Self Monitoring of Blood Glucose

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Research shows that keeping blood-glucose close to normal reduces diabetes complications. For better diabetes care, need to maintain the glucose level at target.

Tests for blood-glucose control

  • Use a glucose monitor to test glucose level at home called self-monitoring of blood-glucose (SMBG).
  • The A1C test gives an average blood-glucose level over the last three months. It is the best way to know your overall diabetes control performance. This test otherwise called as hemoglobin A-1-C or H-b-A-1-C.

For effective diabetes treatment, you need to use both the A1C and SMBG to get a complete picture of blood-glucose control.

Who should self-monitor their blood glucose level?

People who may benefit from checking blood glucose include those who are:

  • Taking insulin,
  • Pregnant women,
  • Struggling to control their blood-glucose levels,
  • Experiencing frequent low levels without usual warning signs, or
  • Having ketones from high levels

Home Blood-glucose monitoring

(Best Test for Day-to-Day glucose level monitoring)

  • Monitoring blood-glucose helps to see how food, physical activity, and medicine affect the glucose levels. The readings can help to manage diabetes day to day or even hour to hour. Keep a record of the test results and review it at each visit with the health care team.
  • Learn to test by yourself - Be sure and confirm with your health care team that you are performing the test in a correct way. Furthermore, know whether the meter gives the results as plasma or whole blood-glucose.
  • Below table shows both plasma and whole blood values of blood-glucose goals for most diabetics. Confirm what is your glucose meter output format is?
  • Test frequency – Blood-glucose test usually done before meals, after meals, and or at bedtime. Insulin users need to test more often than non-insulin’s. Ask your health care team for test frequency.
  • Home blood-glucose monitoring is for day-to-day diabetic care, still need the A1C test for long-term diabetes care.

The A1C Test

(Best test for Long-Term blood-glucose monitoring)

  • A1C test is a simple test that gives an average blood-glucose level over the last three months. You can take the blood sample to check A1C at any time.
  • A1C test is the best test to judge effectiveness of the diabetes treatments.
  • For most people with diabetes, the good A1C goal is less than 7.
  • You should test A1C at least twice a year. Get the test more often (once in three months) if the blood-glucose stays too high or if your treatment plan changes.

Criteria for individualizing your target blood-glucose range

Individualize your target blood-glucose range based on the five important factors, they are:

  • How long you are having diabetes.
  • What is your life expectancy?
  • Other conditions you have, such as blood pressure, cholesterol, etc.
  • Do you have any cardiovascular condition?
  • Do you have asymptomatic low blood-glucose level?

The generalized diabetes target glucose level

•    Pre-prandial plasma glucose (before a meal) is 70–130 mg/dl (3.89 to 7.23 mmol/l),
•    Postprandial plasma glucose (after a meal) is less than 180 mg/dl (10 mmol/l),
•    At bedtime is 100 to 140 mg/dl (5.56 to 7.78 mmol/l)
•    A1C is of less than 7%.

When do you need change in treatment?

If your pre-meal blood-glucose is consistently

  • Below 70 mg/dl (3.89 mmol/l) or
  • Above 140 mg/dl (7.78 mmol/l)  

Alternatively, your bedtime range is steadily

  • Lower than 100 mg/dl (5.56 mmol/l) or
  • Higher than 160 mg/dl (8.89 mmol/l),

Then you properly need to modify your treatment regimen, consult your doctor. However, more stringent target may be appropriate for some individuals with increased risks. Blood-glucose goals may be different for children, adult, or other who is at greater risk for hypoglycemia.

Benefits of self-monitoring blood glucose

  • You can learn which foods are best for your blood-glucose control as well as which foods are most harmful to your diabetes control.
  • You can know what physical activity, and the duration of the activity is right for you, so that you can avoid activities that have ill effects on your health.
  • You can identify your blood-glucose levels rise or fall at any particular time, helps to decide when to do exercise or take snakes.
  • Once your master how your blood glucose is influencing by different factors then naturally your anxiety lowered regarding the blood-glucose level, thus chances are more for efficient control.
  • SMBG provides useful information for you and your doctor, how well your treatment is producing results.

The important aspect of diabetes management is blood glucose tracking. Managing your blood glucose level at or near normal range can help prevent or delay serious diabetes complications such as nerve damage, eye problems, kidney disease, heart attack and stroke.

However, your blood glucose levels may fluctuate through the entire day, thus it is important to track your HbA1c levels quarterly. HbA1C provides a long-term measure of your blood glucose levels.

In addition to diabetes if you are having other related health conditions such as high blood pressure and/or high blood cholesterol, then it is important for you to track this condition too.

How frequently should a diabetes type 1 have to test their blood-glucose level?

Type 1 diabetes should measure their blood-glucose levels every day before meals.
Some individuals are testing their blood glucose once or twice daily, while others do it four or five times. Testing in the morning, during the wake up (before taking any food) help provides you how much insulin you need.

How frequently should diabetes type 2 tests their blood-glucose level?

Type 2 diabetes treating with oral medications should measure your blood-glucose level once or twice a week. It is preferably to test either before meals or after 90 minutes of a meal. However, if you are on insulin instead of oral medication (or in addition to oral medication), then your blood-glucose measurement will be more frequent consult your doctor.

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