By Martha Funnell, MS, RN, CDE
One of the keys to managing your blood glucose is to keep everything in balance: your food, your activity, your medicines and your stress level. When you check your blood glucose levels, you can see how all of these things are balancing out and how all of your hard work is paying off.
1 WHEN DO I CHECK?
Start with a fasting blood glucose level before breakfast. A rule of thumb in diabetes care is to fix the fasting first. If your blood glucose level is high when you first get up, you have to work all day to bring it down. Other times to monitor are:
- before lunch and dinner
- two hours after the start of your meals
- at bedtime
Checking your blood glucose before and after a meal helps you understand how the carbohydrates you ate affected your blood glucose. Checking your blood glucose before bed lets you rest easy knowing that you won’t have a low blood glucose reaction during the night. It also gives you an idea of where your blood glucose levels should be when you wake up. Your bedtime and fasting glucose levels should be about the same. If they’re not, you may need a change in your medicines.
2 WHAT CAN I LEARN FROM MY NUMBERS?
Look for patterns. For example, if you notice that your levels are high after lunch most days of the week, you may decide to eat fewer carbohydrates during lunch. Or you may decide to go for a walk or take more insulin to cover your usual lunch. If you notice that when you are under a lot of stress, your levels are high most of the day, then you might try being more active on those days or learn different ways to relax and cope.
Take your blood glucose record with you when you visit your health care provider. Be sure to tell him or her what you think about your readings and ask questions about results you do not understand. Remember, your readings do not always reflect what you do, and what works one day may not work the next. Let your health care provider know that you are doing all you can, and ask for help and support to solve any problems you detect.
3 WHAT IF I CAN CHECK ONLY ONCE OR TWICE A DAY?
No matter how many times you check, it is helpful to get an idea of your blood glucose levels over the course of a day. That can be especially helpful the week before you see your health care provider. Some ideas are:
- Check at different times on different days. You could check before breakfast on Monday, two hours after breakfast on Tuesday, before lunch on Wednesday and so on. If you do two checks a day, do a fasting check every day and use the pattern above for your other checks.
- Check two hours before and after the first bite of a meal, choosing different days for different meals. For example, check before and after breakfast on Monday, before and after lunch on Tuesday and so on.
- Check four to five times a day. This covers your fasting blood glucose level, before and after meals and at bedtime one or two days each week.
4 HOW CAN I GET A CLEAR PROFILE OF MY BLOOD GLUCOSE LEVELS?
Check your blood glucose levels at different times of the day and look for patterns from day to day or over the course of a week. Think of checking your blood glucose as taking a picture of what is happening at a certain moment in time. But your blood glucose level changes constantly. Knowing your profile along with your A1C helps you see the big picture. Even if your meter has a memory, writing down your results will help you see patterns more clearly.
THE BLOOD GLUCOSE CLUES
The information you get from checking your blood glucose is only helpful if you use your readings to make choices as you go through each day. Don’t think about your blood glucose reading as a judgment. Use your readings as clues for solving the blood glucose mystery.