Effective Monitoring of Diabetes

As a diabetic patient, it is important for you to know what is going on with your blood sugar. In the article titled 'Know Your Diabetes Type and Symptoms', we have outlined the symptoms of diabetes. You may experience these symptoms when the levels of your blood glucose change. Sometimes, you may not observe any change at all. Hence, it is important for you to understand the need and method for monitoring your blood sugar levels.

Closely monitoring your blood glucose levels can help you keep your blood glucose levels in control, without causing them to go too high (known as hyperglycaemia) or too low (known as hypoglycaemia).

Basics of blood glucose monitoring

Getting the blood sample

  • Wash your hands thoroughly

  • Shake your hands back and forth in a pendulum-like motion to move the blood to your fingertips

  • Stick in the lancet deep, but not too deep

  • Get a blood sample from a different finger each time—do not use the same finger for regular testing

Using the meter

  • Read the directions for use before using the meter

  • Clean the meter regularly as per the instructions provided with the device

  • Calibrate the meter for a fresh batch of strips by testing 3 blank strips or as indicated by the manufacturer

  • Do not use damaged strips

  • Always use only manufacturer-provided strips

When and why to test?

Testing around mealtime

  • A fasting blood sugar test can tell you if your medication and bedtime snack are keeping you at safe blood sugar levels overnight or in other terms help to establish a baseline for managing diet and therapy

  • Test your blood sugar levels before lunch and dinner. It will help you decide on appropriate foods, portion sizes and the dosage of your insulin or medication

  • To get accurate measurements of your blood sugar levels, test 2 hours after meal several times a week. Recent studies have suggested that this may be more important than fasting tests, since it provides an indication about how your previous meal has affected your blood sugar levels. You can also prevent heart diseases by following this method. These test results will help you make informed decisions on meal planning

  • It is important for you to have a diet target and follow it. Diet target is the difference between your pre-meal and post-meal blood glucose levels. If this difference in the blood glucose levels is as per the diet target set for you, it indicates that your food choices and portions are appropriate and working well. Consult your doctor/diabetes educator to know your diet target

Adjusting around medication

Be sure to test your blood glucose levels in conjunction with any adjustments made in the dosage of insulin or any other diabetic medication. This will help you understand your body's reaction to the medication prescribed by your doctor.

Instances needing increased glucose monitoring

  • When you make major changes to your eating, sleeping or exercise routines (including changes caused by travel and time zone changes)

  • When you are ill or under stress

  • If you change your medication

Quarterly HbA1c testing:

In addition to your daily blood sugar testing, include a quarterly glycated haemoglobin (HbA1c) test in your glucose monitoring programme. Since the level of HbA1c is the average of your total blood glucose over a period of 3 months, it provides a good measure of blood glucose control over time. It can be used to predict your risk of developing complications associated with diabetes. It is important to measure the level of HbA1c in addition to your regular blood glucose levels. Your doctor/diabetes educator can set a target HbA1c level for you that can be achieved by acting on the information you get from daily blood sugar testing.

What else should be carried out?

Regular and periodic monitoring of urine sugar levels is important. You could get your urine samples tested after consulting your physician. Ensure that the urine sample is collected in a fasting state first thing in the morning. Although measurement of urine glucose is a painless alternative, it works only if you have noticeable levels of urine glucose.

Disclaimer

  • Issued in public interest by Novartis

  • “Always consult your doctor for any medical advice”

  • “The information contained here is not to be used for treatment purpose or for diagnosis of health problems or as a substitute to expert medical advice. Please consult your doctor for any health related problems or queries that you may have. Although great care has been taken in computing and checking the information, Novartis is not responsible or liable in any way for any errors, omissions or inaccuracies in or otherwise howsoever for any consequences arising there from"

References

  • Saudek MD, Christopher D. Johns Hopkins Guide to Diabetes: For Today and Tomorrow. Large Print ed. Baltimore, MD: Johns Hopkins University Press; 2001:64-65,72-73.

  • Taber’s Medical Dictionary. http://www.tabers.com/tabersonline/view/Tabers-Dictionary/759478/all/hyperglycemia?q=hyperglycemia#1. Accessed October 27, 2014.

  • American Diabetes Association. Standards of medical care in diabetes-2013. Diabetes Care. 2012;36(Suppl 1):S11-S66. doi:10.2337/dc13-s011.

  • Holt T, Kumar S, Watkins P. ABC of Diabetes. Chichester, UK: Wiley-Blackwell/BMJ; 2010:56.

  • International Expert Committee report on the role of the HbA1c assay in the diagnosis of diabetes. Diabetes Care. 2009;32(7):1329. doi:10.2337/dc09-9033.

  • Hillson R. Practical Diabetes Care. 2nd ed. Oxford, UK: Oxford University Press; 2005:52.

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