Monitoring your sugar levels can help you to understand much more about the effects of food, exercise, work and general lifestyle changes on your sugar levels. It can be a useful tool to help you make changes to improve sugar / diabetes control. If the diabetes is not well controlled then this makes it more likely that you get complications of your diabetes or become ill because of your diabetes.
There are three ways that diabetes control can be monitored.
Home blood glucose monitoring
Urine testing
HbA1c test -This tells you how well your diabetes is being controlled on average over a 3 month period. Your diabetes team will discuss whether blood or urine testing is best for you.
Who needs to monitor diabetes control? It is impossible to tell how well controlled the sugar level is without doing some form of monitoring with either HbA1c (nurses), or home blood glucose monitoring or urine testing by the person with diabetes. In order to know how your diabetes is controlled on a day to day basis you may need to test your urine or your blood. Not everybody needs to do urine or blood testing themselves because regular HbA1c testing might give enough information.
WHAT IS GOOD CONTROL?
Good control means avoiding:
Very High blood sugar levels are anything above 7mmol/l Hyperglycaemia is the term we use when there is too much blood glucose in the blood. High blood sugars cause both short and long term problems.
Very low blood sugars below 4mmol/l Hypoglycaemia is the term we use when blood sugar levels fall below 3-4mmols/l.This happens when you are on certain medications and if you are late with your meals, or if you have had a burst of exercise.
It is very important to be able to identify when your blood levels are running out of your target range. The target range is between 4-7mmol/l
The way to do this is to regularly monitor at what level your diabetes control is presently running at.
SELF MONITORING YOUR DIABETES
The main aim in managing your diabetes is to ensure that your blood sugar levels are maintained within the range specified by the diabetes team.
There are two ways of monitoring your diabetes control.
Urine Testing -testing your urine for sugar Urine testing can be used when your HbA1c is in the desired range (around 48mol/l or 7%) and your treatment does NOT include insulin therapy. You should aim for negative results.
Blood Testing- take a blood sample for sugar levels. If your diabetes is managed with insulin therapy we would advise that your blood sugars levels are measured rather than using urine testing, and blood sugars should not fall below 4mmols/l. As a general rule blood sugar levels should be in single figures
SHOULD I TEST BLOOD SUGARS OR TEST URINE FOR SUGAR?
This is something that you and the health care professional looking after you should discuss. The amount of testing that you may find useful might be different at different times of your life. In general, it is important to realise that the tests that you do are only worth doing if you are finding them useful and act on the results. If you are not sure about this, please discuss this with your health care professional.
Discuss the advantages and disadvantages in both types of monitoring with your diabetes team as they can advise you based on your situation. At diagnosis of type 2 diabetes many patients may be advised initially to start monitoring their urine for sugar. However, as time passes and treatment therapies are added it may become more appropriate to start blood sugar monitoring.
WHEN TO TEST
It is best to test your blood (or urine) before meals or before bed and at different times on different days. this gives a good overall picture of your diabetes control and makes it easier to see where any adjustments to your treatment may be needed For example Over a period of 4 days
Day 1: Test before breakfast
Day 2: Test before lunch
Day 3: Test before evening meal
Day 4: Test before going to bed These are just guidelines more can be found in the further sections.
You may be asked sometimes to test blood levels 2 hours after meals to find out how effectively the insulin is dealing with your food.
MORE INFORMATION ON MONITORING YOUR DIABETES CAN BE FOUND IN THE SUBSECTIONS
Urine Testing including Ketone testing for type 1 diabetes
