Published on Nov 16, 2014 and last reviewed on Jul 28, 2022 - 5 min read
Abstract
This article discusses self-checking of glucose levels at home, which is helpful and recommended, but variations can occur. Once in three months, HbA1C level estimation is recommended. Please read the article to know more.
Introduction:
Any food or drink intake alters the metabolic milieu in the body. For example, insulin is released, digestion happens, and glucose levels rise in the blood. Therefore the blood glucose level rise and fall with each episode of food intake.
Self-checking of blood glucose looks at the glucose level at that point of time - a snapshot. It is a reflection of the time, type, and quantity of food consumed earlier, with the type of physical activity involved. When there are non-specific symptoms like dizziness, sweating, a self-check helps to show the presence or absence of low-sugar level (hypoglycemia) in the blood. Regular testing can also help to avoid long-term health problems like:
Heart disease.
High cholesterol.
Kidney diseases.
Blindness.
Skin problems.
The pitfall is that if the check is done in the morning, it does not reflect the glucose level changes that happen after lunch, after snacks, or after dinner. Also,
There can be a 5-15% variation of the result when using the glucometer.
Checking at a laboratory with a venous blood sample is the gold standard.
Finger-prick blood (capillary blood) will not reflect the exact glucose level in the blood in the body.
1) Traditional Home Glucose Monitoring Device:
Follow these steps when you measure the blood glucose levels,
Clean the area (tip of the finger) to be pricked with a disinfecting solution like Dettol.
Prick the finger with the sharp needle called a lancet, which is given along with the glucose monitoring kit.
Wipe the first drop of blood with cotton so that you will remove the tissue cells present along with the blood as it can give false readings.
Then massage or squeeze the finger to get a blood drop.
Put the second drop of the blood on the test strip.
The test strip is attached with a meter that displays the blood sugar levels.
Always record the test results because you can share the results with the doctor.
Based on the results, the doctor will adjust the diet, exercise, and medication.
About the Device:
The meter box of home glucose monitoring devices varies in:
Features.
Portability.
Speed.
Size.
Cost.
Readability.
The home glucose monitoring devices deliver the results within 15 seconds, and they store the information for future use. Some devices also calculate the average blood sugar levels over a span of time. Some devices also have software kits that can take information from the meter (past test results) and display it as a graph and chart. These devices are easily available at the local pharmacy.
2) Devices That Test Other Parts of the Body:
Some devices test the other parts of the body, such as-
Upper arm.
Forearm.
The base of the thumb.
Thigh.
But the result of this device differs from the results of the blood sugar levels obtained from a fingertip stick. This is because the levels obtained from the fingertips show the changes more quickly when the sugar is changing fast (after a meal or exercise). When you have low blood sugar, do not always rely on test results from other parts of the body.
3) Continuous Glucose Monitoring System:
Some of the continuous glucose monitoring systems are combined with insulin pumps. But these devices are not accurate as of the results of finger-stick glucose. However, these devices help to find the patterns and trends in blood sugar levels. These devices are called interstitial glucose measuring devices by the doctors.
When this method is preferred, a tiny sensor is placed under the skin to check blood glucose levels every 5 minutes. They start to send the data by monitoring for a few days, and you will still need to check the blood glucose levels throughout the day. This provides the doctor with more information about trends as self-checking might not show.
Each person is different, and the doctor only can tell when and how often one should check for their blood glucose levels.
When a person is on Insulin or Insulin pump more than once a day, checking the blood glucose levels at least three times a day is recommended.
The ideal blood glucose level ranges from 80 to 120 mg/dL before having a meal and less than 180 mg/dL one to two hours after beginning a meal. It is for all adults except pregnant women.
The ideal range of blood glucose levels may be different from another person, and it can change throughout the day, and so check with the doctor for the targets.
Regularly checking the blood glucose levels will,
Help to manage blood sugar levels.
Help to know about the improvement due to the diabetes treatment plan.
Make us think about food affecting blood sugar levels.
Make us think stress and illness affect sugar levels.
Make us know how well diabetes medications are working.
Make us know when blood sugar levels are too high or too low.
The factors that affect the results of blood glucose levels are,
Results will not be accurate when the person has anemia or gout.
When being in a hot, humid state or are at a high altitude can also interfere with the results.
When you take vitamin C before the monitoring of glucose, it can affect the result.
When you constantly see unexpected results, recalibrate the meter; also check the strips.
Conclusion:
One has to understand that, to prevent complications due to diabetes like kidney dysfunction (diabetic nephropathy), eye problem (diabetic retinopathy), and neuropathic problems (diabetic neuropathy) from occurring, the overall glucose control (i.e., 24 hour time period) is equally important.
HbA1C gives an overview of glucose control over the last 90 days and takes into account all three meals and the intermediate snacks too.
Many of the important International Trials looking at diabetes and its complications use HbA1C as a monitoring parameter and not blood glucose.
To conclude, self-checking of blood glucose is useful and recommended,
To have an understanding of the glucose variations that happens due to each type of foodstuff.
To have a gross idea of the prevailing glucose level.
To rule out hypoglycemia.
HbA1C level is recommended to ascertain the overall correctness of diabetes management.
First, wash and dry your hands well to check blood sugar levels at home. Insert a test strip into the blood glucose meter. Then prick the side of the fingertip with the needle provided with the test kit. Carefully drop the blood to the edge of the test strip. The blood sugar level will be displayed on a screen within seconds.
An electronic device called a blood glucose meter, or continuous glucose monitor (CGM) can check the blood sugar level at home.
Blood sugar levels are the highest in the morning from 2:00 AM to 8:00 AM. This is believed to be due to the dawn phenomena, the natural overnight release of the counter-regulatory hormones, including cortisol, epinephrine, growth hormone, and glucagon, that increases insulin resistance and causes blood sugar to rise.
The best time to check blood sugar levels is before breakfast, dinner, or bedtime.
During fasting, the hormone glucagon is stimulated and raises the plasma glucose levels in the body. People with diabetes either do not produce enough insulin or their bodies cannot use the insulin effectively to rebalance their blood sugar while fasting.
The World Health Organization (WHO) recommends using the middle or ring fingers to test the blood glucose level. It is advised not to use little fingers as the skin is thin.
An individual can test their blood glucose levels at home to measure fasting blood glucose levels immediately after waking and before they take anything to eat or drink.
Regardless of when a person consumes food, a level of 200 mg/dL or higher suggests diabetes, especially if they show the signs of diabetes, such as extreme thirst, weight loss, and frequent urination.
The first drop of blood after pricking with a needle contains a greater volume of platelets, this can make the site seal up soon before obtaining enough blood for the test, and the dual wipe will provide a longer, larger flow of blood.
The finger-stick blood samples, also called lancet devices, have two parts: a lancet holder and a lancet or needle placed in the holder. And the lancets are advised to be used only once.
Some diabetic people use their insulin lancets and syringes more than once to save money. But the manufacturers of lancets and syringes do not recommend using them more than once as it is dangerous and can even cause numerous skin infections.
For accurate results, it is recommended to use a fresh lancet every time while checking the blood glucose readings. Also, the needle can get dull and hurt if it is reused.
Researchers have found that if we skip breakfast once a week, it is connected with a 6 percent higher risk of obtaining type 2 diabetes. As we skip breakfast 4 or 5 times per week, it can increase to 55 percent.
If the insulin pens are unopened, they can be stored in the refrigerator until their expiration date. Most makers recommend keeping the insulin pen outside the fridge at room temperature after opening it.
Certain insulin pens are disposable after the insulin is used, while other pens can be reused by inserting a new insulin cartridge.
Last reviewed at:
28 Jul 2022 - 5 min read
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Dr. Ajit Swaminath Venkatapathy
Diabetology
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