Blood sugar testing times

Contents

When Should You Test Your Blood Sugar?

Blood sugar testing is a fundamental part of treating type 2 diabetes. By obtaining regular blood sugar readings, people with diabetes can, among other things, help their doctor make more informed decisions regarding the type and dosage of medication they need. Blood sugar testing also can help you see what foods, events, and activities trigger highs and lows in your blood sugar levels.

So how often should you test your blood sugar? The answer depends mostly on the status of your health and the demands of your daily life.

People with type 2 diabetes should take a blood sugar reading at least once a day. Some may need to test as frequently as seven times a day. Whether you need to or are able to perform more frequent testing depends on a number of factors:

  • Are you newly diagnosed? If so, you will need to take blood sugar tests more often to give your doctors the data they need to shape an appropriate treatment plan.
  • Are you taking insulin? Doctors recommend that people who need insulin to treat their type 2 diabetes perform three or more blood sugar tests throughout the day, especially if they take multiple daily doses or are using an insulin pump.
  • Are you leading an active lifestyle? People participating in sports or working out regularly need to test their blood glucose more often.
  • Are there safety concerns? Patients who drive or operate heavy machinery should test their blood sugar beforehand, to protect both themselves and those around them.
  • Are there factors in your life that limit your ability to test often? For example, people who type at their jobs may need to limit their testing if their fingertips become too painful to work a keyboard. Others may not be able to afford the cost of the test strips needed for frequent testing or can’t fit frequent tests into their busy lives.

You should talk with your doctor about these factors to devise the right blood glucose monitoring schedule for you.

Creating a Blood Sugar Testing Schedule

In general, type 2 diabetes patients should schedule blood sugar testing to coincide with specific daily events. That makes it easier to remember when to test. Regular testing times include:

  • Before all three meals
  • Following a workout
  • At bedtime

Testing prior to meals is important because fasting blood glucose levels give you a better picture of the treatment you need. If you choose to test after a meal, you should wait one to two hours to make sure you get an accurate blood sugar reading.

Changing Your Testing Schedule

Many reasons might cause you to alter your schedule temporarily or permanently:

  • Your overall health. If you are feeling sick, you should increase the frequency of your blood sugar testing until you’re feeling better.
  • You start having high or low blood sugar levels more frequently. Your doctor may want you to increase your testing to pinpoint the problem.
  • You’re going to be more active than you normally are. You should check your blood sugar level before heading off on a hike or hitting the ski slopes.
  • You’ve successfully treated your diabetes for an extended period. Your doctor may let you cut back on testing if you appear to have your diabetes well in hand.

As with most things in life, your blood glucose monitoring schedule should not be set in stone, but should be defined by your individual needs and circumstances and always under your doctor’s supervision.

5 Factors That Affect How Often You Need to Test Your Blood Sugar

  • History of blood-sugar control: The American Diabetes Association recommends that patients who are meeting treatment goals get hemoglobin A1C tests twice a year at their doctor’s office. For patients whose therapy has changed or who are not meeting treatment goals, the ADA recommends hemoglobin A1C testing four times a year. If the hemoglobin A1C test result is less than 7%, suggesting relatively good long-term blood-sugar control, you may be able to test your blood sugar less often (if you’re not on insulin). Many doctors recommend testing twice a day at varying times, such as before and after breakfast, lunch, and dinner, or at bedtime. “Two tests a day over the course of a month can really characterize the glucose profile of a patient,” says Stuart Weiss, MD, of New York University School of Medicine, in New York City.
  • What you can afford: You can usually get a blood glucose monitor free or insurance may cover it. It’s the strips that can be expensive. At a dollar a pop, testing four times a day could cost you roughly $120 a month. Don’t hesitate to tell your doctor if you can’t afford frequent testing. If you’re not on insulin or other medication, you may be able to use “block testing,” in which you test blood sugar four or more times a day, one day each week (or some other pattern to get a “snapshot” of daily blood sugar), and then discuss the results with your doctor. Just be careful not to “game” the results by changing what you do on those days or times when you are testing.

    Don’t deceive yourself by taking more care with exercise, diet, and medication on the day you’re going to do all the monitoring. For example, if you go out to dinner for your anniversary and have a piece of cake, that’s a great day to check blood sugar to see how much you can get away with.

  • Blood glucose monitoring

    Blood glucose monitoring is a way of testing the concentration of glucose in the blood. This is done by pricking the skin to draw blood, then applying the blood onto a testing strip that is placed in a blood glucose meter. This device measures the glucose levels in your blood and gives you a reading.

    An aim of diabetes management is to keep blood glucose levels (BGLs) within a specified target range. You need to balance your food with your physical activity, lifestyle and diabetes medication. Blood glucose monitoring can help you understand the link between blood glucose, food, exercise and insulin.

    The pattern of changes in blood glucose levels can alert you and your health care team to a possible need for a change in how your diabetes is being managed.

    Read more in our fact sheet Blood glucose monitoring.

    How are you going with your diabetes health checks?

    Regular checks can help prevent serious diabetes-related complications like problems with your feet, eyes, heart and kidneys. Individual members of your health care team will let you know how often you need checks, so you can schedule them into your calendar.

    Monitoring your blood glucose levels

    People who take insulin need to self-monitor their blood glucose levels. Your health professional will help you decide when and how often you should check your blood glucose levels, and your target range.

    People with diabetes registered on the NDSS will be eligible to receive a free blood glucose meter associated with their preferred new brand of blood glucose testing strips.

    Your doctor or diabetes educator can help you choose the meter that’s best for you. Your diabetes educator or pharmacist can show you how to use your meter to get accurate results.

    To find out which meters are suitable for NDSS-funded blood glucose testing strips, as well as how to get one of these meters, read the How to access a free blood glucose meter fact sheet.

    Blood glucose meters are also sold as kits giving you all the equipment that you need to start. There are many types, offering different features and at different prices to meet individual needs. Most of these are available from pharmacies and some diabetes centres. You may also be able to purchase them from your local pharmacy or state or territory diabetes organisation if they have a shop.

    How to monitor your blood glucose 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.

    When and how often you should test your blood glucose levels varies depending on each individual, the type of diabetes and the tablets and/or insulin being used. Blood glucose levels are measured in millimoles per litre of blood (mmol/L). Your doctor or diabetes educator will help you decide how many tests are needed and the levels to aim for.

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

    How to access blood glucose testing strips

    If you are registered on the NDSS and you use insulin, you are able to purchase subsidised blood glucose testing strips through the NDSS. If you have type 2 diabetes and do not use insulin, you are able to purchase an initial six-month subsidised supply of blood glucose testing strips.

    This form allows access to testing strips after the initial six-month period provided by the scheme. Learn more about how to access blood glucose testing strips if you have type 2 diabetes and do not use insulin.

    If you have type 2 diabetes and do not use insulin, you are able to purchase an initial six month subsidised supply of blood glucose testing strips.

    Inconsistent readings

    Sometimes you may get a lower or higher blood glucose reading than usual. This could be caused by a number of different things. You should contact your doctor or diabetes educator if you notice that your blood glucose patterns change or are consistently higher or lower than usual.

    Hot temperatures can cause blood glucose levels to fluctuate, so it’s a good idea to check more frequently and take immediate action if necessary.

    Getting accurate results

    The best way to ensure accurate test results is to learn how to use and maintain your meter and equipment. You can also check that:

    • you’re using the right strip for the meter
    • the strips have not expired
    • you have stored your strips correctly.

    You should also make sure you have washed your hands before testing. To check if your meter is working correctly, you can test it with a control solution. Your diabetes educator or pharmacist can help you.

    Ketoacidosis

    High blood glucose levels can put you at risk of a serious condition called ketoacidosis.

    Read more about ketones and ketoacidosis.

    Monitoring your blood glucose levels during pregnancy

    Well-managed blood glucose levels at the time you conceive your baby and throughout pregnancy are important for your health and that of your baby.

    Read more about blood glucose levels and pregnancy.

    Sharps disposal

    Needles from your finger-pricking device (lancets) should go into a special sharps container and not in your general rubbish. Syringes, insulin pen needles and used blood glucose testing strips must also be disposed of safely. Use an approved sharps container and make sure you keep it out of reach of children.

    To find out where to get a sharps container and how to dispose of sharps, call the NDSS Helpline on 1300 136 588 or contact your:

    • local council health department
    • community health centre needle exchange program
    • local pharmacy, community health centre or public hospital.

    Some local councils provide sharps containers free of charge. Discuss this with your health professional or call the NDSS Helpline on 1300 136 588.

    Glycated haemoglobin (HbA1c) test

    The HbA1c test shows an average of your blood glucose level over the past 10-12 weeks. It does not replace the tests you do yourself but adds to the overall picture of your blood glucose management.

    The goal for most people with diabetes will be ≤7%. This may need to be higher for some people, including children and the elderly. Your doctor or diabetes educator can help you decide on a target that is both appropriate and realistic for your individual circumstances.

    You should also arrange this test with your doctor every 3-6 months.

    How Often Should I Check My Blood Sugar?

    Have you ever wondered how often you should be monitoring your blood glucose and at what times of day you should be checking? As a diabetes educator (CDE), I am often asked both of those questions.

    The frequency of blood glucose monitoring can range from a few random checks throughout the week to up to 6 to 10 checks each day. The time(s) of day that blood glucose is monitored will depend on your current treatment plan. Self-monitoring of blood glucose (SMBG) allows you and your physician to assess how your current treatment plan (i.e. lifestyle and medication) is working.

    What factors affect how often and when to check blood sugar?

    The frequency and timing of SMBG should take into consideration the following:

    • Your current diabetes medications (no medication, oral medication, insulin, and/or other injectable medications)
    • Your current level of control
    • Your risk for having a low blood sugar
    • Your personal goals
    • Insurance coverage of test strips

    When should I check blood sugar?

    The following is a list of times you may be advised to check your blood glucose: 1,2

    Fasting/before breakfast

    This information is helpful for adjusting long acting insulin as well as adjusting some oral diabetes medications.

    The American Diabetes Association recommends a fasting blood glucose level of 80-130 mg/dL.1

    1-2 hours after a meal

    Knowing your number after a meal allows you to see how food impacts your blood glucose. For those of you who take mealtime insulin (i.e. rapid acting insulin), this information will allow you to see if your insulin dose was well matched to your food intake.

    The American Diabetes Association recommends a blood glucose of < 180 mg/dL 1-2 hours after a meal.1

    Before meals

    Checking at this time is helpful for those of you taking rapid-acting insulin at meals to assess how well your insulin dose at the previous meal matched your food intake.

    The American Diabetes Association recommends a pre-meal blood glucose level of 80-130 mg/dL.1

    Before bed

    Knowing your number before bed can assist you in screening for low blood glucose (this is an important consideration if you take insulin or an oral medication that increases your risk for low blood sugar). Your doctor may advise to eat additional carbohydrates at bedtime if your blood glucose is below a specified number.

    If you have a snack after your dinner meal, checking your blood glucose before bed will allow you to see how that snack impacted your blood sugar. If it has been 1-2 hours since your snack your blood glucose should be < 180 mg/dL according to the American Diabetes Association blood glucose guidelines.1

    At 2 am/middle of the night

    Overnight blood glucose check, while inconvenient, are typically done to screen for hypoglycemia (low blood glucose) as it is more common to not feel a low blood sugar overnight and to sleep through a hypoglycemia event. If you wake up with a headache or a stomach ache it may be due to low blood sugar that unknowingly occurred overnight.

    Before, during and after exercise

    Exercise typically causes blood glucose to go down. If you take insulin and certain oral medications, exercise may increase your risk for low blood sugar. Monitoring your blood glucose before, during (in particular if exercise is longer than 1 hour), as well as after exercise can help you see the impact of exercise on your blood glucose and help screen for hypoglycemia.

    Before driving

    Checking at this time allows you to better ensure your blood glucose is at a safe number before getting behind the wheel.

    After consuming alcohol

    Alcohol may increase your risk of having a low blood sugar.

    During illness or stress

    Illness and/or stress may cause your blood glucose to be higher than normal.

    Recommendations – standard of care in diabetes

    The 2018 standards of care in diabetes have recommended the following:

    “Most patients using intensive insulin regimens (multiple-dose insulin or insulin pump therapy) should perform self-monitoring of blood glucose (SMBG) prior to meals and snacks, at bedtime, occasionally postprandially, prior to exercise, when they suspect low blood glucose, after treating low blood glucose until they are normoglycemic, and prior to critical tasks such as driving.” 2

    “When prescribed as part of a broad educational program, SMBG may help to guide treatment decisions and/or self-management for patients taking less frequent insulin injections or noninsulin therapies.”2

    Take away

    • Make sure to speak with your physician about how often you should be checking your blood sugar and at what times of day or week checks should be done.
    • Don’t forget to ask your physician: “What should I do with all this information?” Your overall control will likely not improve unless you know what to do with the glucose numbers you are seeing!
    • If you are uncertain how to use your meter, ask to meet with a diabetes educator for additional training.

    Type 2 diabetes is one of the great health challenges of our time, with 1.2 million people currently living with diabetes in Australia, a further 500,000 undiagnosed. The number of people in the world living with diabetes has grown five-fold since 1980.

    There are significant health complications that come with diabetes, such as micro vascular damage which can impact the brain, feet and eyes, and macro vascular damage that can seriously impact organs like kidneys and the heart.

    In addition to that there are substantial healthcare costs that governments need to consider. In Australia, direct costs are $1.7bn a year, the indirect costs, $14bn.

    Avoiding these complications is therefore an absolute health and economic imperative.

    According to a report from the Centre for International Economics, detecting diabetes at its early stages can halve medical costs and significantly improve health outcomes.

    And if you can pick up on your risk at the prediabetes stage, the opportunity to turn your health around without significant medical complications is significantly enhanced.

    So what’s the test and who should take it?

    There are two ways to test for diabetes, the measurement of blood sugar levels or the HbA1c test. The HbA1c test is simpler and does not require fasting and unless your doctor finds a reason that the test is not suitable for you it can be used. The HbA1c test takes a snapshot of your blood sugar levels over the last three months.

    If you haven’t had an HbA1c diabetes test before, you should speak to your doctor about it if the following apply to you: if you’re over 35 years of age, your waist is over 100cm, you have a family history of type 2 diabetes, blurred vision, are thirsty, or do less than two-and-a-half hours of exercise a week.

    The healthy range for HbA1c is less than 6.0% (also expressed as less than 41 mmol/mol) and results of 6.5% (48 mmol/mol) or higher indicates diabetes. Results from 6.1% to 6.4% indicate a higher risk of developing diabetes in the future.

    How often should you take the test?

    How often you should take an HbA1c test to monitor your glycated haemoglobin levels depends on what category you fell into in the first test, as well as ongoing lifestyle choices which we will be looking at in a future article.

    Ideal range

    If you scored a range of 6.0% or lower in your test, that’s a good thing and you’re clearly doing something right.

    ‘A person who has an HbA1c 6.0% or lower is in the expected range for a healthy person and is showing good glucose control,’ says Associate Professor Graham Jones, an Australian Clinical Biochemist and pathologist.

    ‘That being said, there are several other health factors that impact risk, so you need to keep an eye on those things. Your GP is best to advise you here, but as a rule of thumb it’s worth having the discussion with your doctor every three years.’

    Prediabetes range

    An HbA1c from 6.1% to 6.4% places you in the “at risk” range. That’s not ideal, but the good news is that you have the opportunity to institute lifestyle changes which can help you avoid progressing to diabetes and the serious medical conditions flowing from diabetes.

    ‘The thing about prediabetes is that it’s an opportunity to do a stocktake of your lifestyle and make changes before serious medical complications begin,’ says Professor Jones.

    ‘In terms of how often someone in this range should have an HbA1c test, a repeat test in a year is usually recommended, although it should be noted that Medicare does not cover more than one test per year without a diagnosis of diabetes.’

    Diabetes range

    If you have scored 6.5% or above on your HbA1c test, you are in the diabetic range and will need to speak to your doctor about how to manage the condition to avoid further health complications. The first step will be a repeat test to confirm the diagnosis.

    Your doctor will identify the correct HbA1c “target” for you with lifestyle factors being the first line on therapy, but often medications are also needed to keep the HbA1c at the desired level.

    ‘People who have been diagnosed with diabetes need to have an A1c test every three months initially to make sure the measures you’re taking to manage the condition are working.

    ‘If you manage to bring it under control, you might be able to wait longer, but taking a test twice a year would be considered the minimum,’ said Professor Jones.

    How often to test blood sugar levels is a common question particularly amongst people that are newly diagnosed with diabetes or that have moved onto a new treatment regimen.

    The frequency at which you should test your blood will be dependent upon the treatment regimen you are on as well as individual circumstances.

    Blood glucose testing can help you to identify any hypos and hypers and provide information on how to keep your diabetes under control

    It is sadly quite common for some people’s healthcare team to suggest people with diabetes to test less often or not test at all even when their patients are keen.

    Should I test my blood glucose levels?

    If you are on medication that puts you at risk of hypos, you should test your blood glucose levels.
    Medications that can cause hypos include:

    • Insulin (all types of insulin)
    • Sulphonylureas (glibenclamide, gliclazide, glipizide, glimepiride, tolbutamide)
    • Prandial glucose regulators (repaglinide, nateglinide)

    This means that all people with type 1 diabetes need to regularly test their blood glucose levels.

    If you have another type of diabetes and are not on any of the medication above, there is less necessity to test your blood sugar but there is still plenty of benefit to be had in testing your blood sugar.

    • Read about the benefits of blood glucose testing

    It has previously been reported by research that some people may find blood glucose testing distressing

    This is more likely to be the case when people have not received education about how to interpret and act upon the results. When people know how to interpret the results, blood glucose testing is usually regarded as a substantial benefit.

    Blood glucose testing for type 1 diabetes

    The 2015 NICE guidelines recommend that people with type 1 diabetes test their blood glucose at least 4 times per day, including before each meal and before bed.

    Your doctor should also support you to test more regularly to ensure you test at the following times:

    • Before driving and at least once every 2 hours on longer journeys
    • Before, during and after exercise
    • Testing more regularly during periods of illness
    • During pregnancy or breastfeeding or when planning pregnancy
    • If you are having regular hypos
    • If you have an impaired ability to spot hypo symptoms
    • If you are not achieving the target HbA1c of 48 mmol/mol (6.5%)
    • If taking part in high-risk activities

    Blood glucose testing for other types of diabetes

    How often people with other types of diabetes should test their blood sugar will vary depending on what medication is taken and personal circumstances.
    People on multiple insulin injections per day or on an insulin pump should test as often as people with type 1 diabetes.
    If you are on medication that can cause hypos, you should, at the least, be able to test your blood glucose whenever you notice any possible signs of hypoglycemia.
    Blood glucose testing is useful for testing how much different meals and activities affect your blood glucose levels. This tends to be of particular use for people with type 2 diabetes.

    • Read more about pre and post meal blood glucose testing

    Can I test my blood too few times?

    Depending on how your diabetes is treated, it is possible to test too little. For example, people with type 1 diabetes that are testing less than 4 times per day are likely to find it more difficult to understand their sugar levels and are likely to experience poorer control than someone testing at least 4 times per day.

    Struggling to test your blood glucose levels as often you should can often be linked with psychologiocal issues such as being in denial about your diabetes , experiencing diabetes burnout or suffering from depression

    If you’re on medication that can cause hypos, you must by law test your blood sugar levels before each drive and at least as often as once every 2 hours of a journey. Failure to do this could lead to a hypo at the wheel and a number of road accidents happen every year in the UK as a result of hypoglycemia.

    Diabetes.co.uk has been made aware that many people have experienced difficulty with being prescribed sufficient blood glucose testing supplies to adequately manage their diabetes.

    • For more on this issue, read our guide on the availability of blood glucose test strips

    Can I test my blood too many times?

    A situation in which you could be testing more often than you need is if the testing you are doing is not providing any help in managing your diabetes.
    Note that in type 1 diabetes, testing before each meal and before bed is a necessary part of diabetes control as it helps you to keep track of whether or when your blood sugar levels are going too high or too low.
    People with other types of diabetes, such as type 2 diabetes, may be testing too often if it is not understood how to make sense of or respond to the results.
    If you have type 2 diabetes and would like to have a better understanding of what your blood sugar levels mean, you can benefit from joining the Type 2 Testing Program

    When to check your blood sugar

    Your diabetes treatment and self-management plan will determine how often and when to check your blood sugar levels.

    How often to test

    Check your blood sugar levels when you need information to make decisions. How you use the information from testing is more important than how often you test. Whatever you decide is the best testing schedule for you, be sure you have a plan for what to do with the information from your tests.

    Many people find it helpful to check their blood sugar when they first wake up in the morning and again before their evening meal or going to bed. Others test before or after each meal. Many people test before and after exercising.

    In general, most people test at least 1 time a day if they:

    • Manage diabetes by diet and exercise only
    • Take diabetes pills
    • Take 1 to 2 insulin shots a day

    People test 4 to 6 times a day when they:

    • Take more than 2 insulin shots a day
    • Start to have very high or very low blood sugar readings
    • Are pregnant
    • Use an insulin pump
    • Are under more stress than usual
    • Are sick
    • Have changed their routine

    When to test

    Testing at different times of the day can give you different information about how your diabetes care plan is working.

    • First thing in the morning, before eating or drinking anything. This will tell you whether you have enough insulin in your body to control blood sugar levels at night, while you’re asleep.
    • Before each meal. This will help you make decisions about how much medicine to take and how much food to eat.
    • After meals and before bedtime. This can tell you if you’re taking enough medicine to cover the food you eat during the day and whether you’re making the right food choices.
    • Before certain activities, such as driving or using any kind of machine. This will let you know if your blood sugar is in a normal range. If your blood sugar is low, you will want to eat a carbohydrate snack before you begin.
    • Before and after exercise. This can help you make sure blood sugar levels stay as close to normal as possible before, during, and after you’ve finished exercising.
    • Whenever you feel odd. You might feel like your blood sugar is suddenly starting to drop, or that it’s higher than it should be, based on how you feel. But you won’t know for sure unless you test. Testing takes out the guesswork. When you know what your actual blood sugar level is, you can make a better decision about what action you need to take, if any.

    Remember: Use your test results to help make decisions about food, exercise, and medicines, and to have greater control of your diabetes.

    Ask your health care team to help you find a schedule that’s best for your care plan and lifestyle. To help you stick to your schedule for testing, you might find it useful to make an action plan.

    Clinical review by Avantika Waring, MD
    Kaiser Permanente
    Reviewed 01/03/2019

    Monitoring Your Blood Sugar Level

    What tests can I use to check my blood sugar level?

    There are 2 blood tests that can help you manage your diabetes. One of these tests is called an A1C test. This test reflects your blood sugar (or blood glucose) control over the past 2-3 months. Testing your A1C level every 3 months is the best way for you and your doctor to understand how well your blood sugar levels are controlled. Your doctor will likely be the one who orders an A1C test. However, you can also purchase over-the-counter A1C testing kits that you can use at home.

    Your A1C goal will be determined by your doctor, but it is generally less than 7%.

    The other test is a general blood glucose test. It is often referred to as self-monitoring of blood glucose. Using a blood glucose monitor to do regular testing can help you improve control of your blood sugar levels. The results you get from glucose testing at home can help you make appropriate adjustments to your medicine, diet, and/or level of physical activity. If your blood sugar fluctuates, you should own a blood glucose monitor (also called a home blood sugar meter, a glucometer, or a glucose meter) and know how to use it. Your doctor may prescribe a blood glucose monitor.

    The U.S. Food and Drug Administration (FDA) has approved meters that work without pricking your finger. But these meters cannot replace regular glucose meters. They are used to get additional readings between regular testing.

    Path to improved health

    What supplies do I need?

    You will need a glucose meter, alcohol pads, sterile finger lancets, and sterile test strips. Check with your health insurance plan to see if they will pay for these supplies.

    How do I pick a glucose meter?

    Check with your health insurance plan to see if it will pay for your glucose meter. If so, your plan may only pay for a certain meter.

    If your insurance plan doesn’t pay for glucose meters, ask your doctor which meter he or she recommends. Shop around and compare costs. Consider what features are important to you. For example, some meters are made for people who have poor eyesight. If you want to pay a little more money, you can get a meter that stores the results in its memory. This allows you to compare results from several days at one time. Other meters can be hooked up to your computer to analyze your results.

    How do I measure my blood sugar level?

    Follow your doctor’s advice and the instructions that come with the glucose meter. In general, you will follow the steps below. Different meters work differently, so be sure to check with your doctor for advice specifically for you.

    If you have severe diabetes, continuous blood sugar monitoring may be a viable option. These systems use a sensor placed beneath the skin that measures blood sugar constantly. Some insurance programs are beginning to cover these monitors.

    The following are some suggestions for home glucose testing and how to use the results to improve your blood sugar control.

    1. Wash your hands and dry them well before doing the test.
    2. Use an alcohol pad to clean the area that you’re going to prick. For most glucose meters, you will prick your fingertip. However, with some meters, you can also use your forearm, thigh, or the fleshy part of your hand. Ask your doctor what area you should use with your meter.
    3. Prick yourself with a sterile lancet to get a drop of blood. (If you prick your fingertip, it may be easier and less painful to prick it on one side, not on the pad.)
    4. Place the drop of blood on the test strip.
    5. Follow the instructions for inserting the test strip into your glucose meter.
    6. The meter will give you a number for your blood sugar level.

    What if I can’t get a drop of blood?

    If you get blood from your fingertip, try washing your hands in hot water to get the blood flowing. Then dangle your hand below your heart for a minute. Prick your finger quickly and then put your hand back down below your heart. You might also try slowly squeezing the finger from the base to the tip.

    How often should I test my blood sugar level?

    Your family doctor will recommend how often you should test. Testing times are based on the kind of medicine you take and on how well your blood sugar levels are controlled. You’ll probably need to check your blood sugar more often at first. You’ll also check it more often when you feel sick or stressed, when you change your medicine, or if you’re pregnant.

    What do I do with the results?

    Write down the results in a record book. You can use a small notebook or ask your doctor for a blood testing record book. You may also want to keep track of what you have eaten, when you took medicine or insulin, and how active you have been during the day. This will help you see how these things affect your blood sugar. Talk with your doctor about what is a good range for your blood sugar level and what to do if your blood sugar is not within that range.

    What time of day should I test?

    Recommendations for the best time of day to test your blood sugar depend on your medicine, mealtimes, and blood sugar control. Your doctor may provide a chart that outlines when to check your blood sugar and what level you should target. Your doctor may also suggest different goals, depending on your situation.

    The chart may look something like this:

    Time to Test Fasting, Before Breakfast 1-2 Hours After Breakfast Before Lunch 1-2 Hours After Lunch Before Dinner 1-2 Hours After Dinner Bedtime 3 a.m.
    Target Goal Ranges* 80-120 < 180 80-120 < 180 80-120 < 180 100-140 70-110
    Doctor’s Recommendation
    Monday
    Tuesday
    Wednesday
    Thursday
    Friday
    Saturday
    Sunday
    * Blood glucose values are measured from blood samples obtained from the finger or other sites, as read on your blood glucose monitor. The target goals are based on recommendations from a panel of medical experts. Talk to your doctor about what changes to make if your blood sugar levels are not within the range.

    What do my blood sugar levels tell me?

    Time of Test Can Be Used to …
    Fasting blood sugar (FBG) nighttime (3-4 a.m.) Adjust medicine or long-acting insulin
    Before a meal Modify meal or medicine
    1-2 hours after a meal Learn how food affects sugar values (often the highest blood sugars of the day*)
    At bedtime Adjust diet or medicine (last chance for the next 8 hours)

    *Depends on the size of the meal and the amount of insulin in your medicine

    Check your blood sugar if:

    • You have symptoms of low blood sugar (hypoglycemia), which include dizziness, shaking, sweating, chills, and confusion.
    • You have symptoms of high blood sugar (hyperglycemia), which include sleepiness, blurry vision, frequent urination, and excessive thirst.
    • You need to learn how meals, physical activity, and medicine affect your blood sugar level.
    • You have a job in which poor blood sugar control could cause safety problems.
    • You need help deciding if it is safe to drive or perform other tasks that require concentration if you are taking insulin or have had hypoglycemia in the past.

    When should I check my blood sugar more frequently?

    • If your diabetes medicine changes.
    • If you begin taking other kinds of medicines.
    • If you change your diet.
    • If your exercise routine or activity level changes.
    • If your level of stress increases.
    • If you are sick. When you are sick, even without eating, your sugar levels may run high, so testing is important.

    Follow your doctor’s testing recommendations during this time. Continue testing more often until you have maintained your blood sugar goal values for at least 1 week. Or continue testing until your doctor advises you that more frequent testing is no longer necessary.

    Tips on blood sugar testing

    • Pay attention to expiration dates for test strips.
    • Use a big enough drop of blood.
    • Be sure your meter is set correctly.
    • Keep your meter clean.
    • Check the batteries of your meter.
    • Follow the instructions for the test carefully.
    • Write down the results and show them to your doctor.

    Things to consider

    Managing your blood sugar level is critical to your overall health. Often the focus is on keeping blood sugar levels low. But if they are too low, it can put you at risk, too.

    Hypoglycemia is the name for a condition in which the level of sugar in your blood is too low. Your blood sugar level can get too low if you exercise more than usual or if you don’t eat enough. It also can get too low if you don’t eat on time or if you take too much insulin. Signs of hypoglycemia include the following:

    • Feeling very tired
    • Yawning frequently
    • Being unable to speak or think clearly
    • Losing muscle coordination
    • Sweating
    • Twitching
    • Having a seizure
    • Suddenly feeling like you’re going to pass out
    • Becoming very pale
    • Losing consciousness

    How can I deal with an insulin reaction?

    People who have diabetes should carry at least 15 grams of a fast-acting carbohydrate with them at all times in case of hypoglycemia or an insulin reaction. The following are examples of quick sources of energy that can relieve the symptoms of an insulin reaction:

    • Nondiet soda: ½ to ¾ cup
    • Fruit juice: ½ cup
    • Fruit: 2 tablespoons of raisins
    • Milk: 1 cup
    • Candy: 5 Lifesavers
    • Glucose tablets: 3 tablets (5 grams each)

    If you don’t feel better 15 minutes after having a fast-acting carbohydrate, or if monitoring shows that your blood sugar level is still too low, have another 15 grams of a fast-acting carbohydrate.

    Teach your friends, work colleagues, and family members how to treat hypoglycemia, because sometimes you may need their help. Also, keep a supply of glucagon on hand. Glucagon comes in a kit with a powder and a liquid that you must mix together and then inject. It will raise your blood sugar level. If you are unconscious, or you can’t eat or drink, another person can give you a shot of glucagon. Talk to your doctor to learn when and how to use glucagon.

    Questions for your doctor

    • How often should I monitor my blood sugar level?
    • What type of device should I use to check my blood sugar level?
    • Do I need to take medicine to lower my blood sugar?
    • Can you show me how to use a glucose meter?
    • Do I need to track my daily results?

    Resources

    National Institutes of Health, MedlinePlus: Monitoring Blood Glucose

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