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Blood Sugar Monitoring Made Convenient and Accurate
If you have diabetes, you know that maintaining normal blood glucose levels is critical. Fortunately, blood glucose monitors (also called meters) are accurate and reliable. Readings can be used to monitor drug therapy and help adjust your dose of insulin or oral medications. While there are other methods to measure blood glucose levels, such as lab testing and urine glucose test strips, none can match the convenience, accuracy, and reliability of blood glucose monitors.
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Monitors are an Important Tool
Self blood glucose monitoring (SBGM) is an essential part of managing both Type I and Type II diabetes. Diabetics need to be able to measure their blood glucose throughout the day in order to more effectively manage their sugar and insulin levels. The major advantage of blood glucose monitors is that they tell you your CURRENT blood glucose level. This makes them preferable to urine glucose test strips, which give you your sugar levels from a few hours ago.
Make Sure You Know How to Use the Monitor
- Learning the proper use of a blood glucose meter takes at least one month. Make sure you obtain proper training from your doctor or pharmacist.
- Diabetic children over the age of five should be taught to use a blood glucose meter on their own.
- Parents should perform blood glucose tests on the child's meter at least once a week, to stay familiar with the test.
Choosing a Blood Glucose Meter
There are as many differences among blood glucose meters as there are differences in each person's needs. The best way to choose the right meter for you and your lifestyle is to determine which meter and strip combination you are most comfortable with, and make sure it fits your budget. If the meter user is a child, it is best to allow him or her to have a voice in the selection. You want your child to be comfortable with the device.
Choosing a Blood Glucose Monitor
- Most pharmacies and drugstores carry blood glucose meters and their accompanying strips.
- Not all test strips are compatible with all meters. Confirm compatibility before choosing your meter and strips.
- Blood glucose meters vary in technology, price, size, battery requirements, memory, and options. Shop carefully before committing to purchasing one meter.
- Different types of meters require different amounts of blood in order to produce an accurate reading.
- Meters vary in size. Some are very small and perfect for traveling, while others can be more bulky.
- Meters can be as small as pens! While these may be easy to carry, they may be more difficult to manipulate. Make sure the meter is comfortable to use.
- Different meters can withstand different extremes of temperature. Choose one suitable for your region.
- Some meters require batteries. All batteries are not created equal! While some machines may use household batteries, others are specially made or expensive and difficult to obtain.
Extra Options You Might Want to Look For
- Keeping track of your blood glucose levels is essential, so you may want to get a meter that is capable of storing past readings. There are ones on the market that can store up to 250 past readings.
- If you are visually impaired, make sure you can read the digital readout of your meter! Colorblind individuals should make certain that the readouts are not in red or green.
- Some meters can deliver audible readouts.
- Meters come in a number of foreign languages. Contact the manufacturer to see if they offer the meter you prefer in the language you require.
- A wonderful new option is a data management system that is able to take the information stored by your meter and load it into a computer. Check to see if there are any software programs that are compatible with both your computer and your meter.
- Manufacturer's technical support and training is available with the purchase of some meters.
Your Monitor Needs Careful Calibration
- Like all electronic devices, blood glucose monitors require proper care, maintenance, and calibration.
- There are two different technologies used by blood glucose meters to measure glucose levels. In general, they are equally accurate.
- Your blood glucose meter is of little use to you if not calibrated correctly, but it can't tell you when it needs calibration. It's up to you to be certain that it is accurate!
- Blood glucose meters come with control solutions and test kits. Use them!
- Each new batch of strips requires a new calibration.
- The accuracy of blood glucose meters varies from brand to brand and even within the same brand, from meter to meter!
- Remember to take your blood glucose monitor with you the next time you get a lab test performed on your blood.
- Test your blood glucose when the blood for the lab test is drawn, comparing your meter's reading to the test results.
The Long-Term Costs of a Monitor Vary
- You will be pleasantly surprised to find out that the actual meters are relatively inexpensive.
- However, the costs for test strips adds up quickly, running from 75 cents to a dollar each!
- Check with your insurance company to see if it will cover your meter and strips.
- Also ask your insurance company if their allowance for strips covers your requirements.
- Sometimes manufacturers will replace batteries for free, so check first before ruling out a meter with expensive or difficult-to-obtain batteries.
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INGREDIENTS
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Monitor Your Blood Glucose Level
- Blood glucose monitors measure the specific level of glucose present in your blood sample.
- Short of a lab test, blood glucose monitors are presently the most accurate means of providing you with your blood glucose levels.
- Unlike blood glucose urine test strips that give you your blood glucose level from a few hours ago, blood glucose monitors give you the present amount of glucose in your blood.
How To Use a Blood Glucose Monitor
- Blood glucose monitors can be divided into two major categories, differentiated by the kind of technology they use to determine your blood glucose level.
- Both types of blood glucose meters utilize chemically treated strips which are sold separately.
- One type of meter measures the amount of glucose in your blood by using a strip treated with glucose oxidase. The glucose oxidase on the strip reacts with the glucose in your blood, causing a color change. These strips are not the same as visually-read glucose strips. You must place these strips in a meter in order to get a reading. The meter can read color far more accurately than the human eye can.
- The second type of meter runs an electrical current through your blood in order to determine the amount of glucose in your sample. The strip is treated with an enzyme that pulls electrons off glucose and onto the strip. The movement of electrons from glucose towards the enzyme embedded on the strip creates a current. The strip must be placed in the meter and the meter measures the current. A weak current signals a low blood sugar level, whereas a strong current signals a high blood sugar level.
How does at-home blood glucose monitoring differ from the lab tests run at the doctor's office?
- As we have mentioned, blood glucose monitors measure your blood glucose levels in two ways. One, by reacting with glucose in your blood and changing color, and the other by running a current through your sample in order to determine the amount of glucose in the sample.
- The tests run by your doctor through a clinical laboratory also measure the amount of glucose in your blood. However, the means by which they detect and measure glucose presence is much more sophisticated.
- Tests run in labs use spectrophotometry combined with automated equipment.
- What is spectrophotometry? It is a process by which a light of a known wavelength is shined through a solution. A certain amount of light will be absorbed by the glucose in the sample. This will give a quantitative measure of the amount of glucose in the solution by measuring the amount of light absorbed.
Pre-Test Precautions
- Always read the directions provided by the manufacturer.
- Make sure your batteries are not low.
- Frequently calibrate your machine using the test kits and control solution strips provided by the manufacturer.
- A blood glucose meter should never completely have the last word. If you get a normal reading yet you feel as if your sugar level is not under control, listen to your body. Your meter may be malfunctioning!
- All strips have expiration dates. Make sure yours are not expired.
- Oils on your hands can interfere with readings.
- Washing your hands is not completely necessary. Just don't let your skin come in contact with the strip.
- Ideally, only your blood droplet should come in contact with the strip.
- If you do wash your hands, make sure you dry them completely. Excess water can dilute your blood sample.
- Studies have been performed that confirm that washing your hands prior to a test does not decrease your chances of infection.
- If hands are excessively dirty or infected, wash your hands, but remember to dry them thoroughly.
- Always use a lancing device or lancet to stick your skin. Never use a pin or needle.
Performing the Blood Glucose Test
- Using a lancet or lancing device, stick your finger. The quicker the stick, the lesser the pain.
- Obtain a sufficient amount of blood.
- Immediately place the blood droplet on the strip, being careful to avoid skin contact with the strip.
- Do not smear the blood.
- Do not add more blood.
- If you have not provided a sufficient amount of blood, start over with another finger and another test strip.
- If you are using a blood glucose meter which reads color, wait the amount of time instructed by the manufacturer before wiping off the excess blood.
- If you are using a blood glucose meter which reads currents, do not wipe the excess blood.
- Carefully place the strip in the meter and you should have your reading in anywhere from a few seconds to a few minutes, depending on your meter.
- Read immediately and record the result in a log book even if your meter possesses memory.
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Remember Your Medical Identification
- Always wear an emergency information bracelet, necklace, or other form of identification to inform emergency responders and others that you have diabetes. This helps emergency responders deliver appropriate care.
Maintain Your Meter Properly
- NEVER share a blood glucose meter with anyone. Infectious diseases such as hepatitis and AIDS can be transmitted.
- Always maintain your blood glucose meter as directed by the manufacturer.
- Dispose of your strips properly. While not as hazardous as syringes or lancets, strips should be handled with care.
- Keep your meter clean, but make sure you use the proper cleaning ingredients. The wrong chemicals can damage your machine.
- Each batch of new strips calls for a new calibration.
Treat Test Strips Carefully
- Blood glucose/reagent strips are sensitive to humidity and excessive heat. Store them properly.
- If you suspect that a strip is defective, do not assume that the rest of the strips from that batch are okay. Often, whole batches are defective. Contact the manufacturer.
- Presently, there are no drugs that have been shown to interfere with the accuracy of blood glucose/reagent strips.
Hypoglycemia Happens
Hypoglycemia, low blood sugar, may occur if you have diabetes. Don't immediately blame yourself for episodes of hypoglycemia; in managing your diabetes, you are attempting to control a very complex, intricate, and inconsistent system. Hypoglycemic episodes can be avoided. If you are experiencing hypoglycemic episodes, contact your healthcare provider to see how you can avoid hypoglycemia.
Generally, if your blood sugar drops below 50 to 55 mg/dl, you are considered hypoglycemic. Before you decide to treat your hypoglycemia with glucose tabs, gels, or other sugars, take (if possible) a blood glucose test to determine how much sugar you need. Symptoms will vary from person to person, but here are some hypoglycemia warning signs to watch out for:
- Rapid heartbeat
- Excessive sweating
- Muscle tremors (shakiness)
- Anxiety
- Hunger that can be extreme
- Irritability
- Vertigo
- Headache
- Blurred vision
- Confusion
- Convulsions in extreme cases.
- Unconsciousness in extreme cases
- Lethargy
- Fatigue
Hypoglycemia Unawareness
It is possible to have hypoglycemia and not experience any of the early warning symptoms. You may experience only the mental symptoms, and none of the physical symptoms. - Hypoglycemia unawareness was originally thought to be caused by nerve damage from living with diabetes for many years. This causes an absence of epinephrine release in response to low glucose levels.
- It is now thought that hypoglycemia unawareness may be caused by frequent episodes of low blood glucose, without pre-existing nerve damage. Episodes of hypoglycemia seem to lower the glucose levels at which epinephrine release, causing hypoglycemia without any of the physical symptoms.
- Hypoglycemia unawareness tends to affect people who control their glucose levels stringently. It also tends to affect pregnant women.
- An interesting comparison occurs in people who do control their blood sugars poorly. These people experience physical symptoms of hypoglycemia at much higher blood glucose levels than the average diabetic person.
If you have hypoglycemia unawareness, you need to consult your healthcare provider. Together you can develop a treatment regimen to ensure that you have adequate blood glucose levels and avoid situations where you might have low blood glucose. Keeping blood sugars at adequate levels to avoid hypoglycemia for days to weeks has been shown to restore sensitivity to hypoglycemia.How To Treat Hypoglycemia
- Get carbohydrates, "quick sugar", immediately. Carbohydrates can come from glucose tablets, non-diet soda, hard candy -- anything rich in sugar.
- Do not use carbohydrate sources that are also high in fat such as ice cream, chocolate, or cake. The excess fat can inhibit the absorption of carbohydrates.
- Keep your convenient glucose sources in your purse, pocket, car, or any other place that is quick and easy to access.
- Treat hypoglycemia correctly. Do not overeat carbohydrate sources or eat too little carbohydates.
- You should consume about 10 to 15 grams of carbohydates. Look at the nutritional labeling of the products you buy to determine how much you should consume to get 10 to 15 grams of carbohydrates. Do this ahead of time, not when you are experiencing hypoglycemia, because you might be tired and not thinking clearly.
- Below are some food equivalents for 10 to 15 grams of sugar:
6 large jellybeans (not the tiny gourmet kind)
4 to 7 LifeSavers
2 tablespoons of raisins
2 teaspoons of table sugar or honey
6 to 8 ounces of skim milk
Half a can of soda (not diet)
Note: "Quick sugar" is for temporary relief of hypoglycemia. You should eat a small snack after "quick sugar" to avoid prolonged hypoglycemia. - Remember that it can take up to 20 minutes before carbohydates are efficiently absorbed into your bloodstream. If after 30 minutes you still feel symptoms of hypoglycemia, take another 10 to 15 grams of carbohydrate. Repeat this process until your symptoms are gone.
- If after two attempts of consuming sugar your symptoms have not disappeared, seek medical attention.
- It may be difficult but you must resist the temptation to eat more carbohydrates. Overeating can lead to hyperglycemia.
Note: If at any time you feel you are unable to help yourself due to signs and symptoms of hypoglycemia, call 911.
Educate Others
- Please educate your friends, family, and co-workers about what to do if you become unconscious.
- If you do become unconscious or so debilitated that you cannot ingest glucose tabs or food, you need glucagon, an injected drug that counteracts hypoglycemia.
- Instruct friends, family, and co-workers to take you to the hospital and/or call for an ambulance. Remind them that these are life-and-death situations.
- If you cannot receive medical attention immediately (in the case of a long ride to the hospital or a wait for an ambulance), instruct friends, family, and co-workers to place some glucose gel or cake frosting between your cheek and gums and to massage the outside of the cheek to help the gel or frosting dissolve.
- Make sure friends, family, and co-workers do not attempt to force sugar or food down your throat! You can choke!
- ALWAYS, no matter how well you manage your diabetes, carry glucose tabs, gels, or their food equivalent with you at all times and let those who are around you know exactly where they can find them.
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Websites, Organizations & Manufacturers
Sources & Further Reading
Books
- 1. American Diabetes Assocation.American Diabetes Association: Complete Guide to Diabetes. New York: Bantam Books 1996.
- 2. American Pharmaceutical Association. Handbook of Nonprescription Drugs. 11th ed. Washington., D.C.: American Pharmaceutical Assocation 1996.
- 3. Fauci, Anthony S. et al. Eds. Harrison's Principles of Internal Medicine, 14th ed. New York: MacGraw Hill 1998.
- 4. Saudek, Christopher D. et al. (Baltimore: JHU Press, 1997.The Johns Hopkins Guide to Diabetes for Today and Tomorrow. Baltimore: JHU Press 1997.
Find more books on health and wellness at  barnesandnoble.com.
Articles
- 1. Bayne, C. Gresham."How sweet it is: glucose monitoring equipment and interpretation.". Nursing Management; Vol. 28 9/1/1997.
- 2. American Diabetes Association."Blood glucose monitors and data management." (American Diabetes Association's '95 Buyer's Guide to Diabetes Supplies) (Buyers Guide). Diabetes Forecast; Vol. 47 10/1/1993.
- 3. American Diabetes Association."Buyer's guide to diabetes products '98.(Buyers Guide).". Diabetes Forecast; Vol. 50 10/1/1997.
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