Download Diabetes Blood Sugar and Glucose Testing

Blood Sugar and Glucose Testing
While diabetes is a chronic disease with no known cure, people with diabetes can lead healthy
lives by proactively managing their disease. Diabetes disease management includes elements of
lifestyle and behavior changes and proper monitoring.
Everyone with diabetes should test their blood glucose levels regularly. If your levels are not
near your target blood glucose, knowing your blood glucose levels allows you to alter your
diabetes management strategy. Regular testing of your blood glucose levels also can help reduce
your risk of having long-term complications from diabetes.
Based on studies of people with type 1 diabetes (Diabetes Control and Complications Trial) and
type 2 diabetes (United Kingdom Prevention of Diabetes), maintaining near normal blood
glucose and A1c significantly reduces the risks of complications arising from diabetes.
Self-monitoring
Testing your blood glucose levels regularly at home is an important step in managing diabetes.
Keeping a log of your blood glucose results, as well as the effects of lifestyle factors, such as diet
and exercise, is an important step in optimally managing diabetes. This is especially true for
individuals who take insulin, because the timing and dosing of insulin is more effectively
ascertained with patient involvement.
Self monitoring of blood glucose is a key component in:
 Controlling blood glucose levels within target levels
 Guarding against and detecting for hypoglycemia and hyperglycemia
 Making adjustments to medication because of lifestyle changes
 Signaling the need for insulin therapy in gestational diabetics
Home testing
People with diabetes have a vast array of options for testing their glucose levels at home. More
than 25 different glucose meters are currently available. Consulting with a physician is
recommended, because not all glucose meters are well suited for your specific needs and
preferences.
The traditional method of testing your blood glucose involves pricking your finger with a lancet
(a small, sharp needle), putting a drop of blood on a test strip, and then placing the strip into a
meter that displays your blood sugar (glucose) level. Meters vary in features, readability (with
larger displays or spoken instructions for the visually impaired), portability, speed, size, and cost.
Current devices provide results in less than 15 seconds and can store this information for future
use. These meters also can calculate an average blood glucose level over a period of time.
Some meters also feature software kits that retrieve information from the meter and display
graphs and charts of your past test results. Blood glucose meters and strips are available at your
local pharmacy
Testing frequency
The American Diabetes Association® (ADA) recommends that patients taking more than one
insulin injection a day or who are on an insulin pump test themselves at least three times a day.
For other patients with diabetes, no standard guideline exists for the number of tests, but regular
testing is a smart move because it is shown to decrease the incidence of unwanted complications.
Individuals who take oral sulfonylureas or meglitinides are at higher risk for hypoglycemia, so
they should test their blood sugar more often, possibly two to four times per day until glycemic
control is reached. Individuals who take other oral hypoglycemics or who control their blood
sugar with diet and exercise may not need to test daily. Your health care provider’s input is
needed to establish your testing regimen.
How glucose monitors work
The basic mechanism for most glucose monitors is the same. A small blood sample is collected
by using a sterile needle (lancet), placed on a test strip, and then analyzed to determine the
amount of blood sugar (glucose) present. The fingertip is the traditional site for sampling, but
newer models allow for alternate sites, such as the forearm, which may provide a more
convenient location and less pain. However, some of these alternate sites are not as accurate.
Blood glucose levels in the fingertips show changes more quickly than those in alternative
testing sites. This is especially true if your blood glucose is rapidly changing, such as after a
meal or after exercise. It also is important to know that you should not rely on these test results if
you are checking your blood sugar at an alternate site when you are experiencing symptoms of
hypoglycemia.
The method for analyzing the samples ranges from using electrical conductivity to measuring
color and/or light reflection off of the test strips. Test strips generally have chemicals such as
glucose oxidase, dehydrogenase, or hexokinase, which react with the glucose in different ways.
Glucose level guidelines
A person who does not have diabetes should have a glucose level of around 4.5–7.0 millimoles
(mmol)/liter (L) (80 to 125 milligrams [mg]/deciliter [dL]).
The ADA recommends the following blood glucose levels for persons with diabetes:
Time
Before meals
Before bedtime snack
Ideal Adult Level
70–130 mg/dL
180 mg/dL
The ADA publishes a review of available glucose meters and other diabetes supplies in the
annual Diabetes Forecast Consumer Guide found online at http://www.diabetes.org/formedia/2009/2010-forecast-consumer-guide.html.
References and recommended readings
American Diabetes Association. Blood glucose control. Available at:
http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucosecontrol/?loc=DropDownLWD-promo1. Accessed June 15, 2012.
American Diabetes Association. Standards of medical care in diabetes—2012. Diabetes Care
[serial online]. 2012;35(suppl 1):S11-S63. Available at:
http://care.diabetesjournals.org/content/35/Supplement_1/S11.full. Accessed June 15, 2012.
Review Date 6/12
D-0599