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Blood Sugar Testing

Blood sugar control is very important for people with diabetes.

Checking your blood sugar regularly shows you how lifestyle changes affect blood sugar levels and helps you maintain control of your diabetes.

People with diabetes have an increased risk of developing a number of conditions such as heart, kidney and eye disease, nerve damage, stroke and poor circulation.

The risk of health problems caused by diabetes can be reduced if your blood sugar level is regularly 4-7mmol/l before meals and 8-10 mmol/l after meals.

It is important that the blood glucose levels are as near normal as possible (that is in the range of those of a person who does not have diabetes). These are: 3.5-5.5mmol/l before meals less than 8mmol/l, two hours after meals. There are many different opinions about the ideal range to aim for. As this is so individual to each person, the target levels must be agreed between the person and their diabetes team. The target blood glucose ranges below are indicated as a guide.

  • Children with Type 1 diabetes (NICE 2015) on waking and before meals: 4-7mmol/l after meals: 5-9mmol/l.
  • Adults with Type 1 diabetes (NICE 2015) on waking: 5-7mmol/l before meals at other times of the day: 4-7mmol/l 90 minutes after meals: 5-9mmol/l.
  • Type 2 diabetes (Diabetes UK Council of Healthcare Professionals 2015) before meals: 4-7mmol/l two hours after meals: less than 8.5mmol/l.
  • Pregnant women with diabetes (NICE 2015) fasting: below 5.3mmol/l and 1 hour after meals: below 7.8mmol/l or 2 hours after meals: below 6.4mmol/l

When you have a diabetes check-up, a blood sample for the HbA1C is taken -this lets you know what your average blood sugar has been over the previous 3 months - a result of 7% or according to the new range of reporting IFCC 53 mmol/mol) or below is desirable to reduce the risk of health problems associated with diabetes. For more information HbA1C click here

Home blood testing will assist you to keep your diabetes under control. Contact your diabetes care team for advice on meters.

Self-monitoring is most appropriate for:

  • patients with type 1 diabetes
  • type 2 diabetes who use insulin regimes and adjust their dose as a result of blood glucose testing
  • pregnant patients whether they have type 1, type 2 or gestational diabetes.

Many people with type 2 diabetes, especially those who are diet-controlled, on metformin or a glitazone do not need to perform home blood glucose monitoring. There is no risk of hypoglycaemia, and glycaemic control is better and adequately monitored by regular HbA1c testing.

For patients with type 2 diabetes who are taking a sulphonylurea, an incretin mimetic or a gliptin, regular testing is not necessary in normal circumstances. On an individual patient basis testing may be appropriate e.g. as an educational tool, recurrent illness, to ensure safe driving. Where hypoglycaemia is a common occurrence blood glucose should be monitored.

How do I control my blood sugar level?

Controlling blood sugar is a balance between food, exercise and medication

  • Eat a healthy diet
  • Take regular exercise
  • Take your diabetes medication as prescribed
  • Understand how your medication works in your body

Why test my blood sugar?

Blood testing is the best method of being in control of your diabetes because it tells you what is happening immediately. It can help determine if you are at risk of a hypo [low blood sugar] or hyper [high blood sugar]. Never change long term medication in response to a one off high or low reading. First establish if there is a pattern before changing your medication.

What do I do if my blood sugar is high?

If your blood sugar level is consistently above the target set by your diabetes team you may be at increased risk of health problems caused by diabetes.

You may require a change in your medication or advice about avoiding hyperglycaemia. Contact your diabetes care team for advice if your blood sugar is often above target.

What do I do if my blood sugar is low?

If your blood sugar level is below 4mmol/l you are at risk of hypoglycaemia - see the hypoglycaemia page. You may require a change in your medication or advice about diet or lifestyle to avoid hypoglycaemia. Contact your diabetes care team for advice if your blood sugar is often below 4.0 - 4.5 mmol/l.

When should I test my blood?

The frequency of blood testing will be discussed by a doctor or nurse; information will be given according to the individual's requirements. A general guideline will be given below.

If your diabetes is treated with insulin, you will be asked to test your blood glucose levels more regularly. If the results are within your agreed target range then you may be able to reduce the number of tests. You will be provided with the appropriate advice to suit your own circumstances when you see your diabetes nurse or doctor. If your blood glucose levels are out with target you may need to adjust your insulin. Guidelines are available on your local MCN website which you can access via local services links on home page. It may be advisable to check glucose levels more frequently if you use a 'basal bolus' insulin regime, i.e. adjusting your fast acting insulin dose on a daily basis spending on activity and dietary patterns. The appropriate times to blood glucose monitor when on basal bolus regime are pre meals pre bed prior to driving and occasionally 3am readings to assess overnight insulin.

If on a twice daily insulin mixture test blood glucose 4 x daily(pre each meal and bed) in first instance to assess dose requirement. This may be reduced to pre breakfast and pre evening meal one day and pre-lunch and pre bed the next day. Continue to test in this way alternating each day.

When should I test my blood sugar more often?

After change of treatment
Test more often to ensure your blood sugar is regulated to 4-7mmol/l. This should be discussed at the time of the consultation

Your blood sugar may change in response to illness - test blood sugar more often (2-4 hourly especially if you are on insulin). You may require a change in treatment. Discuss sick day rules with your diabetic care team.
If you have type 1 diabetes look up sick day rules for Type 1
If you have type 2 diabetes look up sick day rules for Type 2
For more information on DKA look up meds kit document

Steroid Therapy
Test blood sugar more often. Steroids may alter your blood sugar levels you may require a change in treatment.

Preconception and Pregnancy
Test more often. Blood sugar levels of 4-6mmol/l are desirable before and during pregnancy. Contact your diabetes care team for advice if you are planning a pregnancy or as soon as you know you are pregnant.

How to do a test

For a video tutorial of how to conduct a test click here

  • Wash hands in warm water
  • Prick sides of fingers-less painful
  • Massage finger from base to tip if necessary
  • Place droplet of blood on testing strip * Follow strip manufactures instructions precisely [check expiry date]
  • Check visually or use meter
  • Keep meter clean and check accuracy regularly using quality control solution as required
  • Record result in diary

How do I care for my blood sugar meter?

All meters have manufacture advice brochures, read and comply with the instructions. Helpline telephone advice is available from the Meter Company. Complete the warranty card and return to the company.

Where do I get my strips and lancets?

Your GP will be able to prescribe the equipment you require to use your meter.

Be In control

Testing your blood sugar levels regularly is one sure way of finding out what's happening to your body, so you control your diabetes - not the other way round.

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