You may be eating and exercising according to your healthcare team’s recommendations while faithfully taking your medications.
But how do you know if you are doing the right thing when it comes to self-monitoring of your blood glucose.
The answer is pretty simple: Regularly monitor your blood glucose level and keep a record of your progress.
Self-monitoring lets you:
–Check the impact of different treatment elements on your blood glucose and make adjustments, if necessary.
-Knowing the results early will allow you to take quick actions in restoring your blood glucose level to within a healthy range.
-Identify, quickly treat and prevent hypoglycemia or hyperglycemia.
Also, self-monitoring allows your healthcare team to measure the progression of your diabetes and adjust your medications accordingly. This is why you should self-monitor even when you show no signs of illness, and keep a record of the results.
When should you monitor your blood glucose?
Self-monitoring of blood glucose (SMBG) is the method of choice in assessing blood glucose control and prevent hypoglycaemia.
Self-Monitoring of Blood Glucose data can be used to adjust food intake, exercise, or pharmacological therapy to achieve pre-defined goals. The need for and frequency of SMBG should be re-evaluated at follow-up visits.
Self-Monitoring of Blood Glucose can be done using Glucose Meter.
How do You Measure Your Blood glucose?
The first step is to meet with a health professional. After identifying your characteristics and needs, she will recommend a glucose meter, which you can buy at a pharmacy, along with all the other materials necessary for self-monitoring: lancets (needles), a lancing device (to take blood), test strips and tissues.
You will then learn how to measure your blood glucose properly:
- Wash your hands with soapy water and dry them well.
- Insert the test strip into the glucose meter.
- Insert the lancet into the lancing device.
- Prick the end of a finger (on the side).
- Gently squeeze the end of your finger, if necessary.
- Apply the blood to the test strip.
- Wait a few seconds (the time varies by type of meter).
- Read and write down the result in a logbook or store it in the glucose meter.
According to the Malaysian Clinical Guidelines on Management of Type 2 Diabetes Mellitus (2009), the following practice is recommended.
Timing and Frequency of Self-Monitoring of Blood Glucose:
|Diet Only||Check before and after meal||Check after meal||Check after meal|
|On oral medication only||Check before and after meal||Check after meal||Check after meal|
|On insulin||Check before and after meal||Check before and after meal||Check before and after meal|
*Blood Glucose should be monitor just BEFORE the meal or 2 hours AFTER meal.
|Your blood glucose target|
Post-Prandial (After Meal)
4.4 – 7.0 mmol/L
4.4 – 8.5 mmol/L
Example of Self-Monitoring of Blood Glucose Log Book:
Some Tips for SMBG:
To minimize or prevent diabetes-related complications, always check blood glucose levels as directed by your primary care provider and learn the factors that may alter or affect those levels, such as eating certain foods, taking certain medications, stress, illness, and physical activity.
Although patients commonly check blood glucose levels several times a day (ie, before meals, 2 hours after meals, or at bedtime), if you are uncertain, ask your primary health care provider how many times you should check your blood glucose level each day.
Select a finger from which to obtain a blood sample, and use a lancet device on the side of the finger to obtain a sample. Always prick the side of the fingertip since that area is less sensitive than the flat side of the fingertip and is less likely to bruise. Try to alternate fingers each time a test is performed.
Test strips are for single use and unique for each meter. Test strips must be kept in the original canister, as any moisture can affect the integrity of the strip, and the containers should be kept closed. Check for expiration date.
Exercise, food, medications, and stress can affect your blood glucose level. If you notice any abnormal reading during SMBG, write down the possible factor that may contribute to the abnormal reading e.g. consumption of certain brand of milk or bread.
Monitoring by your healthcare team:
Your healthcare team monitors the progress of your diabetes management efforts by measuring the following:
-Blood glucose level.Check with your healthcare professional whether you need to fast before they measure your blood glucose level.
-Urine testing.This is to determine whether your kidneys are functioning properly.
-HbA1c refers to the protein in your red blood cells, haemoglobin, which are bonded to glucose to give what we call “glycated haemoglobin”. By determining your HbA1c value (measured in %), your healthcare team will get a good idea of your blood glucose level over the last 2 or 3 months.
* This is why you cannot fool your healthcare team by starting to manage your diet only a few weeks before your medical appointment 🙂 *
-Blood pressure. This is to gauge whether your cardiovascular system is in good order.
-Blood lipid level.By measuring the amount of cholesterol and triglycerides in your blood, your healthcare team would have a good gauge of your risk of heart disease, which is usually increased in diabetics, especially those with weight problems.
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