Blood glucose monitoring is one of the more daunting components of diabetes self-management upon diagnosis and on an ongoing basis. For people with long-standing diabetes or those newly diagnosed, poking your finger is likely at the top of the list of diabetes-management chores you'd most want to remove from your life if you could.
The reality is that blood glucose monitoring is one of the best ways for someone to be empowered to make positive changes to their diabetes self-care.
Many people find blood glucose monitoring frightening but it's important to remember that regular blood testing is perhaps THE best step you can take to better understand your glucose readings and help problem-solve methods to meet your blood glucose goals. Those personal goals also set the stage to help you reduce your risk of the long-term complications of diabetes.
To help ease the stress about blood glucose monitoring, you should know that there are some simple steps you can include in your life. Here’s what you should know about the more basic aspects of blood glucose monitoring, including how often to test your blood glucose and how to make sure it's as painless as possible.
Depending upon the type of diabetes you have and the types of medications (if any) you are prescribed usually dictates how often your healthcare provider will recommend that you test your blood glucose levels.
The American Diabetes Association (ADA) recommends that those taking multiple injections of insulin per day should test their blood glucose levels before meals and snacks, occasionally after meals, at bedtime, before exercise and when low blood glucose symptoms occur. However, additional testing may be required during and after prolonged exercise or manual labor as well as during periods of stress, illness or travel. Your diabetes team will help specify your testing goals, but keep in mind these goals may be adjusted over time.
For those not taking insulin, daily blood glucose monitoring may not be as necessary as once recommended. But, that doesn't mean it's not helpful to occasionally test blood glucose levels. It can be a very useful tool during diabetes self-management education, especially when working with a registered dietitian nutritionist (RDN) to further individualize your meal plan.
This is usually accomplished by choosing one meal per day, completing a food log for that meal and testing blood glucose levels before and 1-2 hours after that meal. The goal of this exercise is to assess if the types and amounts of the food you eat affects your blood glucose levels too much.
The information can be especially helpful when reviewed by a certified diabetes educator (CDE) or an RDN who can work with you to fine-tune meal portions to assist you in meeting blood glucose goals.
Carbohydrate from food is the main source of energy that breaks down into sugar. In some people, blood glucose levels can rise and remain high for too long when too much carbohydrate is eaten at one time. Post-meal testing can helps you and the RDN to better understand how much carbohydrate you can tolerate at a meal without leading to very high blood glucose levels. Having this information can lead to specific carbohydrate recommendations for each of your meals.
Testing sites will depend on each person. The finger is the most accurate site to lance (poke) with the lancet device. All blood glucose meter kits include a lancet device, but the majority are designed for finger lancing only.
Alternate site testing—forearm, abdomen, fingers, ear lobes or calf—is possible but will require the manufacturer of the meter kit to send you a lancet cover that can be used elsewhere on the body.
It is important to note that alternate sites should not be used when testing after meals or if you suspect hypoglycemia (low blood sugar). Also, lancing alternate sites requires a different method to accurately obtain enough blood for the blood glucose test so it’s important to receive directions from the manufacturer.
In order to reduce pain upon lancing:
When possible, use soap and water to prepare the site. It is important to clean the site so nothing can interfere with the reading. If you were touching something containing sugar, it could falsely raise your glucose reading. While alcohol is not the first choice to clean your site (since it dries the skin), if you are out and about and do not have access to a sink, it is the next best choice.
Blood glucose monitoring is one of the many tools that can help improve your diabetes self-care. Using the results in can lead to positive behavior changes over time.