For those who take insulin once daily, use oral diabetes medicines, or control their diabetes with diet and exercise, blood glucose readings should be taken twice daily, at least while control is being fine-tuned. Ideally, the readings should be taken at two meals in a row and “rotated” from day to day. For example, on day one, check before breakfast and before lunch. On day two, before lunch and before dinner. On day three, before dinner and at bedtime. Then repeat the process from day one. This approach lets you see when your blood glucose level may be rising or falling.
Blood glucose readings by themselves are not of much use unless they are all running high or low, and for most people, that just isn’t the case. Most people have a mix of highs, lows, and normal readings, and the goal is to figure out what’s causing the highs and lows. So in addition to checking and recording blood glucose levels, it is important to record the amount of insulin or medicine taken and the time it was taken, the grams of carbohydrate consumed at each meal and snack, the type and length of exercise and other physical activities (such as housework, yardwork, shopping, and extended walking), as well as stresses that tend to affect blood glucose level such as illnesses, menstrual cycles, emotional events, and episodes of hypoglycemia.
For those who check their blood glucose twice a day, try to record the pertinent information between the two checks. For example, if you monitor your blood glucose before breakfast and lunch, record all carbohydrates, activities, insulin, and medicines taken from the time you wake up until just before lunch.
To get the most from your record-keeping, organize the information so that it is easy to analyze. A simple daily chart like the one here might serve as a good system. It is often helpful to line up several charts like these in a column so that a pattern of high or low blood glucose at a particular time of day can be detected.
Try it yourself
Whatever type of program you use to control your diabetes, you will benefit from keeping detailed, organized records. Don’t think of it as something you have to do forever; that might seem overwhelming. Try it for a couple of weeks, and then take a few quiet moments to play the role of the impartial physician. Look for patterns and trends. Is your blood glucose level consistently high or low at certain times of day? Do your records give any clues about why?
Nobody expects your blood glucose control to be perfect. But it is reasonable to expect good control most of the time. Every time you make a sensible adjustment, you get one step closer to good control.
So the next time you have an appointment with your doctor, show up armed with useful information and your own personal insight. Who knows? You might both learn something new!
How it works
Let’s have a look at how some people with different diabetes treatment regimens have used tables to find patterns. Examine the three excerpts to see if you can determine the causes of the fluctuations in their blood glucose levels.
Connie. The example here was provided by Connie, a 51-year-old woman with Type 2 diabetes who uses diet, exercise, and oral medicine to control her diabetes. Do you notice anything unusual about her blood glucose levels? What could possibly be done to get them closer to normal? Here are some observations based on her records: