Self-Monitoring of Blood Glucose

People with diabetes are unable to produce enough insulin or to or use it properly, which prevents them from processing glucose, a sugar the body uses for energy. Without insulin, glucose stays in the blood, causing blood sugar to rise to unhealthy levels (hyperglycemia). At the same time, the cells of the body may be starved for glucose, which contributes to further health problems.

There are two types of diabetes mellitus, type 1 and type 2. Gestational diabetes (a form of type 2 diabetes) may affect pregnant women. According to the American Diabetes Association, self-monitoring of blood glucose may enable people with diabetes more freedom to pursue their life goals. Success depends on the self-monitoring being performed carefully and accurately, so it is important that people with diabetes receive instruction from their healthcare providers.

Diabetes puts people at high risk for heart disease, atherosclerosis, cataracts, retinopathy, stroke, poor wound healing, infections, and damage to the kidneys and nerves. Careful blood sugar monitoring helps the cells get the nourishment they need, and lowers the risk of these diabetes-related complications. For the best overall health and well-being, diabetes should be managed with a combination of blood glucose monitoring, a healthy diet, regular exercise, and prescribed medications, as advised by a doctor.

People with diabetes generally have the same nutritional needs as those without

Eat Right

People with diabetes generally have the same nutritional needs as those without. However, when choosing foods to help you manage your blood sugar, it is always important to review your eating habits with your healthcare provider to ensure that they match your body’s particular needs and work well with your medications. In addition, eating well for different conditions involves some specific goals.

Type 1 diabetes

People with type 1 diabetes must take insulin every day in order to process the food they eat and use it for energy. You will work closely with your doctor to determine the right doses and timing for your insulin. The most important things you can do with your diet are:

• Eat at consistent times that match the timing of your insulin doses
• Monitor your blood sugar levels
• Adjust your insulin doses for the amount of food you eat and the amount of physical activity in which you engage

Type 2 diabetes

People with type 2 diabetes may not need to take insulin to manage their disease, but often will take other medication to help control their blood sugar. Your main goals for your diet are to achieve and maintain:

• Normal blood sugar levels
• Normal cholesterol and triglyceride levels
• Normal blood pressure levels
• An ideal body weight

Gestational diabetes

Women with gestational diabetes have the added responsibility of “eating for two.” What you eat and how well you control your blood sugar will impact the growth and development of your fetus, therefore:

• Eat enough calories during pregnancy to support adequate growth and development of your baby without causing hyperglycemia
• Strictly follow the diet prescribed by your doctor, dietician, or other trained healthcare professional

Watch Your Levels

If you have diabetes, your doctor may have you monitor your own blood sugar levels to know when you should take insulin and in what amounts. Self-monitoring is usually done several times daily or several times weekly.

What causes changes in blood sugar?

Any substance ingested by the body—including food, medicines, and supplements—that affects blood sugar levels will directly or indirectly affect the amount of insulin you require. For example, eating a high-fiber diet and supplementing with certain nutrients may improve diabetic blood sugar control. In such cases, the amount of insulin may need to be reduced in order to avoid a hypoglycemic reaction in which the sugar drops too low. Changes in exercise habits may also affect insulin requirements. Anyone taking insulin should consult the prescribing physician before making dietary changes, taking supplements, or beginning an exercise program as adjunct treatment to lower blood sugar levels.

What equipment do people use to monitor their blood sugar?

People who self-monitor usually use:

• A battery-operated blood glucose meter
• Corresponding test strips
• Lancets
• A “sharps container” for safe disposal

Each meter uses a specific test strip that is good for one test and no other strips will work with that meter. Lancets are used to draw the blood drop used in the test and should be discarded in a sharps container after use.

How do people self-monitor?

Monitoring usually involves people placing a small drop of blood (typically drawn from a fingertip) on a test strip that is inserted into the glucose meter. The meter measures how much sugar is in the blood and displays the result on its screen. Self-monitoring may be done anywhere, anytime. How often depends on a variety of factors and is best decided by talking with a doctor or a certified diabetes educator.

What types of blood glucose meters are available?

Many types of meters are available, all of which accurately measure blood sugar. Basic meters are inexpensive and have limited memory and few other features. More expensive models have additional features, which may include using a smaller drop of blood, allowing the blood to be drawn from sites in addition to fingertips, giving test results faster, having memory to store test results, and allowing the meter to download test results to a personal computer. Meters vary in shape and size, with some as small as a pen for convenience and others with an extra large display screen to more easily see the results.

Do self-monitoring supplies require maintenance?

It is important to maintain glucose meters according to the manufacturer's directions. Store open boxes of test strips in the container provided by the manufacturer and check that each new batch of test strips is well within the expiration date before using.