Diabetes Self-Management Articles

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Questions For Your Doctor
Ensuring Good Care

by Jan Chait

“Take a class,” advises Janis Roszler, a registered dietitian and certified diabetes educator. “Not only do you get to hear a variety of experts and learn in a supportive environment, but you’re with people who are in the same situation. They may ask questions you might not think of asking, or are too uncomfortable to ask.” Taking a class — or having one-on-one sessions with a diabetes educator — also helps debunk some of the misconceptions about diabetes. “Treatments and attitudes have changed drastically,” Roszler says. “It’s not your grandfather’s diabetes.” And as you learn more about diabetes, the tasks you are being asked to do to manage the condition make more sense.

“How often should I check my blood glucose levels?”
Sorry, but “Oh, you don’t need to check” is not the correct answer. Monitoring your blood glucose levels can tell you how you react to different foods, exercise, stress, and illness. It can also help you remain in control by showing you whether you have a problem with high or low levels at certain times of day, which may signal a need to adjust your medicine or insulin doses. If you have Type 2 diabetes, which is a progressive condition (meaning that people often need to add medicines or begin using insulin to stay in control as time goes on), monitoring your blood glucose levels can let you know when you need to change your regimen.

How often should you check? Good question. You could check your levels before each meal, plus two to three hours after you first begin eating to see how the meal affected your blood glucose level. You can also check at bedtime, at 3 AM to see if you’re going low in the middle of the night, before and after — and even during — exercise, and in situations such as before you get behind the wheel to drive someplace if you take insulin or a medicine that can cause hypoglycemia (low blood glucose).

How often you check really depends on your situation, including the types of medicine you take, the level of control you are aiming for, and your economic situation. Since test strips can be expensive, even checking the four times a day generally recommended for people using insulin (before each meal and at bedtime) may be beyond your means if you don’t have insurance or have a low income.

In some cases, such as that of people with Type 2 diabetes who control the condition with diet and exercise, blood glucose monitoring may be recommended just one time a day — one day before breakfast, the next day before lunch, the next before dinner, and the next at bedtime, says dietitian and diabetes educator Dana Armstrong, former program director of the Diabetes Care Center in Salinas, California. People with Type 1 diabetes, however, need to check more often, “and this is a tough go without insurance,” she says.

In any case, ask your doctor or educator if he can give you a sample meter and some test strips to start you off. “I don’t think those are unfair things to ask for,” Armstrong says. You can also shop around for an economical store-brand meter that takes less expensive strips. Look for those at places such as Wal-Mart or Walgreens. There is also a brand of strips called the Sidekick Testing System that consists of a vial of 50 test strips with a meter built into the cap.

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