The words you use to describe blood glucose monitoring may affect how you feel about it. For example, it might help to call it a blood glucose check, not a test, because the word “test” implies pass or fail. It might also help to refer to blood glucose readings as either in or out of target range rather than “good” or “bad.”
It’s also good to remember that your blood glucose goal is to aim for a target range, not an exact number each time. Before-meal blood glucose readings of 101 mg/dl, 114 mg/dl, 126 mg/dl, and 97 mg/dl may look like they are up and down, but they’re all within the target range defined by the ADA.
When you begin to analyze your blood glucose readings, it is helpful to recognize the difference between an isolated reading and a pattern of readings. Say you check your blood glucose before lunch one day, and you get a reading of 246 mg/dl. You know that the reading is out of range, but so what? To make sense of that reading, you would need to know your pattern of blood glucose readings before lunch. If you checked three days in a row before lunch and recorded readings of 118 mg/dl, 110 mg/dl, and 113 mg/dl, you’d see that the reading of 246 mg/dl doesn’t fit your usual pattern before lunch and therefore isn’t noteworthy.
Knowing your pattern gives you a background for comparison. Isolated readings can still be helpful, especially when your blood glucose is low. But an isolated reading is meaningless without knowing the story behind it. And the story includes the factors that affect blood glucose level, including food, medicines, exercise, stress, and infection.
How often should I check?
Most people check their blood glucose level once a day, first thing in the morning. It’s a common time to check because it’s easy: You get up, check your blood glucose, take your medicines, and eat breakfast. Then you’re done with your diabetes for the day and don’t have to think about it anymore.
The problem with this routine is that it only tells you about your blood glucose pattern before breakfast. You don’t learn what is happening after meals or later in the day. To find meaningful patterns at other times of the day, you have to check at other times of day.
One option for finding more patterns is to check your blood glucose four times per day three days per week. Checking before breakfast, two hours after breakfast, before dinner, and two hours after dinner three times per week for a few weeks will help you identify your patterns throughout the day.
Try to make blood glucose monitoring a useful tool by checking your blood glucose at times that serve you. Blood glucose monitoring should help you make a decision, give you feedback about a decision, and help you learn about your usual patterns.
You also need to consider the cost of the test strips. For those who do not take insulin, Medicare pays for one strip per day, so you want to put those strips to good use. Instead of just checking before breakfast every morning, you might decide to check before and after breakfast on Monday, before and after lunch on Wednesday, and before and after dinner on Saturday. If you take insulin, Medicare and most health insurance plans will pay for the number of strips written by your health-care provider on the prescription.
There are many ways to keep track of your blood glucose readings so that you can evaluate the patterns. You can use a logbook in which you write down the readings along with any comments (such as what you had for lunch or how stressed you were feeling). Depending on what meter you use, you may be able to use computer software that displays the contents of your meter memory in graphic forms.
Here are some common patterns and probable explanations that will help you make sense of your numbers: