Blood Glucose Testing

Blood Glucose Testing

How to test your blood glucose:

When should I test my blood sugar?
How often you need to test your blood sugar level depends on the type of diabetes you have and your individual diabetes treatment plan.
If you have type 1 diabetes, your doctor may recommend that you test your blood sugar level at least three times a day – perhaps before and after certain meals, exercise, and before bed. You may need to check your blood sugar level more often if you're ill or you change your daily routine.
If you take medication – with or without insulin – to manage type 2 diabetes, your doctor may recommend testing your blood sugar level once a day. If you manage type 2 diabetes with diet and exercise alone, you may need to test your blood sugar level even less often.

How do I make sure my test is accurate?
Get your supplies together
Gather all supplies you will need for testing blood glucose which include:
• A blood glucose meter
• Testing strips
• Control solution
• Short needles called lancets for pricking your skin
• Lancet device for the needle
• Clean cotton wool or tissue.
Make sure strips are in date
Check the expiration date on the bottle. Do not use test strips that have expired as test results may not be accurate
Match code numbers
Match the code number on the testing strips bottle with the number on the meter. If the numbers do not match, follow the directions with the meter for changing the code number. Some glucose monitors must be coded every time you open a new vial of test strips. Each meter has its own coding technique. Follow the manufacturer's instructions carefully.
Be sure to keep the instructions handy for future reference. Some meters have a code chip – often called a key – that slips into the device.
Check if your meter needs to be coded
Not all meters need to be coded and some just involve the insertion of the test strip.
These meters do not need coding:
• Ascensia Contour
• Ascensia Breeze
• FreeStyle Lite
• FreeStyle Freedom
• Glucomen LX Sensors
Follow meter instructions
Follow the instructions with the meter. All blood glucose meters have detailed instructions for performing the test. The instructions for testing are slightly different for each model of home blood glucose meter.
Wash your hands
Wash your hands with warm soapy water. Dry them well with a clean towel.
Insert needle into lancet
Insert a clean needle (lancet) into the lancet device.
Remove a test strip from the bottle of testing strips. Replace the lid immediately after removing the strip to prevent moisture from affecting the other strips
Prepare meter
Prepare the blood glucose meter. Follow the instructions included with your meter.
Stick side of your finger
Use the lancet device to stick the side of your fingertip with the lancet. Do not stick the tip of your finger; the stick will be more painful and you may not get enough blood to do the test accurately. Some new blood glucose meters use lancet devices that can obtain a blood sample from sites other than the fingers, such as the forearm.
Put blood on strip
Put a drop of blood on the correct spot of the test strip.
Apply pressure to finger
Using a clean cotton ball, apply pressure where you stuck your finger (or other site) to stop the bleeding.
Follow the directions
Follow the directions with your blood glucose meter to get the results. Some meters take only a few seconds to give the results
Record the results
Record you blood sugar result in a diary. Bring this diary to all your clinic appointments so as your doctor or diabetes nurse can review your diabetes control.

How will testing my blood sugar feel?
Your fingertips may get sore from frequent pricking for blood sugar testing. These tips will help you to prevent sore fingertips.
Always prick the side of your finger.
Do not prick the tip of your finger. This increases the pain and you may not get enough blood to do the test accurately
Don't squeeze the tip of your finger.
If you have trouble getting a drop of blood, hang your hand down below your waist and count to five.You can also rub your hands together to warm them and increase blood flow. Then squeeze your finger, beginning close to your hand and moving outward toward the tip of your finger
Use a different finger each time.
Keep track of which finger you stick that you don't use some fingers more than others. If a finger becomes sore, avoid using it to test your blood sugar for a few days
Use a lance device that has a dial at the top to adjust the different levels of penetration of the needle.
Use a blood glucose monitor that requires only a small drop of blood to give the reading

How to ‘quality control’ your meters
Every two years
Change or upgrade your blood glucose meter every two years.
Four times a year
Check the quality control test on your meter four times a year at least. However, the companies that provide the meter recommend that ideally you should carry out a quality control test every time you open a new box of testing strips.
If the results are unexpected
The meter companies also recommend that you do a quality control test on your meter if your are getting a high or low blood glucose reading, but you do not feel the symptoms of high or low blood sugar.

Points to remember
• Take proper care of blood glucose testing equipment to ensure safety and accurate results.
• Do not store your meter or test strips in a very hot or very cold place.
• Carry your meter and extra test strips in your hand luggage when you travel abroad.
• Understand your target blood glucose range set by your doctor.
• Understand what hypoglycaemia is, the symptoms and how to treat it.
• Understand what hyperglycaemia is, the symptoms and how to treat it.
• When you monitor your blood glucose it means you can understand how your food, physical activity and medication affects your blood sugar readings.

What your blood glucose results should be:

Know your blood glucose target range
Your doctor will set your target blood sugarrange. For many people, target levels are:
• Fasting blood sugar – between 4 and 6 mmol/L
• Two hours after meals — ideally less than 8mmol/L
• Before bedtime — between 6 and 8 mmol/L.

What can I do if my blood sugar is out of range?
It is difficult to keep your blood sugars within range all the time. Sometimes your blood sugar can go too low (hypoglycaemia) or too high (hyperglycaemia).

What are the symptoms of a low blood sugar?
Hypoglycaemia or ‘Hypo’ is when your blood sugar levels are too low (below 4mmol/L).
What causes low blood sugars?
• Too much tablets or insulin
• Missed or late meal or snack
• Too little starchy food at meal or snack
• More exercise than usual
• Alcohol (can be a delayed low blood sugar a few hours).
What are the symptoms of a low blood sugar?
• Sweating
• Headache
• Hunger
• Shakiness or dizziness
• Being pale
• Lack of co-ordination
• Confusion
• Anxiety or irritability.
How to treat a low blood sugar in two steps
Step one – quick-acting carbohydrate
• Three-four glucose sweets, or
• Half glass of Lucozade, or
• A glass of non-diet soft drink, or
• Tea or water with two teaspoons of sugar.
Immediately after this follow step two.
Step two – slow-acting carbohydrate
• Two plain biscuits, or
• A sandwich, or
• A glass of milk, or
• Your usual meal if it is due.
If you have followed step one and step two, but you don’t feel better after five minutes, take your quick-acting sugar again.

What are the symptoms of high blood sugar?
Hyperglycaemia or high blood sugars occur when your blood sugars are too high typically above 10mmol/L.
What causes high blood sugars?
• Eating large portions or eating sugar-rich foods
• Reducing your level of regular physical activity
• Your medication may need to be increased
• Illness or infection or injury
• Stress or emotional upset
• Some medications, for example, steroids.
What are the symptoms of a high blood sugar?
• Thirst
• Passing urine more frequently
• Tiredness
• Weight loss
• Blurred vision
• Repeated infections

What should I watch out for when I am ill?
It is particularly important to be aware that your blood sugar can go up and down when you are ill.
Drink plenty of water
Drink at least two to three litres of water every 24 hours. Drink more if you are still thirsty.
Have nourishing fluids
If you can't eat regular meals, have nourishing fluids. Most people can take soft drinks or soups even when they are too nauseated to eat solid foods.
Check more frequently
Check your blood sugar more frequently and continue taking tablets
Check ketones
If you have type 1 diabetes, check for ketones when you are ill.
What are ketones?
If cells are not getting enough glucose, the body starts to break down fat for energy. When body fat is broken down in this way, ketones are produced. A high level of ketones in the body is harmful.
Keep taking your insulin
Continue to take your normal dose of insulin when you're sick. You may even need extra insulin. Test your blood sugar and check for ketones every three hours.
Sick-day regime
If your diabetes team has given you a sickday regime, stick to this or else contact a healthcare professional for advice.
Get medical help if necessary
If your blood sugar keeps rising, ketones will build up in your blood and ketoacidosis can develop. This is a serious condition that needs immediate medical help. If you have ketones while you are ill with a fever or vomiting, you should call your doctor immediately and be prepared to go to the hospital right away.
You can use Optium Xceed from Abbott diabetes care to check the blood glucose and ketone levels.

What should my ketone levels be?
When you test for ketones the following results means the levels in your body are:
• Less than 0.6 mmol/l – trace levels
• Between 0.6 and 1.5 – moderate levels
• Greater than 1.5 – large levels.
Monitoring your blood glucose levels can help you take better care of your diabetes. Checking your blood sugar will help you learn how food, activity levels, stress, medicine and insulin change your blood sugar level. This information will help you stay healthy and prevent or delay diabetes complications.

Elaine Newell,Regional Development Officer, Diabetes Federation of Ireland
Published in Diabetes Ireland, Vol 6 Issue 3 Autumn 08

APP KOL/AC/2008-11-10

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