Sam was gaining weight and he knew why. Ever since his doctor started him on a diabetes medicine that might cause hypoglycemia, he frequently felt hungry and a bit shaky, especially late at night, and he realized he felt better after having a little snack. In fact, most nights he found himself getting up for a snack as many as four times after going to bed. He was convinced that he was genuinely hungry and that his blood glucose levels were low at those times.
However, he wasn’t checking his blood glucose level with his meter when the shaky, hungry feeling hit, nor did he have any plans to start. After all, he thought he knew what he had to do to feel better: eat! But his new nighttime snacking routine was leading to other problems: He was tired and irritable during the day and had trouble focusing at work. And at his next doctor appointment, his weight had risen to 225 pounds, which, on his 5′8″ frame, classified him as mildly obese.
At his doctor’s prodding, Sam made an appointment to speak with a diabetes educator. She explained to him that he could probably resolve his perceived hunger and shakiness during the night by monitoring his blood glucose levels at specific times. Reluctantly, Sam agreed to check his blood glucose with his meter before going to bed and again when he woke up in the morning. He was shocked by the results: His bedtime numbers were in the 160’s (mg/dl), and his fasting numbers before breakfast were in the 130’s. Based on how he was feeling, he had expected to see really low numbers, in the 50’s and 60’s!
The next step was to check his blood glucose during the night when he woke up hungry. He agreed that he wouldn’t eat anything unless his numbers were below 90 mg/dl and, to his surprise, they never were. After reviewing all of Sam’s monitoring results with him, the diabetes educator assured him that he was not experiencing low blood glucose (hypoglycemia) during the night. Sam was genuinely relieved. He admitted that because he lived alone, he was fearful of feeling ill during the night and not being able to get help. He realized that he had convinced himself that he was hungry so that he would eat, and this would keep his blood glucose levels from dropping too low during the night. Monitoring his blood glucose at various times and seeing his numbers for himself convinced him that he did not need his multiple nighttime snacks after all.
What about you? Could regular blood glucose monitoring help you resolve a problem you may be having with your diabetes management?
Monitoring your blood glucose gives you real-time information about how the decisions you make throughout the day affect your blood glucose levels. For example, monitoring can show you the effects of having a hamburger and milk shake for lunch or of taking a half-hour walk. Monitoring can also show you how emotional stress or a change in your daily routine affects your blood glucose levels. When you are ill, monitoring shows you how your illness is affecting your blood glucose levels and enables you to make any necessary changes to your diabetes regimen. (See “What Makes Blood Glucose Go Up or Down” for more things which may affect blood glucose levels.)
Regular monitoring may reveal patterns in your daily blood glucose levels. For example, you may see that you are consistently low at the same time every day. This may be caused by exercising at a particular time or by having too much medicine acting in your system at that time. Seeing patterns in your blood glucose levels helps to “connect the dots” between personal choices or situations and the effect they have on your blood glucose control. The patterns that show up in your monitoring records also allow your doctor to see how your medicines are working and whether changes need to be made. Learning to identify patterns in your blood glucose levels and how to respond to them helps you feel confident that you are doing your best to keep your blood glucose under control.