Step 5: Monitor your blood sugar

Checking your blood sugar level with a blood glucose meter (glucometer) is one of the most important steps you can take in managing your diabetes. Regular self-monitoring will give you the best chance of success.

The only way to know your blood sugar level is to test it. Some people say that they can feel when it is high or low, but that type of guesswork is NOT accurate. When you keep track of your blood sugar you will:

• Start to see patterns that will help you plan meals, activities, and what time of day to take your medications.
• Learn how certain foods affect your glucose levels.
• See how exercise can improve your numbers.
• Provide your doctor with important information regarding the control of your blood sugar, which will help your doctor make recommendations for your care.

How to test your blood

The traditional glucose meter comes with test strips, small needles called lancets, and a logbook for recording your numbers. There are many different kinds of these meters, but they all work essentially the same way. A complete testing kit can be purchased from a pharmacy without a prescription. Your doctor or nurse can help you choose the equipment that's right for you, help you set it up, and teach you how to use it.

At first, some people worry and feel squeamish, but they quickly become comfortable with it. You will do fine!

See an illustrated series explaining how to monitor your blood glucose.

Glucose checks are often done 2 or 3 times a day, but you should determine the timing and frequency with your doctor or nurse. Often, blood sugars are checked when you wake up and then 2 hours after a meal. Goals for blood glucose levels are usually under 130 when fasting and under 180 2 hours after a meal. Your goals should be individualized for you.

Continuous glucose monitoring systems (CGMs) use a needle-like sensor inserted under the skin. They can provide readings as frequently as every 3 - 5 minutes. The sensor can store thousands of readings in an electronic diary and sound an alarm if glucose levels are too high or low. To date, these newer monitors are intended to supplement, not replace, traditional glucose monitoring, and you still need to check your blood sugar using a glucose meter about 3 times a day. CGMs can be paired with insulin pumps to help track your glucose levels and insulin doses.

Your doctor will test your HbA1c

The individual readings you do at home using a glucometer give a sense of your blood sugar at any given moment. They also track patterns when you keep an accurate log. In addition to home testing, your doctor will want to get a sense of your blood sugars over time. To do this, your doctor will periodically check your hemoglobin A1c (HbA1c). This test evaluates the average amount of sugar in your blood over the last 2 - 3 months.

Your HbA1c determines whether your blood sugar levels are under good or bad control. Keeping blood sugars under good control can protect you from many of the complications associated with diabetes. A reading under 7% is considered reasonable control. For some people it is even better to aim for less than 6%. Your HbA1c goal will be personalized and depend on many individual factors. Ask your doctor about your level and target goal.

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