Self Blood Glucose Testing
Blood testing is an important part of diabetes self care.
People with diabetes can test their own blood using a finger prick blood
sample and a simple small electronic blood testing meter.
Should all people with diabetes
test their blood?
Not everybody needs to and nobody
should force you to. Some people on diet treatment, or even when
talking tablets, can be safely checked by using other blood test
done by their doctor, especially if they have no problems with low
blood sugars (hypos). However, most people will benefit from self
blood testing especially if they are on certain diabetes tablets
(sulphonylureas) or insulin.
Why should I test my blood?
It is an
easy an accurate way of finding out how well your diabetes is controlled
on your current diet and treatment plan.
It is the only real way to find out about how your blood sugar changes
throughout the day with your treatment and with foods and exercise and
to know about “hidden” low or high blood tests that don’t
cause symptoms. This is especially true of people who have serious problems
with hypos and don’t get warning.
It is common for people not to have any symptoms or not be unwell even
when the blood tests are too high or too low. That is why you cannot
rely on the way you are feeling to assess your diabetes control.
It helps you to know what is going on if you are unwell with some other
illness or infection and to work out if any action needs to be taken.
It is a helpful way of adjusting your treatment – especially
when you start a new treatment such as tablets or insulin. It gives
many people confidence to know what is going on.
As well as informing you, it can be used to help your medical team check
and understand your diabetes control when they see you.
What are the disadvantages?
many. It can be a bit of a chore and it is never nice to have to prick
your finger but nearly everybody copes with that.
How should I test my blood?
worry about this, is easy to learn how to do it but you should get
some training and not just start up yourself without really knowing all
When should I test my blood?
than in certain circumstances, it only needs to be done once a day – but
check it if you think your blood sugar may be too high or low, especially
if you are not feeling well.
There are many different patterns of testing. Some say test in the morning,
others before meals or after meals and it can get confusing.
A simple pattern is to do 1 test a day but at different times on different
days, before breakfast one day, before lunch the next, before the evening
meal the next and last thing at night before going to bed the next day.
Then start again in the morning.
Sometimes you will be asked to do a blood test in the
middle of the night at about 3 to 4 am because that is when blood sugars
can go low without waning in people with diabetes treated with insulin.
Test at other times if you are worried about the blood sugar being to
high or low. Test if you are exercising, or are ill, or have missed food
or if you are going to drive, particularly on long journeys.
What should my blood levels be?
aim of your treatment is to keep your blood sugar levels as good as possible
without allowing them to fall too low. Before meals, the ideal range
is between 4 and 7 mmol/l. If you do test after meals the sugar can normally
rise to as high as 11. Blood tests greater than this are considered high,
especially so if they are more than 15 mmol/l. A blood tests of less
than 4 mmol/l is low and should be dealt with as if it were a hypo, even
if you have no symptoms.
What do I do with the answer?
is no point in blood testing if you cannot or do not do anything with
Test accurately – mistakes can affect
Record the result in your book – if you
do not write it down you will not get to see the overall pattern
and nobody else can look at it.
Know the targets for the blood tests – do
not just do the test without knowing what the level should be otherwise
you might just be recording bad diabetes control without knowing
it. Results should be between 4 and 7 before meals.
Do your reckoning – every
week or two go over your book and see if you have been happy with
the control, whether it’s in target,
where problems occurred and how to explain them.
Look for any patterns
that need to be put right. For example, you may always be high at
one certain time of the day or you may be getting hypos at a certain
Take Action – If things are not right work out how to
adjust diet and exercise or how to adjust your treatment to fix the
just “wait and see”. Get advice as you need it. You should
be encouraged to make these changes yourself if you are confident to
do so. If not, get help from your usual health team.
Use it in clinic
visits – don’t keep all your good work
and effort a secret. Take the record with you when you see the doctor,
nurse or dietitian so that they can get a good idea of what’s
going on. If you have a memory meter, take that as well because it
can be fed into a computer to analyze the results.
What to do with one off results?
fix a low blood test by taking something to eat.
Whether the reading is high or low, don’t make sweeping changes
to diet or treatment on one blood result. If you are concerned about
a single result or a recent run of results and you don’t know what
to do about it, you should consult your usual diabetes health care advisor-this
may be your GP, Practice nurse or Diabetes specialist nurse.
What care to expect and seeking
You should be offered blood glucose testing when you
first develop diabetes or along the way if things change. You should
be taught about how to do it, what to look for and how to record it.
You should be helped with taking action for yourself by knowing how to
adjust your treatment –especially
your insulin treatment. When you have particular problems, your team
should discuss them with you. They should always ask to look at your
record book as well as you meter when you go to see them and use the
information to adjust your treatment plan as needed. Please don’t
expect diabetes teams to continue prescribing the blood strips if you
can’t show them the results or that there is any benefit out
of doing it. Remember, more money is spent on blood strips than all
of the diabetes tablets and insulin put together – so please
don’t waste it.