Blood Sugar Monitoring – Right time, Right frequency, Right reporting

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If you are a sea voyager, the nautical compass guides you by telling the right direction and guiding you to the shore. Similarly, if you are a person living with diabetes, blood sugar monitoring helps you to know how your blood glucose values are fluctuating and alter your treatment regimen accordingly.

Blood sugar monitoring is one of the important pillars of diabetes management. It can help you understand the link between blood glucose, food, exercise and insulin. While people on insulin are encouraged to check their glucose values daily, people who are not on insulin are also encouraged to check their glucose values in a structured manner.

Structured self-monitoring involves checking your blood glucose levels at certain times of the day (for instance after meals) for a given period (i.e. two weeks) and then working with your diabetes healthcare team to figure out how food, physical activity and medications are impacting your blood glucose levels.

How do I test my blood glucose levels?

  1. Self-monitored blood glucose(SMBG) meter/Glucometer
  2. Continuous glucose monitor
  3. Flash glucose monitor

Different types of glucose monitoring methods are available:

The SMBG meter or the glucometer is the most common and popular method to check your blood sugar.

Checking your blood sugar using Self-monitored blood glucose (SMBG) meter:

You require the following to check your blood sugar using the Self-monitored blood glucose (SMBG) meter

  • A blood glucose meter
  • A lancet device with lancets
  • Test strips

How do I test my blood sugar levels?

To test your blood glucose levels, you prick your finger with the lancet and add a small drop of blood onto a testing strip. This strip is then inserted into the meter, which reads the strip and displays a number – your blood glucose level.

Blood glucose levels are measured in milligrams per deciliter of blood (mg/dl).

Keeping a record of your blood glucose levels can be very helpful for you and your doctor. You can keep a diary or use a mobile phone app or website to record your levels.

When should I test myself?

When you should test your blood glucose levels and how often you should test varies depending on each individual, the type of diabetes and the tablets and/or insulin being used. Your doctor will help you decide how many tests are needed and the levels to aim for. Possible times to test are:

•Before breakfast (fasting)

•Before lunch/dinner

•Two hours after a meal

•Before bed

•Before rigorous exercise

•When you are feeling unwell

What are the blood glucose values that you should target?

The American Diabetes Association suggests the following targets for most non-pregnant adults with diabetes. A1C targets differ based on age and health. Also, more or less stringent glycemic goals may be appropriate for each individual with diabetes.

  • A1C: Less than 7%
  • Before a meal (preprandial plasma glucose): 80–130 mg/dL
  • 1-2 hours after beginning of the meal (postprandial plasma glucose): Less than 180 mg/dL

Important things to keep in mind while measuring your blood glucose:

1. Your personal blood glucose targets

2. Over what period of time and how many times a day you should check your blood glucose levels?

3. How will you report your blood glucose values? – logbook, app, website etc

4. How often will you share the blood glucose values with your doctor?

It is important to draw patterns of your blood glucose values:

  • Decide on one week period when you will be able to check your glucose levels at set times
  • Everyday for these seven days, check and write down your glucose level before and two hours after breakfast, lunch and dinner, and then again before bedtime
  • Also write down any other relevant information, e.g. what you ate, any physical activity.
  • Check your glucose levels against your personal targets, to see if they are within, above or below target
  • What did you discover? Was your glucose level ever low (hypo) before meals or after activity? Was it ever high (hyper) after meals? By how much? What had you eaten?
  • What does this mean for your ongoing diabetes self-care? e.g. you might want to reduce your portion sizes, or take a daily walk after breakfast or lunch
  • You would want to discuss your blood glucose pattern with your doctor

Remember, regular blood glucose monitoring is an essential tool to help you take control of your diabetes. By identifying and recording changes in your blood sugar levels, you’ll have more information about how food, exercise, stress, and other factors affect your diabetes. Right glucose monitoring is all about Right time, Right frequency & Right Reporting.

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