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Monitoring Blood Sugars In Diabetes

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One of the most important things that patients with diabetes can do is monitor their blood sugar levels at home. As their physician, I find it extremely useful when it comes to managing their diabetes.

However, monitoring blood sugars has to be done the right way.

Please note that for the purpose of this article, I have used “glucose” and “sugar” synonymously.

Introduction

Diabetes is a long-term condition, but it can usually be managed with changes in lifestyle, medication, and self-care. The main goal of treating diabetes is to keep your blood sugar in the target range. 

One of the best ways to see how well your diabetes treatment plan is working is to check your blood sugar now and again. 

Finger-prick glucose meters (called capillary glucose meters) or a continuous glucose monitoring (CGM) device can be used to check blood glucose.

Why You Should Be Monitoring Blood Sugar Levels

There are many reasons why you should check your glucose levels at home.

  1. Check how diabetes medicines are affecting your blood sugar levels.
  2. Find out if your blood sugar is high or low.
  3. Keep track of how close you are getting to your overall treatment goals.
  4. Find out how diet and exercise affect blood sugar levels
  5. Learn how other things, like being sick or stressed, can affect blood sugar levels.

Time and again, I ask my patients to check their blood sugar levels and glycated hemoglobin (A1C). 

The A1C test measures the average blood glucose level over the last 2 to 3 months. This gives a general idea of how well your blood glucose levels are being controlled. 

RELATED READING – WHAT IS HBA1c?

Studies have shown that people with diabetes who keep their blood glucose levels normal or close to normal are less likely to develop complications from their disease. They also postpone the development of complications such as heart disease and kidney disease.

Who Should Check Their Sugars

For people with type 2 diabetes, the recommendations for how often to check blood glucose depend on things like the type of treatment (oral medications, insulin, or lifestyle changes), the A1C level, the risk of developing low blood sugar (hypoglycemia), and the treatment targets that have been set during the consultation.

People with type 2 diabetes who take insulin or other medicines that can cause low blood sugar can also benefit from checking their blood sugar regularly.

People who control their diabetes with diet alone or with medicines that don’t cause hypoglycemia usually do not need it, especially if they have reached their blood glucose goals. Some people still prefer to watch it now and again.

Based on your situation, your doctor can help you figure out how often you should check your blood sugar.

How To Do A Blood Sugar Check At Home

In the table below, I have written out general instructions for testing blood glucose levels at home using a glucometer. 

Please do not share needles or devices. Also, please note that devices can be different and sometimes require specific steps to be taken when checking the sugar levels.

STEPS TO CHECK YOUR BLOOD SUGAR AT HOME
  1. Use soap and warm water to wash your hands, and then dry them.
  2. Put a new lancet in the lancing device to get it ready. To reduce the risk of bone damage, don’t prime the lancet to more than 2.0 mm.
  3. Get the blood sugar meter and test strip ready. 
  4. To avoid hurting the bone as much as possible, the side of the end of each fingertip is the best place to check the blood sugars. Stay away from the little finger because the skin may not be deep enough to protect the bone. Avoid touching your index finger and thumb, as these are the most sensitive parts of your hand. Avoid the arm if you are getting an intravenous infusion or if it is on the side of your body where a mastectomy was done recently, if any.
  5. If you can’t get a good drop of blood from your fingertip, try rinsing your fingers with warm water and shaking your hand below your waist. This improves blood flow to the hand and makes it easier to get a small blood sample.
  6. The first drop of blood should be wiped off with clean gauze or tissue because it may contain intracellular or interstitial fluid or be hemolyzed, both of which could change the blood sample.
  7. If you put gentle downward pressure near the puncture site, it might help the blood flow and make it easier to get the second drop of blood.
  8. Touch the tip of the glucose test strip to the second drop of blood as it forms. After a few seconds, the results will show up on the meter.
  9. Throw away the used lancet in a sharps container. Do not throw it in your trash. 

Blood Glucose Meters – Which To Choose?

There are many glucose meters available on the market, some with more capabilities than others. The choice is yours. 

There is a wide selection of glucometers available on Amazon which you can view here.

Are Blood Glucose Meters Accurate?

Blood glucose meters are pretty accurate when it comes to monitoring blood sugars. But different meters can be different, so it’s always best to be careful and use common sense.

For example, if you feel like your blood sugars are low but the device tells you they are normal, check with another device if you can. 

Unfortunately, blood glucose meters are not accurate at very low or very high sugar levels.

Also note –  If you use strips that are past their expiration date or store them in a way that exposes them to high temperatures and humidity, don’t clean your skin well enough, or take vitamin C or acetaminophen, you might get a false reading.

As a rule, glucometers are allowed a 15% error. If the values fall within 15% of the lab value, the device is considered accurate.

It’s a good idea to bring your blood glucose meter with you when you go to get your blood tested so you can check how well it works. This way, you can use your home monitor to check your blood sugar at the same time that blood is drawn and compare the results. 

Continuous Glucose Monitoring

More recently, I have been offering continuous glucose monitoring as a service to our patients.

Continuous glucose monitoring (CGM) lets you check how much sugar is in your blood every 5 to 15 minutes, 24 hours a day. 

I have discussed continuous glucose monitoring elsewhere on my blog.

Closing Remarks

Keeping an eye on your blood sugar levels at home is a great way to make sure your diabetes is under control.

Dr Vivek Baliga B
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