One of the most important management habits that you must develop when you have diabetes is to test your blood levels daily. A blood glucose monitor is essential when maintaining your level management. If you are too high or low you can do preventative actions to help bring you back to a normal level.
Sometimes depending on your day and how things are occurring, you might have high or low levels but this is not an indicator of doing something incorrectly. Food, sleep, anxiety, or stress can affect your levels. The information provided by the monitor is good information for you to determine our next course of action, whether you need to have more sugar or you need to exercise or even change your diet to improve the numbers.
The steps needed to provide you with good monitoring are:
1. Make sure you have a good blood-glucose monitor.
- If you have insurance that covers the costs, your pharmacist usually will provide you with a good monitor. Some manufacturers have low costs for monitors if you have out of pocket expenses. Some considerations when choosing a monitor:
- blood sample size;
- ease of use;
- size of monitor;
- size of display screen;
- memory of monitor- (most have a memory and store your results);
- USB port which enables download for your data for reports;
- Some have Bluetooth ability for wireless transfer to an insulin or to an app;
- Some have a bolus calculator for determining insulin doses;
- If you are visually impaired, choose a large meter display and get your doctor to write a letter of necessity for your insurance company; and
- If you are type 1, some meter have the ability to check ketone levels. You can always do this with urine tests using testing strips that check the blood ketone levels.
2. Safely getting your blood sample.
- Make sure your hands are clean and dry before testing. If you have anything on your hands, it may result in an incorrect test. If you touch fruit, it leaves residue on your hands and the blood sample will include the residue in your test. If you can’t wash your hands, use alcohol swabs or gels to clean your fingers.
- The lancing devices have adjustable levels so you can pick the appropriate level to get a blood sample. Use the side of your finger as it has less nerves. Rub or activate the area you are going to lance. After lancing make sure that you squeeze below using your other hand and apply some pressure while sliding your finger up to the lanced area. If you don’t have enough blood you will have an error indicator on your monitor and will have to lance again. With practice this gets easier.
LANCETS AND NEEDLES
3. Acknowledge error messages.
- Most likely you will get different readings every time you lance if there is an error reading. Regulations require a result within plus or minus 20 percent margin error. Most of the devices have a 10-15 percent error rate. If you have a blood disorder you are likely to get incorrect results. High altitudes affect the results as well as lower temperatures. Because of the errors resulting in temperature it can be difficult to test your blood. The best method is to keep strips in the container protected from the elements and weather and review your monitor for error messages and variable which affect it.
Blood Glucose Testing Strips and Monitor
4. Ensuring accuracy.
- Check your test strip expiry date which is found on the container and do not use expired strips. Make sure that the strips are carried in the original containers and are sealed completely. Store you strips away from heat, light or moisture and do not store them in your washroom because of humidity.
- Some strips allow you to take samples from other areas such as your arm but be aware that the blood is not as accurate when testing. You should use your fingertips before and after eating because of the flux of the level you will experience. I have psoriasis and it is on my right hand and fingers so when I am testing I try to find the best spot away from my affected fingers.
- Bring your meter with you when you have a medical or doctors appointment. Your doctor can help assist you if you are not testing correctly. If you have to have blood testing done you should test your blood so you can compare results with the blood testing.
5. Disposal of strips and lancets/needles.
- The recommended procedure is to put in a new lancet or needle each time you test. the needles will become dull over time if reused, can bend and hurt more.
- Always dispose of your strips and needles in a container called a sharps container.
- When the container is full you can bring them to your pharmacist for disposal. Used needles cannot go in regular garbage because of blood contamination. You do not want to pass on or risk passing on serious diseases. Some cities have needle disposal exchange programs which you can research to find out the correct information and disposal guidelines. Pharmacists will usually give you a sharps container to take home. I leave my container in a closed closet because we have pets and I do not want them to get near the container and injure themselves. I advise you to keep it located away from small, curious hands as well.
6. Vary your test times.
- This is advisable when you first start testing but after a week or two you need to test in the mornings only when you are about to eat and after. This ensures better accuracy results. I have to check once a day but sometimes it is necessary to check several times a day depending on your level of serious diabetes. Type 1 diabetics need to check more often than type 2 diabetics.
7. Know your blood glucose targets.
- Your doctor should advise you on what levels are needed for you to know your blood glucose targets. The average A1C targets are between 5-7. You need to consider other health factors when determining your targets. The US uses milligrams per decimiter (mg/dl) when assessing blood level testing. If you live elsewhere testing is done using millimoles per liter (mmols/L). Fasting BG under 15 mg/dl and post-meal BG below 160 mg/dl are usually appropriate levels if you have type 2 diabetes.
- If you use insulin and have a risk for hypoglycemia your targets should be 80-130 mg/dl before and BG of below 180 mg/dl after meals. You need to talk with your doctor to confirm your targets.
- I test using a monitor device that show levels that show it in a decidmal number. I usually have to stay between A1C of 5.0-7.0 and if I am higher I need to take preventative steps to lower the level and if lower I need to eat.
8. Keep a log.
- It is important to track your levels using a log. This data shows you and your doctors your glucose levels and they are able to diagnose you better and give you targets to achieve. Counting carbs and marking them down helps to highlight any areas where you may be having problems. The data also shows you several variables that are necessary in your daily activities including exercising, stress, or hypoglycemia. If you don’t keep a log do it for the first few weeks to determine your levels and help to give you a target and include intervention and diagnosing from your doctor.
Three Samples of Charts You Can Use
9. Get A1C done regularly.
- This lab test details your average blood glucose level over a 3 month period. The test measures how much glucose has attached to the hemoglobin proteins in red blood cells and other proteins in the body. This is important to help determine if you are being affected visually or if your nerves and kidnesy are affected.
- Knowng your A1C helps to show you results and where you need to target. The following chart shows appropriate A1C targets:
|NON-PREGNANT ADULTS||BELOW 7|
|KIDS AND TEENS||BELOW 7.5|
|MEDICALLY COMPLEX PATIENTS||BELOW 8|
A1C TESTING FOR DIABETES
|NORMAL||LESS THAN 5.7|
|DIABETES||6.5 OR HIGHER|
Three Samples of A1C Charts
I hope this helps you with targeting and getting to know your levels and adjusting to make sure you are doing the right things to keep balanced. The next article I am going to be writing about is a continuation of the foods, carbs and intake for appropriate levels and maintenance.
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