An important part of managing your diabetes is knowing — and understanding — how it’s doing.
For many people with diabetes, monitoring blood sugar levels is a key part of diabetes self-management. Sure, your hemoglobin A1C gives you a good idea of how things are going, but your A1C level is really a marker of average glucose levels over the past two to three months. And while, ideally, it’s best to get your A1C checked four times a year, many people only get their A1Cs done every six months or sometimes even only once a year.
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Your daily blood sugar snapshot
It’s always helpful to look at the big picture when it comes your diabetes. But in order to see how your diabetes medications, your food choices, and/or your physical activity are affecting your blood sugars on a day-to-day basis, you need to check your blood sugars with a meter, a process called blood glucose checking or doing “finger-sticks.” Think of blood glucose checks as a “snapshot” of how your diabetes is doing at a moment in time. Some people with diabetes use a continuous glucose monitor (CGM) instead of a blood glucose meter; a CGM provides continuous glucose data, 24 hours a day, allowing the user to view their glucose levels every few minutes.
Who should check blood sugar?
If you’re not checking your blood sugars or aren’t sure if you should be, it’s always a good idea to talk with your healthcare provider or a diabetes educator. The American Diabetes Association suggests that the following people check their blood sugars:
· People who take insulin
· Women with diabetes who are pregnant
· Anyone who is finding it hard to manage their blood sugars
· People who have low blood sugars (hypoglycemia)
· People who have “lows” and don’t feel symptoms
In addition, whenever there is a change in your diabetes treatment plan (for example, changing the dose of a medication or starting on a new medication, or making a change to your eating plan), it’s helpful to check your blood sugars so that you and your healthcare team know if the change or changes are working or if adjustments may be needed.
You’re checking blood sugars; now what?
Great job if you’re checking your blood sugars! But there’s more to checking than just doing a finger-stick. The next step is to track your blood sugars. How? One option is using good old pencil and paper (aka, a logbook). Many glucose meters come with a logbook; you can also purchase logbooks online (check out this logbook on Amazon) or download free logbook sheets online. You can also create your own logbook using your computer or laptop, say, with a program like Excel.
Most logbooks are designed for you to enter your blood sugar levels, obviously, but many also provide space for you to enter medications, carb grams and physical activity. There may even be a section to make note of things that can shed more light on your glucose levels, such as illness, stress, travel or forgetting to take your medicine.
Not a big fan of using logbooks? No worries. Technology makes so many things simpler, including tracking blood glucose levels. As the saying goes, there’s an app for that, and there are quite a few apps that you can use to track and manage your blood sugars.
Blood sugar tracking apps
Some apps are basic trackers; others come with many more bells and whistles, like reminders, food databases, and even the ability to synch with fitness trackers. Some apps can even notify you when your blood sugar is too high or too low. Some are free; others may cost a small fee. Using diabetes apps may help you lower your A1C, and may even help you lose weight, if you need to. Apps aren’t for everyone, however, so if you don’t have a smartphone or just don’t think they would work for you, you can always track your glucose levels with a logbook!
Making sense of your blood sugar results
It’s one thing to write down or enter your blood sugar levels in a logbook or electronically, but it’s another thing to try and make sense of the numbers. Your blood sugar numbers are data, after all, and they tell a story. But if you don’t know what to look for, the data can seem meaningless. Here’s how tracking your blood sugars can help you and your healthcare team:
It’s easy for your eyes to glaze over if you’re randomly looking at rows or columns of numbers. However, if you start looking for patterns, or trends of times when your blood sugar is high and/or low, things may start to make more sense. “Logging your blood sugars helps you be more aware of your numbers, and also can help you pay better attention to what’s going on with your diabetes,” says Patty Bonsignore, RN, CDCES, a nurse educator at Boston Medical Center.
Start by looking at your blood sugars at certain times, such as:
· when you wake up
· before and after each meal
· before going to bed
· before and after doing physical activity
Aim for at least three days of glucose readings at these times. Then, if you’re seeing patterns of highs or lows, or if you don’t see any patterns, think about causes and solutions. For example, if you notice that your blood sugars are high when you check first thing in the morning, possible causes might be eating too much carb at night, forgetting to take or not taking enough diabetes medicine, or even having a low blood sugar in the middle of the night. If you can’t make sense of your numbers because you don’t see patterns, let your healthcare provider or diabetes educator know. They can help figure out what may be going on and discuss solutions with you.
Why blood sugar logging can help
Logging blood sugars can seem like a lot of busywork, especially since you’re likely busy with so many other things. However, there really is value in logging. Here are a few instances where logging definitely is helpful.
It’s easy to be overwhelmed if you’ve just been diagnosed with diabetes. Starting on medication, changing up your eating habits, and trying to be more active can definitely take you out of your comfort zone. How do you know what’s helping and what isn’t? Answer: checking and tracking your blood sugars!
Changing or starting a new medicine
How do you know if your diabetes medicine is working? Checking your blood sugar certainly helps. Use your logbook or your app to note when you start a new medicine or make a dose change; if you’re seeing low blood sugars, or if you see that your blood sugars continue to remain high, for example, let your provider know. The information will help to determine if a change is needed.
Using advanced carb counting
If you’re using an insulin-to-carb ratio and correction factor, you need to know what your glucose levels are in order to determine how much and when to take fast-acting insulin. Keeping tabs on your blood sugars can let you and your healthcare team know if your insulin-to-carb ratio or correction factor is working, or if it needs changing.
You might be thinking, why do I need to keep a log or use an app when my meter tracks my blood sugars for me? Indeed, most meters allow you to store your glucose results. However, unless you look at those results, you’re not getting the big picture of what’s going on with your diabetes. Most meters these days download data to a computer or laptop, and provide an array of reports that basically slice and dice your data to show patterns and visuals of your glucose results. Granted, you may not want to download this data all the time, but periodically doing this can be helpful to you. By the way, if you use CGM, your CGM provides you with a similar tool (e.g., Dexcom CLARITY or LibreView) to allow you and your healthcare team to view your data.
Many people with diabetes check their blood sugars or use CGM, but the point is to look at your numbers to figure out how you’re doing and get an understanding of your diabetes management, overall. Bonsignore adds, “You don’t necessarily have to log all the time, but you might do some logging when your blood sugars are running high or low, for example.”
Making the most of appointments
Whether you’re at an appointment with your primary care provider, endocrinologist, diabetes educator or dietitian, it’s likely that a discussion of your blood sugars will occur. Be prepared for upcoming appointments — this means checking blood sugars regularly (maybe even a little more often than usual, such as before and after meals) and keeping track of the results. Here’s where a logbook or an app can be extremely useful. Your meter’s memory will do the trick, too — just make sure that you’ve correctly set up the date and time so that results are recorded accurately. You should also check to make sure that the provider’s office is able to download the data. And don’t forget to bring your meter to your appointment.
Also, do your homework before your appointment. This means reviewing your glucose readings to look for patterns and events, such as an illness, so that you can make the most of your appointment. Rather than telling your provider, “My blood sugars have been too high,” for example, you can show your provider specifically when your blood sugars are high, as well as how medication, food and exercise have been affecting your readings.
What if your provider doesn’t ask to see your blood sugar results? Pull out your logbook or open up the app on your phone and ask them to take a look! It helps, too, if you raise specific issues, such as a concern about hypoglycemia during the night or why you think the dose of your insulin may need tweaking. Numbers can speak volumes, so don’t be shy about talking about them. Realize, though, that your provider may not have time during your appointment to sift through weeks or months of data; aim have about two weeks’ worth of numbers to share.
Learn more about blood sugar tracking in “Analyze This: Interpreting Your Blood Sugar Monitoring Log.”
Want to start keeping track of your own blood glucose patterns? Download our free printable blood glucose log book sheets today!