Your glucose meter is truly your own personal laboratory in the palm of your hand. Every person living with diabetes should have and use a glucose meter. Finding out your blood sugar level in relation to eating, exercising, sleeping, concurrent medical illnesses, emotional stress, medications, and all of the other many factors that can effect our glucose levels throughout the day and night is truly invaluable.

Home glucose monitoring (HGM) is not just pricking your finger and writing the result in a log book for your health care provider to look at during your next appointment, which may be weeks or even months away. HGM is knowing what your individual blood glucose goals are and then doing something about any abnormal values to get them back into a desirable range. One of the biggest barriers that I see as a diabetes specialist is that people with diabetes are not educated about how to act on their results, leading to frustration, helplessness, inaction and chronic poor control.

If you are a person with type 1 or type 2 diabetes on insulin, is impossible to keep your blood glucose values in a desirable range most of the time without testing on a regular and frequent basis. How can you know if you took enough insulin or too much, before your daily meals? How can you correct or know how much extra insulin to take if you were unexpectedly high? How can you avoid hypoglycemia during exercise and other activities like driving a car or caring for a young child? Please do not tell me that you can “feel” whether you are too high or low, and that you do not need to test!

One of the controversies in the medical arena is whether or not people with type 2 diabetes, treated with oral medications alone, should perform HGM. Besides, those glucose test strips are expensive and why poke into our limited heath care dollars (and fingers!) if testing does not make a difference? If you have type 2 diabetes treated only with Glucophage (common oral medication for diabetes that does not cause hypoglycemia) and have never had an A1c greater than 6.5%, then you certainly do not need to test on a regular basis. However, if you are a 57 year old male with type 2 diabetes in poor control and on several oral medications, HGM can help you and your caregiver make the proper medication adjustments and/or additions. The results can also be a powerful behavior modification tool in terms of your food choices and portion sizes as well as seeing the beneficial effects of exercise.

Individualizing your HGM testing schedule is crucial to getting the most out of the results. For example, a person with diabetes taking fast acting insulin before meals may need to test before and 2 hours after most meals in order to stay off the blood sugar roller coaster. On the other hand, a person on oral medications may only need to test once a day alternating between first thing in the morning and two hours after the largest meal.

Consider this challenge: If you are not content with your A1c, take a look at the average blood glucose feature on your meter. My meter gives me an average for the last 2 weeks, as well as the number of times I’ve tested in those time periods. If you’d like to use your meter a little more effectively, push yourself to get the 14 day average inside your goal blood glucose value window. As for frequency, if you only have part of the blood glucose picture, challenge yourself to get enough data to get your blood sugars in control.

The key is to test at times that will give you information on how your medications are working and/or how your daily lifestyle is affecting your control. Remember that your glucose meter is your own personal laboratory in the palm of your hand. Know when to test and know what to do with the number!