Blood Glucose Monitoring
Best Practices For Diabetics

Blood Glucose Monitoring

Contents

• What Is Blood Glucose Monitoring?
• How Is It Done?
• How Often Should It Be Done?
• What Do The Results Show?
• Safety Instructions
• What Is Continuous Glucose Monitoring?

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What Is Blood Glucose Monitoring?

Blood glucose monitoring is the ongoing measuring of a diabetic’s blood sugar (glucose) level. It is an essential part of diabetes treatment, and daily self-monitoring is carried out using a portable device called a glucose monitor. Glucose monitors are also called glucose meters and glucometers. If you have diabetes, careful monitoring of your glucose levels at home is one of the most important things you can do to manage your disease and to reduce the risk of long-term diabetes complications. Keeping track of your levels will tell you:
1. How your body is reacting to meals and physical activity. As a pattern emerges, you will be able to better plan when to take your insulin or diabetes pills, and in what dosage.
2. How specific foods affect your glucose levels, some will cause more spikes than others.
3. How exercise improves your levels.
If you have not yet received a diabetes diagnosis, but you are showing symptoms of diabetes, your doctor will order a blood sugar test to screen for the disease. It is also worth mentioning at this point, that glucose monitoring is only one type of test that diabetics need to do regularly. To read more about other the health checks, see diabetes testing.

How Is It Done?

A glucose meter kit comes with several items (image):
1. The meter itself.
2. Disposable test strips which you place a drop of blood on.
3. Small disposable needles called lancets which are needed for piercing the skin. They are inserted into a lancing device.
4. Control solution, this is used to test your monitor for accuracy from time to time. A drop is placed on a test trip instead of a drop and blood. The result should come back with a specific reading if it is working correctly.
5. A log book to record your readings.
All kits can be purchased through a pharmacy without prescription; and your diabetes healthcare team will help you choose the right one for you. There are several factors which you need to consider when buying a monitor, to find out more, read our guide to buying glucose monitors. To see how to carry out a test, check our step by step guide in pictures.

How Often Should It Be Done?

Insulin dependent diabetics need to test before and after every meal and at bedtime. Patients with type 1 diabetes will also need to occasionally test one hour after eating and in the middle of the night. If you manage your condition with pills or just diet and exercise (type 2 diabetes) you may only need to test your glucose levels twice a day - before breakfast and before dinner. Remember, no matter how well you think you are controlling your blood sugar, studies show that people estimate incorrectly 50 percent of the time. So never try to 'guess-estimate', always do your testing. You may find our article on diabetes facts interesting, it highlights the benefits of glucose monitoring in preventing longterm complications. Also, take a look at diabetes resources for research and clinical trials.

What Do The Results Show?

Normal Results
A normal result, which indicates that your blood sugar levels are in a healthy range are:
Before meals: 70 to 100 mg/dL
After meals: Less than 140 mg/dL
These ranges can vary depending on how much physical activity you take and the type of meal you ate. Your doctor will discuss the individual meaning of your results with you. This is why it is so important to log your readings on a daily basis. Most glucose meters also have a memory database which allows you to store your readings for a certain period of time. You can download these results to make a chart on your PC, or your doctor’s office may provide this service. For more general advice, see: what is a normal blood sugar count?
Abnormal Results
If your levels are low this indicates hypoglycemia, or low blood sugar, so you need to eat something. You may also need to change your next insulin dose and possibly future ones as well. If levels are too high, this means you have hyperglycemia (too much blood sugar), and you will need a further shot of insulin.

Safety Instructions

Never share your lancing device, glucose meter or insulin pen with another person because of the risk of infection. According to the Centers for Disease Control and Prevention (CDC) there have been several outbreaks of hepatitis B in facilities such as nursing homes where residents require assistance with their glucometers and/or insulin administration. In the past decade there have been at least 15 such outbreaks due to sharing of devices. For safety:
1. Never share a lancing device - even if the device is marketed for multi-patient use. Failures to change the components and difficulties with cleaning it in disinfections have been linked to virus outbreaks.
2. Never share a blood glucose meter. If you really must, it should be cleaned and disinfected between uses.
3. Never share insulin pens.

What Is Continuous Glucose Monitoring?

Continuous glucose monitoring (CGM) (image) involves the use of tiny sensors which are placed under the skin of the arm or chest and continuously monitor a patient's blood sugar. The sensor remains in place for up to a week and then needs to be replaced. It emits readings via radio waves which are picked up by a wireless handheld monitor. CGMs are more expensive than conventional monitors but they do provide instant continuous feedback. The patient can set an alarm in the device to go off when their glucose levels fall too low or rises too high. CGM's are FDA approved but are only available on prescription. Most health insurance companies don't cover the cost. An average CGM starter kit costs about $1,000 and the sensors which need changing every 3-7 days are about $35 each.

Related Articles on Blood Glucose Monitoring

For more diabetes, see the following:

• Causes of diabetes: Infections to milk.
• Hemoglobin A1C Test: Testing for diabetes.
• Diabetes in pregnancy: Signs and treatment.

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