On this page:

• When to Monitor
• Glucose Meters
• Continuous Glucose Monitors
• Tips for Good Monitoring

When to Monitor

To find out how your blood glucose specifically responds to your treatment plan, check your blood glucose at different times throughout the day. Good times to check include before and after meals, and whenever you feel “low” or sense that your blood glucose may be off target. Blood glucose checks also are a good idea when you are sick or changing activity. The number of blood glucose checks a day depends upon your individual treatment plan. People taking medications that increase insulin secretion from the pancreas (insulin releasing pills) or insulin need to check more often. Ask your medical provider to recommend the blood glucose monitoring system that best fits your needs.  A continuous glucose monitor may be considered.

 

Get smart about your blood glucose: Check it regularly.

 

Glucose meters

All glucose meters test blood glucose levels with a drop of blood obtained from your fingertips. Some meters also are approved to test blood obtained from alternative sites.

Fingerstick Testing Glucose Meters

There are many brands and models, which vary in price and features. Different health insurance plans may limit coverage to specific models, and may limit the number of test stips that will be supplied. Each meter needs a blood sample that is usually obtained by pricking your finger with a lancing device. The sample is placed on a test strip that has been inserted into the meter and analyzed by the meter.

Fingerstick and Alternative Site Testing Glucose Meters

Some meters are approved for both fingerstick and alternative sites testing, which means poking your skin somewhere else on your body other than your fingertip for a blood sample. Alternative site testing may lag behind fingerstick testing by 20 minutes or more. Alternative site testing results are similar to fingerstick testing results only when the blood sugar is steady and not moving rapidly up or rapidly down. For example, after eating, your blood glucose may be rapidly rising, and the alternative site testing may give a blood glucose result that is erroneously low. Conversely, after exercising, your blood glucose may be falling, and alternative site testing may give a result that is misleadingly high. These incorrect results can result in making the wrong decision such as not eating a carbohydrate containing snack when you blood glucose is low, or not taking other corrective action.

Fingerstick testing is still the most accurate reflection of glucose levels in the blood stream.

It’s a good idea to discuss meter selection with your health care provider or diabetes educator. Do not share your lancet or meter with anyone else. Register your meter with the manufacturer so that you can be notified if there is any product recall.

Accuracy Always

• Read the directions that come with your glucose meter.
• Keep the strips in the original capped container. Light and air can damage them.
• Be sure your test strips are not outdated.
• Re-calibrate your meter if you believe your meter may be inaccurate or damaged.  
• Retain the help-line telephone number provided by the manufacturer.

How to use your glucose meter:

1. Wash and dry your hands
2. Insert test strip into meter
3. Prick your fingertip with a lancing device
4. Apply blood sample to the test strip
5. Read result
6. Record result in your log

Refer to your specific meter's instructions for use, which typically includes written and visual instructions.

Continuous Glucose Monitors

Continuous Glucose Monitors (CGM) are devices that measure glucose in body fluids between cells (also known as interstitial fluid); they do not directly measure the blood glucose. The devices are set in place by you the user and changed every few days to a week or more. Most sensors are taped to the skin and a probe passes through the skin into fatty tissue where it analyzes glucose levels in the fluid between the cells. The sensors continuously collect samples from under the skin and transmit the data to a receiver. Every 1-5 minutes, the receiver displays a glucose reading which is an average of these samples. The receiver also shows glucose trends and can be programmed to sound an alarm if the glucose level gets too high or too low.

Continuous glucose monitors can help you achieve your target blood glucose control

• The Alarms for high and low blood glucose and trend alarms allow earlier intervention and help you prevent more severe highs and lows.
• The 24 hour trend data helps fine tune diabetes or insulin dosing algorithms
• Use of these devices improves blood glucose control because you can minimize the time spent with high or low blood glucose

But remember:

• The glucose level obtained with CGMS may lag behind a blood glucose level by 5 to 25 minutes. The levels may not be the same as those obtained with a blood glucose meter.
• CGM still have to be calibrated or reconciled with blood glucose readings obtained with a blood glucose meter. So you still have to do fingerstick glucose monitoring
• And most important, before you even consider any treatment changes, you will need to do traditional blood glucose testing to verify a glucose level determined by a CGMS device. The continuous glucose monitor results have to be verified before you change your therapy.

Considerations

There are several continuous sensors on the market. Here are some questions you will need to consider:

• Sensor life: How long does the sensor last?
• Where on the body is the sensor worn or inserted?
• How are the sensor and receiver connected?
• How big is the sensor and receiver?
• Does the sensor have the ability to link the glucose results directly to an insulin pump (continuous subcutaneous insulin infusion – CSII)?
• How much does it cost and how much will be covered by medical insurance?
• How accurate are the glucose results?
• How are the glucose levels displayed and is the display easy to read?
• How complicated is it to understand the technical aspects of the device?
• Is the sensor comfortable?

Tips for Good Monitoring

• Monitor your glucose levels frequently when you change your routine, and this includes everything from trying new foods, new form of exercise, when you are sick, stressed, traveling, or changing medications.
• Know the limitations of alternative site testing and continuous glucose monitors. Finger tip blood glucose monitoring still provides the most accurate reflection of glucose levels in the blood stream. Blood samples from other, non-finger tip sites may not be “real time” as they lag behind the blood glucose found in finger-tip blood. This means that if your blood glucose is falling quickly, the results from the alternative site may be higher than the blood glucose really is. The converse also is true. If the blood glucose is rising, the alternative site reading can be misleadingly low. Do NOT use alternate site testing if your blood glucose is rising or falling quickly, you suspect you have a  low blood glucose or if you have hypoglycemic unawareness.
• Verify continuous glucose monitoring sensor results with a fingerstick glucose test before making any acute change in your therapy. For example, if your continuous glucose monitoring device gives a high glucose result, double check with a finger stick test before taking extra insulin or diabetes medication. Conversely, if the sensor glucose value is low, validate the result with a fingerstick test before eating additional carbohydrate containing snacks or reducing your diabetes medication or insulin dose.
• Keep your monitoring equipment with you at all times. It’s important to be able to check your blood glucose if you feel low, or are unsure. Guessing is unwise and risky. This is especially true if you are engaged in activities that require your full attention and coordination, such as driving or playing sports, or at work, where the safe performance of your job – construction being one example – requires alertness at all times.

Vigilant monitoring of your blood glucose is essential to your health