By Steve Edelman, MD
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! Knowing your blood sugar level in relation to eating, exercising, sleeping, concurrent illnesses, emotional stress, medications, and all of the other many factors that can effect our glucose levels throughout the day and night is invaluable.
Glucose monitoring is more than just pricking your finger and writing the result in a log book for your healthcare provider to look at during your next appointment, which may be weeks or even months away. It 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 I see as a diabetes specialist is that most people with diabetes do not have enough information regarding how to act on their results, which leads to frustration, helplessness, inaction and poor control.
No more fingersticks??
If the fingersticks are a hurdle for you (and trust me, I get it!) a brand new technology for glucose testing without fingersticks was just approved by the FDA. Abbott’s FreeStyle Libre device is a “flash glucose monitoring system” that measures glucose levels with a quick and painless sensor swipe. No fingersticks are required and you get real-time glucose readings as often as once per minute. You can read more about it here.
Don’t rely on how you feel!
If you are a person with type 2 diabetes and on insulin, it is impossible to keep your blood glucose values in a desirable range most of the time without testing on a regular 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!
If you have type 2 diabetes, are on several oral medications and your diabetes is not in great control, glucose monitoring can help you and your healthcare provider make the proper medication adjustments.
Individualizing your glucose monitoring testing schedule is also key 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.
Your meter has cool features – use them!
If you want additional information other than your A1c, take a look at the average blood glucose feature on your meter. Your meter gives you an average and a standard deviation (how much you bounce around) for the last two weeks and longer, as well as the number of times you have tested in those time periods. You can use this feature to compete with yourself to get the 14-day average to your goal level, such as below 150mg/dl for example. As for frequency, you need to test enough to make that average meaningful. If you only test 3 times in one week the average does not mean much, but on the other hand, testing 2 or 3 times a day can be informative.
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 right in the palm of your hand. Know when to test and know what to do with that number!