Why do I need to check my blood glucose levels?
Monitoring your blood glucose means you can:
● See if your levels are in the target range or if they’re too high or too low.
● Get a better understanding of how different foods, exercise, stress and illnessaffect your blood glucose.
● Know when you need to speak with your healthcare team to adjust your care plan.
When and how often should I check?
This will depend on the type of diabetes you have and how you’re managing it – for example, with multiple insulin injections, insulin pumps, tablets, diet and exercise. Your diabetes management has an effect, so it’s best to discuss this with your doctor or diabetes educator. In general though, the best times to check are:
● If you have type 1 or insulin-treated type 2 diabetes: before each meal, before bed and occasionally overnight (2am to 3am), particularly if you’ve experienced overnight hypos.
● If you have non-insulin-treated type 2 diabetes: before breakfast (fasting) and two hours after any meal (from the start of the meal).
It’s also good to check more regularly when you are:
● Unwell or under a lot of stress.
● Experiencing symptoms of high or low blood glucose levels.
● Changing your routine, such as travelling or going on holiday.
● Making changes to your diabetes management plan, such as altering your diet, activity levels or medication.
● Driving – if you take insulin or medication that causes hypos you should check before you drive and every few hours during long-distance driving. Only drive when your levels are above 5mmol/L.
If you’re not taking medication that causes hypos and your blood glucose levels are stable then you may not need to monitor at all. It’s only useful to monitor if it’s helping you in the day-to-day management of your diabetes. A short period of structured monitoring – before and after meals – is usually more helpful than just checking fasting readings every day.
What should I aim for?
The target blood glucose range for people with diabetes differs depending on a number of factors, including your age, how long you’ve had diabetes, the type of diabetes medication you take and any other medical problems you might have. If you’re not taking medication that can cause hypos, you may be able to aim for lower levels, similar to a person without diabetes. It’s important to speak with your doctor about your own personal targets, but Diabetes Australia recommends the following general targets:
● If you have type 1 diabetes: 4-8mmol/L before meals and under 10mmol/L two hours after starting meals.
● If you have type 2 diabetes: 6–8mmol/L before meals and 6-10mmol/L two hours after starting meals.
What if my reading is very high or too low?
If you go out to dinner, have a very stressful or inactive day or are unwell, you may get a high reading. This is often nothing to worry about but consistent high readings can increase your risk of complications and are a sign that you need to review your diabetes management plan. You should also see your doctor if you have frequent low BGLs (below 4mmol/L).
How do I check my blood glucose levels?
You’ll need a blood glucose meter, a finger-pricking (lancet) device with lancets and test strips. There are many different meters available so talk to your diabetes educator about which one might be best for you. They may be able to give you one for free, or you can buy a meter at pharmacies or through Diabetes Australia. You’ll also need to register for the NDSS (National Diabetes Services Scheme) – this is a Government subsidy that allows you to buy strips at a discounted rate. Your diabetes educator can help set up your meter and show you how to use it, but for the majority of meters, you’ll need to:
● Remove a test strip from the vial or foil packet and insert it into the meter, which will turn on and give you a message that it’s ready to go.
● After washing and drying your hands, prick your finger and apply a drop of blood to the test strip.
● Within five to 10 seconds, the meter will tell you your reading. You can record this in a record book, or your meter can usually keep a history of your readings with times and dates.
● Used strips can be placed in the rubbish bin but lancets should be disposed of in a sharps container.
How can I make sure my readings are accurate?
You'll go a long way towards ensuring the accuracy of your readings by doing the following:
● Wash your hands before monitoring as anything on your fingers can affect results.
● If a meter needs coding, check that the machine is calibrated for the bottle/box of strips you’re using.
● Check the strips are within their expiry date.
● For strips that come in a vial, replace the lid as soon as you take out a new strip as air and moisture can affect the accuracy.
5 ways to take the pain out of testing:
1. Make sure your hands are clean, dry and warm.
2. Use the side of your fingertip, not the tip.
3. Choose the right depth setting on your lancet device – the shallowest setting that gives you enough blood.
4. Use a different finger each time and use both sides of the fingertip.
5. Change your lancets regularly – they are designed for single use and will become increasingly blunt with each use.
By Dr Kate Marsh, Diabetic Living diabetes educator
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