As diabetes educators, this is a question that we are faced with daily, and the answer is usually going to be “it depends.” Not always the answer we want to hear.
People with diabetes tend to have higher than normal levels of sugar circulating in their blood streams. This excess circulating sugar causes the damage from diabetes that we are all trying to prevent: nerve damage, heart disease, vision loss and kidney disease. Testing our blood sugar at home can be a very useful tool to help us make decisions that can better manage diabetes. Testing lets us know about the effects of the food that we eat; the effect of physical activity or exercise; what happens to our blood sugar when we are sick or stressed; or how our medications are working.
When first diagnosed with diabetes, your health care provider will likely prescribe a blood glucose meter or glucometer. Your diabetes care team or pharmacist will be able to show you how it works, help you understand your blood sugar targets and when to test. Blood sugar testing is not just for your health care team to review. It is actually the most useful tool for you. Bloodwork done routinely at the lab helps your healthcare team stay on top of things but testing at home is most helpful for you to manage on your own.
Targets for blood sugar with diabetes are that our fasting blood sugars (before breakfast, after sleeping) and before other meals, should be four to seven, and two hours after eating a meal, should be less than 10. If you are testing your blood sugar, these are the best times to try testing. You may test at different times of the day, pick different meals and test before and after, or you may just be checking your fasting sugar levels. Some medications may require that you are testing much more often than others, usually related to the fact that they may be responsible for low blood sugars and you want to be aware of those so you can make changes. For example, people who take insulin several times a day should be testing much more frequently than someone taking insulin only once per day. The important thing is that testing is helpful to you to make decisions about how you manage your diabetes, that you are gaining new knowledge. If you are not learning anything new by testing your fasting sugar every day, because it is always the same, then don’t test so often first thing in the morning or try testing another time of day and see what’s going on. Testing before driving is always a good thing to do and is mandatory if you are taking insulin or any oral pills that could cause a low blood sugar. If you are not above five then you should have a small snack before driving and test every four hours if you are on a long trip.
There are many different brands of glucose meters on the market, including a new one that will continuously monitor your sugar for you. It requires a small looney size disc be affixed to your arm and the meter can scan it and get a reading without finger pricking, a very amazing way to test, however it is only covered on a few insurance plans at the moment. If you are testing your sugars more than 5x/day, it will be equivalent cost to your test strips, but otherwise it be can be costly. It does provide great insight and can help those struggling to get good control. It also can let us know things that testing once daily will never let you know. Remember that your bloodwork at the lab provides an average blood sugar level over the period of a couple of months, which could reflect relatively stable blood sugars over the day or could be the average of wide swings of highs and lows, which should be addressed and can’t be seen in lab testing.
Continuous monitoring can show the fluctuations over the course of a day, and give you loads of information that may be helpful in making changes in your management to keep you healthy. Many conventional meters now have apps and the test results can be downloaded to your smart phones or computers that create graphs and charts of useful information. The good old fashioned log books are still really useful too.
Whatever you decide, make sure you know why you are testing, when to test, the targets you are aiming for and what to do with the information that you are collecting. Then, together with your healthcare team, you can learn to self-manage your diabetes and be as healthy as possible, reducing your risk of developing any complications.
For more information about any of the free services offered by the Minto-Mapleton Family Health Team, visit www.mmfht.ca or call the Drayton/Palmerston office at 519-638-2110 or Clifford office at 519-327-4777. Like the team on Facebook (Minto-Mapleton Family Health Team) and follow them on Twitter (@MintoMapleton) for healthy living tips and information on programs and events.
