Overview

If you take insulin for your type 2 diabetes, your doctor may ask you to test your blood glucose daily and keep records of the results. Regularly monitoring your blood glucose at home helps you better control your glucose levels and gives your doctor a clear picture of how well your medication is working. If you are taking your medications as directed, and your blood glucose is not under control, your doctor will be able to change the timing or dosage of medicine to be more effective.

Urine testing for ketones can show whether your blood sugar is dangerously out of control. This type of testing is much more common for those with type 1 diabetes.
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If you use an insulin pump, your doctor may recommend a continuous blood glucose monitor.

What does it involve?
Blood glucose monitors that require a blood sample are considered to be much more accurate than those that utilize urine samples. Use urine-based testing only in situations where it is impossible to use blood-based testing.

If your health insurance is paying for your blood glucose monitor, you may not be able to choose which model you use. If you do have a choice, there are many options. Some models require less blood and do not stick your finger as deeply. Most models can only be used at the fingertips, although certain models are multisite, meaning that you can use them to prick areas of your arms, legs, or hands as well. However, testing at different sites can provide less consistent results. Some models provide results more quickly, which may be useful if you experience hypoglycemia and need to act quickly to treat it. Other models are smaller and more portable, or offer more memory to store more results. There are also models with larger screens and sound features for those with vision problems. Before you choose a model, note the price of the testing strips. You will need to purchase these regularly, and they can become costly. Each model of blood glucose monitor is slightly different, so follow the operating instructions that come with yours.

Your doctor may recommend that you test two or more times each day. They will tell you the best times to test; these will likely be at mealtimes and bedtime. Follow your doctor’s instructions on when to test, and keep accurate records of each result. Your doctor will also explain your target range and what to do if your blood glucose falls above or below that range. Your target range will depend on many factors, including your age, overall health, how long you have had diabetes, and whether you have developed complications. Your target range may differ from that of other people with type 2 diabetes.

Your doctor will explain how to interpret the results of your blood glucose testing. Blood glucose levels are expressed in terms of milligrams per deciliter (mg/dL). For instance, people under age 60 who have diabetes but are otherwise relatively healthy might have a range of 80 and 120 mg/dL, while older people and those with other conditions such as heart or kidney disease might have a range of 100 and 140 mg/dL. In addition to the daily measurements you take at home, your doctor will measure your A1C levels twice a year. AIC levels indicate your average blood glucose levels over the past few months. A1C levels are expressed as a percentage. A1C may also be expressed as eAG, or average glucose. Your eAG number may be easier to understand, since it is expressed in mg/dL like the tests you take at home. Your doctor will help you understand what your A1C or eAG numbers indicate about how well your blood glucose is controlled.

Make sure the skin where you plan to test is healthy. If one area is sore, wait until it heals before you prick it again. If you are testing at your fingertip, choose a site on the side of your finger near the nail bed rather than the pad of the fingertip, which hurts more. When you are ready to test your blood glucose, wash the area you will prick with soap and water. Any lotion, other skin product, or traces of food can cause incorrect blood glucose results. Do not use alcohol to sterilize the spot; it can cause stinging. Used lancets quickly grow dull and cause more pain, so use a new lancet each time. If the stick does not produce enough blood, let your hand hang down below your waist for a minute to allow blood to gather. Squeezing hurts more.

Each time you visit your doctor, bring your testing results with you. Be honest with your doctor about how consistently you take your medications as directed. Occasionally, bring your home blood glucose monitor with you to your doctor’s office and test yourself with it at the same time the doctor tests you, and compare the two results. If the results from your monitor are off from the laboratory results by more than 15 percent, you may need a new monitor.

If you use an insulin pump, your doctor may recommend continuous blood glucose monitoring. A continuous blood glucose monitor consists of a sticky patch with a tiny needle worn on the skin and a small electronic recording device. The monitor in the needle wirelessly transmits blood glucose level readings to the recording device, which must be kept near you. The device will test your glucose levels and display the results once every few minutes. You will need to remove and replace the patch on a different part of your body each week. You will still need to perform regular finger sticks with a traditional blood glucose monitor to make sure that the continuous glucose monitor is calibrated correctly. Continuous blood glucose monitors are more expensive and less accurate than traditional testing.

If your type 2 diabetes is poorly controlled, your doctor may recommend that you test your urine for ketones. Ketones are acid molecules released when your body has very high blood glucose levels and is forced to break down fats for energy. Ketone testing kits, which involve dipping a testing strip into a cup of urine, are available at pharmacies. You may need to test for ketones if your blood glucose is exceptionally high, if you are ill, or if you are experiencing nausea, vomiting, and stomach pain that could indicate ketoacidosis. If you have moderate or high levels of ketones, call your doctor immediately or go to the nearest emergency room.

Intended Outcomes
Regularly monitoring your blood glucose levels can help you better control your diabetes and use your medications more effectively. The results of your home blood glucose testing help your doctor understand how your diabetes is progressing and change your medications if necessary.

Results
A study published in 2003 followed 689 people with type 2 diabetes, half of whom monitored their blood glucose levels, while half did not. At the end of 24 weeks, the A1C of all participants was tested. Those who had monitored their blood glucose levels showed significantly better control compared with those who did not.

Constraints
Cost and your health insurance program may limit what type of blood glucose testing monitor you can choose.

Some people find the skin pricks associated with blood glucose testing to be uncomfortable.

It may be difficult to remember to test your blood sugar at the correct times. Consider leaving yourself notes or setting alarms on clocks or phones to help you remember.

It will be necessary sometimes to carry your blood glucose testing materials with you when you are out of the house.

Blood glucose testing Questions

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