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A Do It Yourself Blood Test?
The Importance of
Blood Glucose Monitoring
Written By: Theresa Bill, R.Ph., CDM,
Rite Aid Pharmacist
Syracuse, NY
Managing your diabetes requires making adjustments in your lifestyle on a daily basis, way beyond taking your pills and avoiding certain foods. Managing diabetes means managing the delicate balance of sugar in your blood all day, everyday. Blood sugar is affected by all the foods we eat, our activity level, and even our health. Too little sugar and the brain starves and shuts down, too much and the blood vessels become inflamed, leading to diabetes’ many complications. Studies have shown that the closer you can keep blood sugar to the normal range the lower your risk for diabetes complications.
In a perfect world, we would have a monitor that continuously checks your blood glucose throughout the day without multiple fingersticks. But until that day comes, we have to settle for snapshots of different times of the day. Knowing your blood sugar before you eat and 2 hours after you eat gives you and your healthcare provider information on how your body is handling meals. You can see how things effect your blood sugar by keeping detailed records including your blood sugar value, time of the test, what and how much you ate, and whether you exercised or felt sick. With this information, adjustments can be made to the dose and timing of your medication, and more importantly, you can determine the effects that various foods and the quantity of those foods have on your blood sugar. This can help you make some important changes that could improve your health.
I know what you’re thinking, you do not want to test yourself that many times each day. A National survey in 1989 showed that most people with diabetes felt the same way. Overall, only 33% of people with diabetes (40% with type 1 and 26% with type 2) were even meeting the goal of once a day testing.
The cost of testing supplies can add up. Your strips can be expensive. Be sure you look into your insurance coverage of diabetic supplies. Sometimes insurance plans use the medical benefit instead of the pharmacy benefit to cover specific supplies, so be sure to discuss these details with your benefit manager. If you’re ready for a new meter, watch for special offers. Many meter companies offer a free meter with the purchase of strips. Store branded meters, like Rite Aid's True Track Smart System, offer many of the features of higher priced monitors at a much lower cost. While the cost of testing can put a dent in your wallet, the cost of not testing is too high to ignore. Lack of glucose control can lead to complications and increased medical costs, not to mention a decrease in your quality of life.
There are many meter features available so you can select a meter that works best for you. Pocket-sized meters are convenient for people on the go. There are meters that load the strips in the monitor for those with arthritis or vision problems. There are even talking meters. Newer meters are easier to use and no longer require complicated calibration or cleaning. They also tend to be more accurate because they are easier to use. Some meters will even keep track of when the reading was taken (such as before or after a meal or exercise) and how you feel. Most meters require much less blood than they did in the past. This allows for testing at alternate sites like the palm or forearm. This can be an advantage, since these areas have fewer nerve endings which may mean less pain.
We all know frequent testing is important, but how do we realistically get this done in the most comfortable, cost-effective way that fits into your busy life? Getting a better picture of your blood sugars throughout your day can be as simple as just varying the time of day you do the test. Instead of checking your blood sugar every morning before breakfast, vary the time and test after breakfast, or after dinner. Another approach is to select a period of time and dedicate yourself to testing before and after each meal and at bedtime. Be sure to keep detailed records. Then, evaluate your diet and try to make some good changes. As you make changes, you should increase the frequency of testing again to see what differences the changes made. As you set up your testing schedule, don’t forget to test at important times such as anytime you feel your blood sugar is low or around times of increased activity.
What results are we looking for? The American Diabetes Association recommends fasting levels (before meals) between 90-130 mg/dl and less than 180mg/dl 1-2 hours after meals. While these are the recommended levels, we always have to balance our desire for near normal blood glucose levels with the risk for hypoglycemia (low blood sugar). Goals should be individualized. Certain populations (children, pregnant women, and the elderly) require special considerations. Less intensive blood sugar goals may be appropriate, for example if you have severe or frequent hypoglycemia. Work with your diabetes management team to set the goals that are best for you.
For more information on hypoglycemia (low blood sugar): www.diabetes.org/type-1/hypoglycemia.jsp
Blood glucose monitoring is important in maintaining your health. This ’do it yourself’ blood test gives you the ability to immediately address your results. While at times this can be overwhelming, work with your diabetes management team to develop the best self monitoring plan for you. Properly timed and frequent testing of your blood sugar can help your diabetes management team identify the most effective treatment for your diabetes.
Your Rite Aid pharmacist is part of your diabetes management team and available to help you. From over–the–counter testing supplies to your prescription medications, your pharmacist is ready to answer your questions as you test your way to better health.
About the Author: Theresa Bill has been a pharmacist for 26 years. Over the years, she has worked at Fay’s, Eckerd and Rite Aid. She has provided nursing home consulting and was a supervising pharmacist in Baldwinsville, NY. Theresa has provided Medicare and Career talks for Community Outreach programs. Currently, Theresa provides Medication Therapy Management (MTM) services in the Syracuse, NY area.
