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Living well with diabetes (Series 3/6)

Self-monitoring of blood glucose plays a vital role in the management of diabetes. Studies have shown that self-monitoring of blood glucose helps to achieve better diabetes control as it enables people with diabetes to keep track of their blood glucose levels, and to make appropriate choices in their daily lifestyle (diet, physical activity and insulin or medication doses) to manage diabetes. To help you get started on self-monitoring, here are a few common questions and answers on the topic.

If I have my diabetes medication regularly and watch my diet carefully, does it mean I do not need to monitor my blood glucose level anymore?

The only way you can tell if your blood glucose level is close to normal is by monitoring it regularly. Without checking your blood glucose, you are merely guessing and assuming that your medication and diet have helped you to achieve your glucose goals.

It is important to note that there are many factors in your lifestyle and daily routine that influence the level of your blood glucose. Hence it is no surprise that your blood glucose level changes throughout the day.

Factors that can increase your blood glucose level are:

Food
Stress
Illness

Factors that can bring down your blood glucose level are:

Insulin and medication
Exercise

Monitoring your blood glucose regularly helps you to know how well your diet and medication works, and if you need to make changes to improve your plan. Also, regular monitoring enables you to keep a record of your blood glucose, which helps in your management of diabetes.

How often should I do the test for self-monitoring of blood glucose?

The frequency you need to check your blood glucose depends on your reason for doing so.

If you have type 1 diabetes and are taking insulin, you may need three or four tests a day to help you adjust your next insulin injection or your food intake, and to check on your insulin dose.
If you have type 2 diabetes and are taking oral diabetes medication, you may need to test your blood sugar levels only once or twice a day, or three or four times a week.
If you have gestational diabetes, you may need to test your blood sugar levels four or more times a day.

"When should I test my blood glucose level more frequently??"

You might want to test more frequently – when:

You are sick or have an infection. You may need to change your medication dose as a cold, flu or infection can make your blood glucose go higher than usual.
You are trying to find the best dose of medication that works for you.
You are starting on a new type of exercise.
You may want to test before and after the activity, and 1 to 2 hours later to check if there are any unusual effects.
You are more physically active than usual.
You change your diet.
Your stress level increases.
You suspect you have symptoms of low blood glucose (hypoglycemia) or high blood glucose (hyperglycemia).
Your glucose levels are often out of your target range.

When is a good time to do the test?

The standard times to check your blood glucose are:

Before meals (breakfast, lunch and dinner)
1 to 2 hours after meals
Before bedtime
At 2 or 3am

You can work with your doctor to decide which testing times best match your diabetes medication, meal times and exercise plan.

What do the results of the different test times mean?

Testing at different times helps you to decide on what changes you may need to make to your diabetes care plan.

Before meals (breakfast, lunch and dinner) – To enable you to modify meals or medication
1 to 2 hours after meals – To find out how food affects your glucose levels
Before bedtime – To decide if you need to adjust diet or medication, as this is your last chance for the next 8 hours
At 2 or 3am – To adjust medication or long-acting insulin

What should my blood glucose levels be?

Ideally, try to maintain your blood glucose levels as close as possible to normal. You can use these guidelines, which are taken from the Malaysia Clinical Practice guidelines for glycemic control 2005.

Fasting	4.4 - 6.1 mmol/L
Non-fasting	4.4 - 8.0 mmol/L
HbA1c	< 6.5%
Note: HbA1c (glycosylated haemoglobin) should be done every 4 to 6 months.

However, the recommended blood glucose levels for women with gestational diabetes are tighter. It is best to discuss your blood glucose goal with your doctor.

Should I keep a record of the test results?

It is useful to keep a record of the test results. You can write down your glucose results in a logbook and bring it to show your doctor during your check-up. Having a record of the test results helps you to learn how the test results relate to events and activities, and to look for patterns as this enables your doctor to decide if you need to make any changes in your diabetes management plan.

Optium Xceed Meter

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This article is intended for reference and information purposes only. Please consult your doctor for more information on diabetes mellitus and interpretation of blood glucose results.

This article is the third in a series of six.