Effective management of your diabetes often requires regular testing, especially if you are aiming for tight control. Home blood glucose monitoring uses small portable meters to accurately measure glucose concentrations in finger prick blood samples. Refer to the leaflet on 'tight control' for more advice on the benefits and difficulties of achieving tight blood sugar control.
HBGM provides useful information for you and your carers to
There is no reason why anyone with diabetes should not measure their blood sugars, however certain people are strongly advised to do so
Discuss this with your doctor or diabetes nurse. As a general rule test at different times of the day, rather than at a single fixed time each day. It is useful to have a general idea of your blood glucose before breakfast, lunch and dinner and at bedtime. Blood glucose concentrations two hours after meals also provide useful information. Remember that blood glucose levels go up and down all the time. Eating will make your sugar go up; exercise, insulin and oral hypoglycaemic tablets will make your sugar go down.
It would be nice to have information about your glucose concentrations 4-6 times a day but this is not very practical and we would not usually ask you to do this unless you happen to be pregnant! If your control is good, a single reading each day is adequate for most people providing you sample at different times from day to day.
Fingers being sensitive, sore fingers are an occupational hazard of checking your blood sugars frequently ! Reduce the pain factor by avoiding overly frequent sampling and by using the side of your fingers rather than the pulps. Also avoid using alcohol to wipe your fingers before a test. Studies have shown it does nothing to prevent infection.
It also helps to use different fingers - you have ten to choose from! One of my patients had a particular finger assigned for each day of the week ! This allows the site to heal before you inflict another 'stab'.
Some modern meters use very tiny amounts of blood, thereby reducing the depth of finger stab which is necessary. This can also influence the pain factor.
Blood sugars vary throughout the day. Target blood sugars will also vary according to how tightly you need to be controlled. Your doctor or nurse will advise you on the range of blood sugars you should aim for.
Extra blood tests are useful during
Extra night-time tests are sometimes used to help identify the cause of nocturnal hypos.
Laboratory blood glucose measurements are more accurate when your blood glucose concentrations are very high or very low. Furthermore capillary (finger prick) blood gives a different reading from venous (arm) blood.
Most blood glucose meters have memory functions for storing reading. It is recomended, however that you keep a paper-based record or diary. Ask your diabetes nurse for a log book. Write down any comments on changes in food, activity, sickness or stress in the column provided.
Always bring your log book with you to clinic as it helps decision making !
The following features may be worth considering in selecting a glucose meter
If you are constantly on the move, a smaller meter may be more important to you. People with visual impairments may require a large display. If you like keeping paper records, memory functions may be less important. Most meters available on the market today are reasonably accurate within certain limitations.
Yes, if you are on tablets or insulin treatment, your doctor will be able to prescribe test strips and lancets for you on a standard NHS prescription. If you are on diet alone, you will have to purchase the test strips. The blood glucose meters, finger pricking device and control solutions are not available on prescription as yet.
Alternative site testing is now being trialled though still not in widespread use. Further information will be provided when available.
Some meters allow you to transfer the readings from your meter, using special software and a connecting cable, on to your Personal Computer. The data is then analysed by the Computer and made available in the form of graphs and charts. If you wish to have this facility check with your meter supplier before purchase as this is likely to involve an additional cost.
Dr Nishan Wijenaike, Consultant Physician,
West Suffolk Diabetes Service