type 1 diabetes. Children, teens, and younger adults may benefit, too.
Currently, the FDA requires users to confirm CGM readings with readings from a traditional blood glucose meter before making treatment decisions because CGM devices are so new.
Logbooks
One of the most important tools in your diabetes toolbox is also the most overlooked. A logbook may not look like much, but it will help you and your health care providers understand your blood glucose levels. It will alert you to any red flags that could signal a serious problem and help you determine whether your treatments are working—and how to fine-tune them.
Your health care provider can provide you with a logbook or your meter may come with one. Call the toll-free number for your meter manufacturer to request more. Some manufacturers have logbooks that you can download to your computer and print.
If you like the idea of keeping a paper logbook, you can photocopy blank pages and compile them in a loose-leaf notebook or create your own custom logbook. You may want a lot of room to write in your logbook. Consider buying a spiral-bound notebook or using a loose-leaf notebook, where you can add pages as needed, to jot down extra notes. You may find it useful to have extra space to record different symptoms and situations that could be relevant to your health. Your logbook is an important tool that can help you spot patterns in your blood glucose control, so be sure that it is easy to use.
Some meters come with an electronic logbook that records your readings and allows you to enter comments about your meals or other situations. Some people may prefer the convenience of using an electronic logbook rather than paper. However, you should always keep some type of logbook rather then just storing readings in your meter’s memory.
Ask your health care provider which readings you should write down in your logbook. You should also bring your logbook with you during doctor’s appointments so that you can look over your readings together.
Ketone Tests
People with type 1 diabetes, and occasionally people with type 2 diabetes, can experience a dangerous condition called ketoacidosis. Ketoacidosis is a buildup of ketones in your urine. It can lead to a diabetic coma and death if left untreated. It can happen at any time, but may be more likely during illness, stress, or pregnancy. You can read more about ketoacidosis in chapter 8 about blood glucose emergencies.
Luckily, you can test the ketones in your urine with a urine test strip to make sure you don’t develop ketoacidosis. It’s important to detect ketones before they grow to large levels. Checking for urine ketones is especially important for people with type 1 diabetes who do not make any insulin. People with type 2 diabetes usually produce some insulin, so they are less likely to develop ketoacidosis. However, everyone with diabetes needs to know how and when to check for ketones. Read more about when and how to check for ketones in chapter 8.
Urine Ketone Test Strips
You put a test strip in your stream of urine or in a cup to test for ketones. Urine strips vary in how quickly they show a result, so read and follow the directions so you know how long to wait. A change in color will indicate the presence of ketones. Some strips will indicate ketone levels as 0, trace, moderate, or large, whereas others will give a specific reading. Some urine strips also measure glucose and have two test pads on each strip.
Where to Buy Supplies
People with diabetes now have more choices than ever about where to buy their diabetes supplies and devices. You can shop online, in a local or chain pharmacy, and through the mail. It’s up to you to decide which is the most convenient and cost-effective place to shop. Be wary of online marketplaces where people sell and auction personal items. It is not possible to know if testing supplies have been stored properly or have been altered in any way. Only buy from a reputable source.
Packaging
Individually foil-wrapped ketone strips are the most expensive up front, but they last longer. They may save you money because you are unlikely to need to test ketones very often. Ketone strips that come in a vial all spoil at the same time, probably 6 months after you open them.
Pharmacies
Some pharmacies offer a smaller selection of equipment, so check the aisles to see how your pharmacy stacks up. If you have a good relationship with your pharmacist, you may be able to ask him or her to order what you want. Although small pharmacies can be more expensive, establishing a good working relationship with your pharmacist can save you a lot of running around. Pharmacists can often give you information about the ins and outs of different products and models. Local pharmacists will know the products they sell and will be able to spend time training you to use the purchase. This is often a real, convenient advantage.
Most grocery store and chain pharmacies carry diabetes supplies, which might be convenient if you are shopping for other items.
Diabetes Supply Stores
Another shopping option is to visit a diabetes specialty store. To find one near you, call your local American Diabetes Association office or check in the phonebook under “Diabetes” or “Medical Supplies.” If you are lucky enough to have one nearby, you may be able to get many nonprescription items along with diabetes information and support in one easy stop. You may also find a selection of healthy foods, books, and information on local diabetes events and organizations. Many diabetes shops have knowledgeable staff who can help you compare models, answer questions, and provide training on new tools.
Mail Order
Purchasing your diabetes supplies, such as test strips, through a mail-order supplier can save you money. However, you’ll also have to calculate the extra time it will cost to ship supplies and perhaps the extra time to deal with insurance coverage.
Buying Supplies Online
When purchasing supplies online, make sure to look for an Internet site that is secure and reputable. The FDA recommends purchasing from websites that are located in the United States and provide clear ways to contact the company with questions or concerns.
Making Mail Order Work for You
• Pay extra attention to timing. Some orders will ship automatically, whereas others will take up to 2 weeks. Order your supplies far enough in advance that your current supply won’t run out before the new ones arrive.
• The mail-order company should confirm your insurance coverage before filling out your first order. If you use Medicare to help pay for supplies, note that the prices shown in advertisements or quoted over the phone may differ from the amount that Medicare will reimburse for that item.
• If you live in a warm climate or order during the summer, ask how perishable items will be shipped. Strips can spoil in excessive heat, so overnight shipping is best for these items.
• Compare prices by shopping around. Most mail-order firms have toll-free numbers and websites.
• Always keep copies of any orders you send through the mail. If you call in an order, be sure to write down when you placed the order and what you ordered.
• Check the expiration date on each item that arrives. If you’ll need the item in 6 months, make sure it
