November 15, 2014

Testing Your Blood Glucose When You Have Diabetes

At least everyone agrees how important blood glucose testing is except the American Diabetes Association and the American Association of Clinical Endocrinologists. Yet doctors will write articles for WebMD saying how important testing is. If we could only convince the ADA to take a firm stand and say we needed to test more often, then the insurance companies would allow reimbursement for more test strips with less restrictions.

For people with type 2 diabetes, there are several places to test and this depends on how well your blood glucose levels are stabilized and the medication you are taking.  If on insulin, it is your fingertips that should be use on each side and many people are able to use their thumbs. To do this, insert the new lancet into the lancing device and then insert a test strip into your meter. Then using the lancing device set to the correct depth, prick you finger. If enough blood is created, or if not carefully milk the finger to cause enough blood to pool for the test strip in the meter to be pushed carefully into the blood and wick into the test strip. Wait a few seconds and the meter will give you your blood glucose reading.

Most meters today will allow you to test at other sights and for most oral diabetes medications, this may be allowed. Just realize that for using what are termed alternate testing sites, the reading will be for a period of 15 to 25 minutes earlier than the time shown on your meter. Why the difference you ask? Because using the alternate sites is obtaining blood from a vein instead of an artery. The alternate test sites include your upper arm, forearm, base of the thumb, and thigh. You will normally receive different results from alternate sites. Blood glucose levels in the fingertips show changes more quickly than those in other testing sites. This is especially true when your blood glucose is rapidly changing, like after a meal or after exercise. If you are checking your blood glucose when you have symptoms of hypoglycemia, you should use your fingertip if possible, because these readings will be more accurate.

Checking your blood glucose levels may be required several times per day. Always as soon as your arise in the morning, before meals (preprandial), after meals (postprandial), and before retiring for the night. Depending on the medication(s) you are taking, it may be necessary before driving and before and after exercising. Because everyone is different, talk to your doctor about when and how often you should test your blood glucose. If you are sick or feeling like you are low, you will need to check your blood glucose more often.

Your blood glucose levels can be affected by many things, such as anemia, gout, high altitude, stress, illness, or if it's hot or humid. If you see unusual results, rewash your hands paying attention to the finger you will be using and thoroughly dry. If necessary, use the control solution to check the test the test strips. The following chart is published by the ADA for their ideal levels and the second chart is my suggestions.

ADA guidelines:
Time of Test Ideal for Adults With Diabetes
Before meals 70-130 mg/dl
After meals Less than 180 mg/dl

My suggestions:
Time of Test Ideal for Adults With Diabetes
Before meals 70-95 mg/dl
After meals Less than 140 mg/dl

Again, because everyone is different, learn to set your own goals with the doctor's knowledge and if things change, do not be afraid to contact the doctor.


Denise Elliott said...

Great article, Bob! What are your thoughts about safe ranges pre-exercise? I've always heard that no lower than 100 is safe but the upper number I'm quoted is 250 and that seems awfully high to me, so I'd love your thoughts.

Ila East said...

A number of years ago I was on a diabetes mailing list and someone complained about sore fingers. A person who was T1 and had been testing for a long time gave this example of the way he kept track of which finger he used.

Left hand was used on Monday, Wednesday, and Friday. Right hand was used on Tuesday, Thursday, and Saturday. Both hands were used on Sunday.

Before and after breakfast he used the index finger. The middle finger was used for before and after lunch. And the ring finger was used for before and after supper.

On Sunday, he used his thumbs and then any other fingers.

If you had to test more than 6 times a day, then he added thumbs for that day, but he never tested on the little fingers.

I've used this method for all these years and it has worked for me.

Bob Fenton said...

Denise, you have the numbers correct, I have looked for better numbers, but keep finding the same range. You would be amazed the number of type 2's that exercise with readings above 250. This is too high even to my way of thinking.

Bob Fenton said...

Ila, I say what works should be used. I have my own system and test before bedtime as well.