Blood Glucose Monitoring

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For patients with diabetes to be in control of their diabetes, constant blood glucose monitoring must be done to ensure levels are not too high (hyperglycemia) and do not go so low that the diabetic risks hypoglycemia.

The results of the tests will let the diabetic know if their diabetes treatment is working based on their activity level, the foods they eat and the Insulin they take.

Unlike other tests that must be performed in a doctor's office or at a hospital, daily monitoring of blood glucose levels must be done by the patients multiple times each day. For many, this is the most daunting task that interferes with their day. This is why more and more people are choosing to have insulin pump therapy with continuous glucose monitoring.

There are two different ways to monitor blood glucose level.
The first is random blood test, which requires the diabetic to give themselves a fingerstick with a small needed called a lancet. Using test strips and a drop of blood, a glucose meter will read the level of blood glucose the diabetic currently has in their bloodstream. Testing on blood will give glucose levels over a period of minutes.

The second test is a urine test, which test glucose levels over hours. At one time, urine tests were used for daily monitoring, however, monitoring is no longer done that way. There are times when a urine test is beneficial, such as if a fingerstick test shows a reading of 240 ml/dl or higher, if the diabetic is under prolonged stress or if they have feelings of nausea, vomiting, or abdominal pain, which might indicate ketoacidosis. A urine test taken throughout the day will give a clear indication of when sugar is being passed through the urine.

The urine ketone testing kit is available at local pharmacies without a prescription from the doctor. The diabetic can urinate into a cup and dip a test strip into the urine, or place the test stream into the stream of urine. After waiting the required amount of time, the test strip should be checked against the readings on the kit. If ketones are present in the urine, the test strip will change color. The darker the test strip changes, the more ketones are present in the urine.

The type of treatment the diabetic is currently having, whether once per day insulin injections, multiple insulin injections or insulin pump will determine how many times per day the diabetic needs to test their blood glucose. Generally, the diabetic will need between 3 and 12 tests per day.

Regardless of the type of treatment the diabetic has, a baseline 24 hour test should be done at least once every other week. A 24 hour test is very much like regular monitoring, however, the test goes a step further. Not only is a fingerstick blood test done before meals, but another test is done 1 ½ to 2 hours after meals and snacks. Another test is done during the night, usually between 2-3 AM, to test levels during sleeping hours.

All test results need to be recorded by time, date and the dose given after the reading. Notes should also reflect information about stress factors, illness, and symptoms of ketoacidosis. The diabetic should bring these notes with them when they visit their doctor so they can be reviewed to identify daily patterns and so that adjustments can be made to their treatment, if necessary.

Things to consider when testing blood glucose levels.
  1. The accuracy of the tests can be affected by the blood glucose meter the diabetic uses. There may be slight variations in readings between glucose meters, therefore, it's best never to use someone else's meter as you may get a false reading.
  2. During episodes of hypoglycemia a blood glucose meter may not be as accurate because the glucose level has dipped too low.
  3. Test strips can vary from batch to batch. Therefore, if you get a reading on a new batch of test strips that you don't feel is accurate, take the test again and make a note of it in your blood glucose log. Never mix different batches of test strips together and always store them as required on the package.
  4. If the fingertips are particularly sensitive, testing can be done in other areas of the body, such as the arm, hand or leg. However, keep in mind that when the diabetic needs to take a test because they will be exercising heavily or they feel their blood glucose level is going low rapidly, testing in alternative areas may give a delayed result compared with a fingerstick.