blood glucose testing Notes Convenient Home Delivery of Diabetes Testing Supplies, Prescription Medications, A1C Testing, Ostomy Supplies, Incontinence and CPAP supplies. © 2010 Liberty Medical Supply, Inc. All rights reserved. Liberty Medical Supply, Inc., a Medco Health Solutions, Inc. company. This communication is not affiliated with Medco client programs or communications. Liberty and We Deliver Better Health are registered trademarks of PolyMedica Corporation. Different types of meters are available for people with special needs such as those with vision problems or difficulty using their hands or fingers. 1-800-353-0206 www.libertymedical.com DIABETES EDUCATION Keeping in Check: Knowing Your Blood Glucose Numbers Why should I check my blood glucose? How often should I check my own blood glucose (sugar)? Checking your blood glucose (blood sugar) can give you valuable information. This information can help you make decisions about food, activity and medications on a day-to-day basis since all of these things have an effect on the blood glucose levels. Keeping your blood glucose “in check”, in a target range, can help you prevent some serious health issues that can come with diabetes. How often you check your blood glucose will depend on a number of things. If you are using the glucose numbers to adjust medications, you may need to test more frequently. Whenever there are changes to your treatment plan, checking more frequently will help you know how the change is working. Your physician or other health care provider may prescribe a certain number of blood glucose tests based on your individual needs. The important thing is that you get the information you need to help you make decisions that will keep you healthy and feeling well. How can I keep track of my blood glucose levels? Checking your blood glucose (sugar) at home using a blood glucose meter is one way to help you keep track of how you are doing with your blood glucose control and also help you to make decisions about food, activity and medications day to day. It helps you to see patterns and how all these factors may be affecting your blood glucose level. This is called self-monitoring of blood glucose. Having your A1C checked at least twice per year can help you know how you are doing with overall control and whether you may need changes to your treatment plan. People often refer to this as the “three month average blood sugar” because it lets you know how your blood glucose has been for about the past 2-3 months. This test may be done at your health care provider’s office or at a laboratory. Monitoring of Blood Glucose (sugar) How do I test? Using a blood glucose meter (also called a monitor) at home is the most common way to check your blood glucose (sugar) level. The meter is a small, hand-held machine that can provide results in seconds. By obtaining a small drop of blood with a small pen-like device called a lancet and applying it to a test strip, the meter will give you a reading of what your glucose (sugar) level is at that moment in time. Different types of meters are available for people with special needs such as those with vision problems or difficulty using their hands or fingers. Talk to your health care provider about what is right for you and learn to use your meter from a professional. When and how often you check your blood glucose (sugar) is a decision for you and your health care provider. DIABETES EDUCATION When should I test? Checking your blood glucose (sugar) level at different times throughout the day can be very useful. Many people check first thing in the morning before they eat, this is called a fasting blood glucose. Other common times are before lunch or supper or 2 hours after the start of a meal. Some people check at bedtime or even in the middle of the night, especially if they are concerned about a low blood glucose which may happen when they are sleeping. When and how often you check your blood glucose (sugar) is a decision for you and your health care provider. The more information you have, the more you will be able to figure out how food, activity, medications, illness and stress affect your numbers. Checking can even help you recognize that you may have an infection before you start to have other symptoms. You may want to check more often if there is a change in your treatment plan, if you are eating more or less, if you are more or less active than usual, if you are stressed or if you are sick. Remember, feeling okay does not necessarily mean your blood glucose (sugar) is in an acceptable range. The only way to know your blood glucose is to test. What should my numbers be? According to the American Diabetes Association (2008), the recommended targets for people with diabetes are: • Pre- meal (including fasting) 70 - 130 mg/dl • 2 hours after the start of a meal under 180 mg/dl • A1C under 7% You and your health care provider may choose target numbers for you which may be different and are based on your individual needs and circumstances. The A1C results look different from the readings you get from your blood glucose meter. The A1C results are reported in a percentage and you don’t need to fast for the test. Here’s how it works: Red blood cells contain a substance called hemoglobin. Hemoglobin is a protein, and although its main job is to carry oxygen to the lungs, substances like glucose (sugar) stick to the hemoglobin. We are constantly making new red blood cells and the old ones last about 12 weeks. Because the glucose sticks to the hemoglobin in the red blood cell and because the cell lasts about 12 weeks, the A1C test tells us how much glucose (sugar) has been sticking for about a 2-3 month period of time. It includes all of the blood glucose levels, every second of the day. It’s kind of like a batting average, some days are good and some days not so good, but your average at the end of the season tells the real story. It’s the same with the A1C, the number tells your average for that 2-3 month period of time. If your number is above 7%, it may mean you need a change in your treatment plan to get things back on track. The important thing to remember is that A1C is just a piece of the puzzle but along with self-monitoring can give a total picture of glucose control. Some meters today allow you to use sites other than your fingers for testing your blood glucose. This is called alternate site testing. It doesn’t mean you don’t have to obtain a drop of blood, but only that you can use places other than your fingers to do it such as the fleshy part of your palm, the forearm and outer thigh, to name a few. Check your own meter to see what sites may be used. Times when you should NOT use alternate sites because your blood glucose may be rapidly changing: For family and Friends For every one point decrease in A1C, you reduce your 1. Wash your hands with warm water 4. When you have a good drop of risk of long-term diabetes and soap. Using the warm water helps blood, apply it to your test strip complications by up to 40%. make getting a drop of blood easier. according to your meter instructions. Washing also helps to remove any A1c ..... Average Blood Glucose food residue from your skin which 6% ............... 126 mg/dl (sugar). 7% ............... 154 mg/dl 8% ............... 183 mg/dl 9% ............... 212 mg/dl 10% ............. 240 mg/dl 11% ............. 269 mg/dl 12% .............. 298 mg/dl 5. Read your results from your meter and be sure to record the results in could affect your blood glucose your blood glucose log book. Be sure to include any comments which will 2. Hang your hand down by your side help you remember why a reading for a few seconds. This allows blood to may be out of range such as “sick flow to your finger tips. today” or “skipped lunch”. The log 3. Prick the side of the tip of your finger with your lancet device. Make sure it is set for the right depth. You can check book makes it easier for your health care provider to review your readings at your next visit. the directions (enclosed with your device) to see how to do this. Be sure not to squeeze your finger hard. Fact • When you think your blood glucose may be low • If you have trouble recognizing when your blood glucose is low • It’s less than 2 hours since the start of your meal • You’ve been physically active Blood glucose meters have been shown to provide accurate and precise results. Unfortunately, inaccurate results can happen and are often due to human error. To assure the most accurate results from your blood glucose meter: • Keep your meter clean, a dirty meter may not work as well. Follow the manufacturer’s instructions for how to clean your meter. • Be sure that your meter is accurately calibrated if this is required. Tips • Check the test strip bottle for the expiration date and don’t use test strips that are outdated. • Wash your hands with soap and water and dry well before obtaining a drop of blood. • Be sure you have an adequate amount of blood to place on the strip. • If your meter or test strips have gotten too cold or too hot, it will not give accurate results. Be sure the meter and test strip temperature is within the manufacturer’s suggested range before using; this usually means room temperature. It’s a good idea to have your health care provider or diabetes educator check your skills using the meter at least once a year. It’s easy to develop habits that can have a negative effect on your blood glucose readings. Your educator or health care provider can help you to recognize and correct these habits.