Monitoring of Blood Glucose in Diabetes
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03 May 2010
SOME FREQUENTLY ASKED QUESTIONS ABOUT THE PROCESS AND FIVE INSTRUCTIONS
Why do we monitor blood glucose?
Monitoring blood glucose gives important information which you need to manage your diabetes on a daily basis. You can also note effect of particular diets and exercise on blood sugar values, and modify them accordingly.
Are glucometers reliable?
Yes, a glucometer is a fairly reliable source for self–monitoring of blood glucose levels. The internationally accepted standard error for blood glucose values estimated by glucometers is ±1015%, but it is important to note that these devices are not intended for use in the initial diagnosis or for intensive care management.
How do I calibrate my glucometer? It depends on the type of glucometer you have. Usually the glucose strips come with a code which has to match the glucometer code. If the code on your meter differs from that on the test strip vial, your glucose reading might be incorrect. You can even check the accuracy of your meter by comparing it with a lab reading. Most glucometers come with a test solution for calibration.
What is the difference between checking blood sugar from a lab and by a glucometer?
The lab value gives an estimate of blood glucose in venous blood while the glucometer gives it for capillary blood. The difference is slightly higher for a glucometer reading because in the capil lary blood, the glucose is not fully taken by the cells.
I do not feel well in the morning and although the doctor has increased my night–time insulin, my fasting blood sugars still come high. What is the reason? How do I monitor?
This is called Somogyi Effect. It is the tendency of the body to react to extremely low blood sugar (hypoglycemia), which may occur at night through overcompensating, which results in high blood sugar in the morning. A sugar reading of less than 70 mg/dL at 3 am will indicate that your high sugar in the morning are due to low sugar during night. In such a case, high dose of medicine or insulin at night needs reduction rather than an increase.
What is the best time to check blood sugar?
The post–meal blood glucose levels should be checked 2 hours after the start of your meal. Some doctors may also advise you to check pre–meal glucose levels, which should be done half–an–hour before meal.
What should be frequency of testing blood sugar in case of fever, diarrhoea, abdominal pain or any infection?
Such health problems in case of diabetes may get complicated easily. Do not stop taking insulin or omit doses. Test your blood glucose levels more often. If the levels are unstable, consult your doctor immediately. In case of recurrent vomiting, inability to take food orally and blood glucose reading less than 70 mg/dl, approach your nearest hospital for immediate Intravenous glucose. The doctor has increased my dose of drugs/insulin. How frequently should I monitor?
After escalation of dose, the monitoring should be more frequent, especially if you are on insulin therapy.
Five General Instructions for Blood Glucose Monitoring: Always use glucometers from a standard company. Check frequently with standard strips/solution provided or with laboratory values.
In the test strip, the area for placing blood drop should be adequately filled with blood; otherwise the reading will be inaccurate.
Avoid glucometer and test strips from extremes of temperature. Close the lid of strips holder immediately after use.
Always carry glucometers while travelling locally or abroad.
Always keep a glucose monitoring diary for keeping record of your blood sugars.
Prof Anoop Misra Director and Head, Department of Dia betes and Metabolic Diseases Fortis Hospital, Vasant Kunj Neha Gupta Diabetes Educator Fortis Hospital, Vasant Kunj