Managing diabetes is one part investigation and two parts action. Unlike some other diseases that rely primarily on professional medical treatment, diabetes treatment requires active participation by the person who has it. Monitoring your blood glucose level on a regular basis and analyzing the results is believed by many to be a crucial part of the treatment equation.
When someone is first diagnosed with diabetes, he is usually given a blood glucose meter (or told to go buy one) and told how and when to use it, as well as what numbers to shoot for. However, the advice a person receives on when to monitor and what the results should be generally depend on his type of diabetes, age, and state of overall health. It can also depend on a health-care provider’s philosophy of care and which set of diabetes care guidelines he follows. At least three major health organizations have published slightly different recommendations regarding goals for blood glucose levels. (See “Blood Glucose Management Goals.”)
There is some common ground when it comes to blood glucose monitoring practices. For example, most people take a fasting reading before breakfast every morning. Some people also monitor before lunch, dinner, and bedtime; some monitor after each meal; and some monitor both before and after all meals. However, when monitoring after meals, some people do it two hours after the first bite of the meal, while others prefer to check one hour after the start of a meal.
To help sort out the whys and when of monitoring, three diabetes experts weigh in with their opinions. While they don’t agree on all the details, they do agree on one thing: Regular monitoring is critical in diabetes care.
Self-monitoring is an integral part of diabetes management because it puts you in charge. Regardless of how you manage your diabetes — through diet and exercise alone or combined with oral medicines or insulin — regular blood glucose monitoring provides immediate feedback on how your program is working.
“Checking your blood glucose gives you the freedom to make choices without worry, the confidence to learn from your actions, and the motivation to keep striving to do better,” says Linda Dale, RN, BA, CDE, Clinical Nurse Specialist in the Outpatient Diabetes Education Program at the University of Michigan Comprehensive Diabetes Center in Ann Arbor, Michigan. “Monitoring tells you that what you’re doing either is working or isn’t, and it serves as motivation to keep up actions that are working or to make changes.”
The important thing is to know how to interpret the numbers and take the necessary action. For example, if you take insulin and your blood glucose is high, you may need to bolus, or take more rapid-acting insulin, to bring your levels down into range. If you manage your Type 2 diabetes with diet and exercise, you might treat high blood glucose with a walk around the block.
People who use insulin and certain oral diabetes drugs are also at risk of developing low blood glucose, or hypoglycemia, which needs to be treated promptly when it occurs. Regular monitoring may enable you to catch and treat it early, and any symptoms of hypoglycemia should be checked with a meter reading.
Over time, blood glucose monitoring records can be analyzed for patterns of highs or lows that may suggest that a change is needed in the treatment regimen.
“Regular monitoring is especially helpful for showing the positive effects of exercise,” says Dale. “Say your readings have regularly been around 140 mg/dl, but you start taking a walk every day and you start getting more readings around 120 mg/dl. That will definitely boost your motivation.”