GLUCOSE MONITORING Why Self-monitoring of blood glucose is the best way to see how your body handles food, activity, diabetes medication (pills and/or insulin), stress and illness. You can also see what effect your medications have on your blood glucose level, which tells you whether your medication is working or not. This also helps your doctor in deciding what changes in your treatment plan are necessary if any. Your blood glucose result may prompt you to eat a snack, take more insulin, or exercise (go for a walk). It also lets you know if your blood glucose level is out or range, which requires treatment. Monitoring your blood glucose is a very important part of managing your diabetes. You will be able to see how changes in your treatment plan effect your blood glucose control and what happens if you do not follow your treatment plan. How When There is no set time or amount of times to monitor for everyone. There are many reasons to monitor at different times of the day. Monitoring at different times of the day lets you and your diabetes health care team know your overall blood glucose control and how to make changes in your treatment plan. The American Diabetes Association recommends that people with type 1 diabetes monitor frequently (at least 3-4 times per day) and people with type 2 diabetes should do monitoring at least once daily for those on insulin and/or diabetes pills. (The optimal frequency of monitoring for This product was developed by the Jordan Valley Community Health Center s Better Self 5-1
type 2 diabetes is not known, but it should be enough times to achieve reaching glucose goals). Some of the most common times to check are: Before each meal and at bedtime. Once a day testing before a different meal each day. Twice a day alternating, monitoring blood glucose before each meal of the day. Once a day alternating times. Fasting and two hours after a meal. Between 2 and 3 A.M.-tells you if you have low blood glucose in the middle of the night. Discuss with your doctor and/or your diabetes health care team to see how often he/she wants you to monitor. Do extra blood glucose monitoring when: Your doctor is trying to find the best dose of diabetes pills or insulin for you. You change your exercise program or meal plan. You start a new drug that can affect your glucose level. You think your glucose level is too high or too low. You are sick. You are pregnant. You travel. You are under a lot of stress. You drink alcohol. You eat unusual foods. Before, during and after exercise. Before you drive. Before activities that take a lot of concentration. Results Discuss with your doctor what your personal target blood glucose goals should be. Goals can vary according to age, other medical problems, and frequency of low blood glucose reactions. This product was developed by the Jordan Valley Community Health Center s Better Self 5-2
The American Diabetes Association has recommended the following target goals for blood glucose monitoring. Remember everyone s goals may be different! Whole Blood Time Glucose Goals Plasma Goals Before Meals 70-110 mg/dl 90-130mg/dl Bedtime 100-140 mg/dl 110-150 mg/dl Two hrs. After Meals less than 140 Most blood glucose meters use whole blood to measure glucose, while lab equipment uses the plasma portion of blood. Whole blood results are about 12% lower than plasma results. It is important to know the type of meter you are using when comparing your results. Always write down your results with the date and time they were done, and any other information that might affect your blood glucose levels. Use your logbook even if your meter has a memory. This will help you see the whole picture. Watch for patterns-look for high or low glucose values at the same time each day. Monitoring your blood glucose allows you and your health care team to make needed changes in your diabetes treatment plan. A better plan makes it easier for you to manage your diabetes. And, when you manage your diabetes, you can delay or prevent the long- term complications. So, use the results of your self-monitoring to help you manage your diabetes. This product was developed by the Jordan Valley Community Health Center s Better Self 5-3
HEMOGLOBIN HBA 1 c The HbA 1 c is a test that reflects your over-all blood glucose control for the past 2-3 months. Since your red blood cells live for about 3-4 months this test shows your blood glucose concentration levels during that time. It measures the amount of glucose that attaches itself to protein in your red blood cells. The greater the amount of glucose in your blood and the longer it remains high, the more glucose that will attach (coat) to those red blood cells. The HbA1c test does not replace your blood glucose monitoring. It is another way to look at your diabetes control. It is important to keep a record of your test results and know what your last HbA 1 c level is. This will help determine if you need to make changes in your diabetes management plan. Remember: This result does not tell you if you have been having multiple lows or highs and it can give you a false sense of control. Desired results and frequency of testing: The American Diabetes Association recommends the HbA 1 c test be under 7%. The ADA also states people who take insulin should have the test done four times per year. People who control their diabetes with diet, exercise and/or oral medications should have the test done as often as necessary to achieve their blood glucose goals (i.e. every 6 months). Hemoglobin A 1 c Level Concentration Of Blood Glucose Range for Last 3 months 6.0 % 135 mg/dl 7.0 % 170 mg/dl 8.0 % 205 mg/dl 9.0 % 240 mg/dl 10.0 % 275 mg/dl 11.0 % 310 mg/dl 12.0 % 345 mg/dl HbA 1 c Results Level of Control Less than 7 % Good 7 8 % Fair Greater than 8 % Poor This product was developed by the Jordan Valley Community Health Center s Better Self 5-4
KIDNEY FUNCTION High blood glucose, high blood pressure, and elevated lipid levels can damage the kidneys. The following blood and urine tests can evaluate the kidneys. 24-hour urine Is a test, which requires collecting urine over a 24- hour period in a special container that is returned to the doctor s office or lab for evaluation. BUN (blood, urea, and nitrogen) and creatinine A blood test that can be done to measure the BUN and creatinine. As kidney function deteriorates, the blood levels of these substances rise. Microalbumin This is a urine test which measures microalbumin and helps to show if kidney damage has started before too much damage is done. If microalbumin is found in your urine you may need to take medication or change your diet to reduce damage to your kidneys. Talk to your doctor about your results of these tests! This product was developed by the Jordan Valley Community Health Center s Better Self 5-5