Diabetes mellitus affects millions of people across India, and the rising numbers only indicate that the awareness of this condition is still lacking. While it is believed that there are currently over 62 million diabetics in our country, it may well be that the real number is a lot higher.
All doctors do is advise the patients and prescribe the medication; patients must understand the importance of this advice and follow it word to word.
It is rather difficult for an individual to know how well their sugar is controlled unless they get a blood test from time to time. Blood tests will not only determine how high the blood sugar levels are, but can also indicate how well sugar levels have been controlled over a 3 month period.
This is where monitoring blood sugar at home can help tremendously.
What Is Home Glucose Monitoring?
Home glucose monitoring, also called self-monitoring of blood glucose levels (or SMBG) is a method of monitoring blood glucose values at home using a simple hand-held device called a glucometer.
Recently, self monitoring of blood glucose has been shown to help achieve better control of diabetes in patients.
In this article, we have used ‘sugar’ and ‘glucose’ synonymously.
So what are the advantages of checking your blood sugar levels at home? Let’s take a look.
Benefits Of Checking Blood Sugar Levels At Home
There are 4 primary advantages of checking your blood glucose levels at home with a glucometer.
- It helps the doctor and the patient detect high or low blood glucose levels, thus helping them adjust their medication as required.
- It protects patients by identifying high or low glucose levels, prompting them to take action straight away.
- It facilitates education of patients regarding diabetes and how to manage it effectively.
- It motivates patients into making healthier choices
If you are diabetic, then you may know that individuals with type 1 diabetes require insulin as their main treatment, while those with type 2 diabetes need tablets. However, there are a proportion of patients with type 2 diabetes who sometimes require insulin.
In individuals with either type 1 diabetes or insulin treated type 2 diabetes, self monitoring of blood sugar at home on a regular basis has been shown to achieve better control of A1c levels. The A1c level is indicative of how well blood glucose levels are controlled over a 3 month period. An A1c level of less that 7% is indicative of good blood glucose control (some studies recommend keeping A1c levels between 7 and 8%).
Type 1 diabetes
In a study performed by Davidson and colleagues in patients with type 1 diabetes, the authors found that those patients who checked their glucose levels on a regular basis had lower A1c levels. However, this advantage wore off if the levels were checked more than 6 to 7 times a day.
A similar result was shown by Strowig and colleagues, who found a 0.25% decrease in A1c levels for each self monitoring test that was performed every day. Once again, the advantage wore off after 8 tests a day.
At HeartSense, we feel that checking your blood glucose levels once or twice a day is sufficient, unless advised by your doctor to check it more often.
Type 2 diabetes
Self monitoring has also been shown to be of benefit in managing patients with type 2 diabetes on tablets. It is a great way of taking note of your sugar levels and showing them to your doctor so that treatments can be changed if needed.
SMBG has been met with some skepticism in the management of type 2 diabetes, which is the most common type of diabetes that affects the Indian population. This is because patients are unaware of what changes to make to their tablets if their sugar levels are too high or too low.
However, the general advise is that patients never attempt to change their tablets without consulting their doctor. Self monitoring will prompt the patient to call their doctor, so that appropriate changes can be made.
A well designed study by Martin and colleagues found that those who kept a close eye on their blood glucose levels using self monitoring devices at home not only managed their diabetes better; they even followed a healthier lifestyle. Most important of all, glucose monitoring at home is associated with fewer diabetes related complications and a lower risk of other health problems.
In other words, research has shown that if you regularly check your blood glucose level at home, then you will likely have better control of your diabetes and your overall health.
How Often Should I Check My Glucose Levels At Home?
There is no clear consensus on how often blood glucose levels should be checked at home. In 2004, a global consensus came up with the following guidelines as to how often you must check your glucose levels at home that was published in the American Journal of Medicine.
The table below details how often blood glucose levels must be measured at home.
In a study published in ‘Clinical Diabetes’ journal by Gerrald et al, constantly testing blood glucose levels at home had no real advantage over checking it once in a while.
However, if you are on insulin, frequent checks may be needed. Some experts have stated that those patients who take insulin must check their sugars at least 4 times a day – before breakfast, before lunch, before dinner and before retiring to bed.
Pregnant women with type 1 diabetes may need to check their levels at least 7 times a day.
If you decide to check your glucose levels at home, the guidelines in the above table should be sufficient. However, if your doctor requests that you check them more often, then please do so.
How Accurate Are Home Glucose Monitoring Kits?
There is a common fear among patients regarding the accuracy of home monitoring device reading of blood glucose as compared to ones that are conduced in a laboratory setting.
In a study that was conducted by Alto and colleagues looking at home glucose monitoring in 111 patients, 53% of patients had blood glucose values within 10% of the control, 84% within 20% of the control and 16% had values of around 20% or more. This indicated that the values obtained are clinically useful to both the patient and the doctor.
Other studies have shown similar results. In a study by Bergenstal and colleagues, only 19% of patients had inaccurate results of more than 15%. Reasons for this inaccuracy included improper hand washing before checking sugar levels, using unclean meters and lack of appropriate calibration.
In a nutshell, home glucose monitoring devices (glucometers) are accurate and their use is encouraged. There may be small differences between devices, but these are often negligible. If you have any doubts regarding the accuracy of your glucometer, speak to your doctor.
Save Money By Checking Blood Glucose Levels At Home
Buying a glucose monitoring device is a cheap and efficient way of keeping tracks of your blood sugar levels in the comfort of your own home.
State of the art devices that not only detect blood glucose levels, but also warn you when the levels are too low or too high have made it easier for the patient to realise when they should seek medical attention.
By monitoring sugar levels are home, you could be saving money in the long term. How you ask?
Firstly, constantly getting your blood sugars checked in a certified pathology lab can be an expensive affair. On the other hand, the only cost your will bear once you have purchased a monitor is on the strips and lancets, which are a lot cheaper.
Secondly, the long term complication rate is lesser in patients who have well controlled blood glucose levels. It is well known among the general public that being admitted to hospital can be very hard on the pocket, especially for those who do not have health insurance. If your sugar levels are under control, then the chances of complications developing are low, and the need for admission to hospital is also low.
In the long term, this will save money.
In other words, you can save a large amount of money in the long run by investing a small amount of money on a handheld device today.
Choosing The Right Glucometer
So how do you choose the right glucometer?
There are a large number of glucometers that are currently available on the market. Some just do basic blood glucose monitoring, while some provide detailed reports on trends etc. US FDA approved devices such as the SugarChek glucometer are extremely useful in ensuring your diabetes is well controlled.
Here are some simple tips that will help you choose the right glucometer.
Tip #1 – Expensive is not necessarily better
An expensive glucometer is not always the best one. Newer glucometers are now quite cheap and affordable. Find one that is in your budget or use any one that is recommended below.
Tip #2 – Must be easy to use
A glucometer that is difficult to use defeats the purpose of measuring glucose levels in the comfort in your own home. Find one that is easy to use, and one that requires a small drop of blood that can be obtained painlessly. Most glucometers are easy to use.
Tip #3 – Accurate results every time
The glucometers listed below are well known for their accuracy.
Tip #4 – Ability to monitor progress
Most glucometers now have a test memory that helps to recall previous blood glucose levels. Some even have accompanying software that can help generate graphs based on blood glucose levels. Monitoring your progress is an important part of diabetes management. Choose a glucometer that has a decent memory.
Monitoring blood sugar at home is now easy. A small investment in a home monitoring device can go a long way in maintaining normal blood sugar levels when on treatment. Scientific evidence has proven its use at home.
Never try to self-treat diabetes. Always make sure to speak to your doctor if you have any questions.
The role of self-monitoring of blood glucose in the care of people with diabetes: report of a global consensus conference. Bergenstal RM, Gavin JR 3rd, Global Consensus Conference on Glucose Monitoring Panel Am J Med. 2005 Sep; 118(Suppl 9A):1S-6S.
Self-monitoring of blood glucose in type 2 diabetes and long-term outcome: an epidemiological cohort study. Martin S, Schneider B, Heinemann L, Lodwig V, Kurth HJ, Kolb H, Scherbaum WA Diabetologia. 2006 Feb; 49(2):271-8.
Assuring the accuracy of home glucose monitoring.Alto WA, Meyer D, Schneid J, Bryson P, Kindig J J Am Board Fam Pract. 2002 Jan-Feb; 15(1):1-6.
Identifying variables associated with inaccurate self-monitoring of blood glucose: proposed guidelines to improve accuracy. Bergenstal R, Pearson J, Cembrowski GS, Bina D, Davidson J, List S Diabetes Educ. 2000 Nov-Dec; 26(6):981-9.