbA1c actually means an average blood glucose level of 6.17mmol/L (111.3mg/dL) which I would consider pre-diabetic. Doctors are only concerned when our levels reach 7mmol/L, but by then it is indicating serious insulin resistance. Research shows that when we’re in prediabetic stage our beta cells are already 20-40% damaged. If this is caught early enough the damage can be reversed.

insulin resistance -> hormone imbalances -> migraines

concept map demonstrating how too many carbs can result in migraines

Honestly, maybe I wouldn’t care that much if being pre-diabetic means I could continue to eat whatever I want and get it managed by medicine. But insulin resistance causes hormonal imbalance (and polycystic ovary syndrome), which contributes to the severity of my migraines. Before I was on a regular low-carb diet I was frequently having serious PMS: painful migraines and breasts, wild mood swings, suicidal feelings. PMS aside I was frequently tired and it would be normal for me to wake up fatigued with serious brain fog. Medicine can only manage blood glucose levels, not improve insulin sensitivity.

I also do not want to surrender to the diseases we assume are all part of getting old. Currently my blood pressure is 100-110+/60-70+ (101/65 at this very moment) when many people around my age (41) or younger is already diagnosed with high blood pressure.

I think as a society we’re conditioned to only worry when things go through with our body, but chronic damage is invisible and takes a long time before symptoms appear. There is also a difference between optimal health and the minimal health that is required for survival.

I’ve never been healthy until the last 7 years, but now I feel like I have a taste of what it is like to be truly healthy.

pricking 5x a day

I went from pricking my finger every morning when I wake up to pricking it one hour post meals – which means I prick my finger 3x a day. In the recent months I have begun to prick my finger pre-meals as well, so that means 5x a day. Testing blood sugar post-meals can help clarify what food is creating unhealthy spikes, because they can cause endothelial damage – contributing to high blood pressure and cardiovascular disease. I now test pre-meals because they show if my blood glucose levels returned to baseline after my previous meal. If I eat a bad breakfast my blood glucose level can stay elevated for more than 3 hours – it should return to baseline by the 3rd hour – sometimes it would not return to baseline by the time I eat my dinner.

is it necessary

Some people only test their fasting blood glucose in the morning, but I’ve learnt that we can have a good fasting blood glucose but a bad hbA1c. It means that the body recovers enough during sleep to get to a good enough glucose baseline in the morning, but on the average our blood glucose can remain high in-between meals and throughout the day.

I also tend to succumb to temptations very easily, so a chocolate cake here and an ice-cream there. It is just once in a while, why would it be so bad? I ate “healthy” things like granola and apples – if you love them please do not test your blood sugar after eating them.

It was hard to ignore what my food choices were doing to my body when the data is so clear. I went through periods when I stopped testing because it was just easier being in denial and still eat my favourite foods.

Maybe many people can get away with less vigilance. But I know I can’t. Some people may think people like me have an eating disorder because I intermittently fast and can be really strict on what I eat. But trust me, I would not do this if I can eat anything I want and be pain free.

positive reinforcement

Testing my blood sugar frequently allowed me to see the patterns that come out of my food choices. I noticed eating a lower carb diet in general gave me stable energy levels (no more blood sugar crashes) and made me have a lot less cravings. I still crave, because I am addicted to food as pleasure and comfort. But the sort of cravings I get is not the type I used to get, those cravings were physiologically unbearable. I tend to think twice now when I feel tempted, because I would have to live with an ultra-high glucose reading later, and knowing the damage it could inflict just makes it difficult. Isn’t it a form of self-sabotaging if we know something is harmful to our body and yet we keep ingesting it?

considering the short people curse

Being short has its perks but it also means the ability to absorb glucose is a lot less compared to an average man. I think this is why many women deal with hormonal issues, because we are not very aware that we’re eating the same level of sugar as men. Imagine going to MacDonalds with your taller friend/partner. We both order a meal each right? But our body mass and hormonal status determines how we handle the resulting glucose from the very same meal. Think about bubble (boba) teas, starbucks drinks, restaurant meals. Short people ingest the same amounts most of the time as our taller counterparts. It is not like short people order short sizes and taller people order the ventis. Yes, biology and genetics suck sometimes. But my partner tells me I’ll survive longer if there is a famine. ;/ I have been re-evaluating the portions I consume ever since I had this epiphany about my height. It is very easy to over-consume sugar if I was not mindful that I am consuming portions that is meant for an average-sized human being.

balance & experimentation

I get less migraines now, and they are less severe. I have better mental clarity and have a lot less body aches and fatigue. My PMS symptoms are mostly gone, I don’t even get bad cramps anymore – just slight crampy discomfort instead of the disabling ones. I’ve been doing this for a few years now, with periods in between when I just take a “holiday”. Pre-covid I would also take a break whenever we travel. But I notice myself wanting less breaks now, because every I take a break it was fun and all during the break, but the suffering afterwards can be extremely painful and prolonged. I keep asking myself if that short-term gratification is worth the longer-term consequences.

I am still trying to find a sustainable balance, and experimenting with the amount of carbs I can eat without terrible spikes to my blood sugar. I hope to not avoid entire foods but rather eat reasonable portions. Sometimes I take a couple of bites when my partner eats a pastry.

I’m going to experiment with a continuous glucose monitor (cgm) so I can stop pricking my fingers 5x a day. I’ll probably be more adventurous with my food experiments since I can get a blood glucose reading anytime I want. I think pre and post-meal testing has actually expanded my food choices. Previously I would just avoid everything that resemble carbs. Now I am discovering my tolerance.

I am not sure if people find posts like this interesting. But it would have helped me a lot if I read something like this early on in my health journey, instead of searching blind in the dark. Maybe someone struggling with PMS and migraines would find experimenting with the blood sugar readings helpful. Since managing my health is such a large part of my life, I foresee myself writing a lot more similar posts with experiment findings, and probably finally working on a wikipedia-style notebook that pulls together everything so it can be used as a public resource for anyone stumbling onto this site.

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