DIABETES

Monitoring and Diabetes

It is extremely important to monitor your diabetes control on a day-to-day basis. This may involve blood glucose testing and sometimes even ketone testing at home.

Knowing when and how often to monitor is very important. Your results will help you and your physician to decide whether changes need to be made regarding your meal plan, activity, and treatment plan.

SELF BLOOD GLUCOSE MONITORING (SBGM)

Listed below are times that you may be asked by your health care provider to monitor your blood sugar:

1. Fasting (first thing in the morning - usually 8 hours without eating or drinking anything but water)

2. Before meals

3. 1-2 hours after meals

4. At bedtime

5. At 3 a.m.

You may be asked to monitor more often if:

1. You are newly diagnosed

2. There have been changes made to your regimen (meal plan, medication regimen, or activity)

You may need to check more often for at least one to two weeks in order to decide how your medication and treatment plan is working. Your health care provider may ask you to monitor several times throughout the day and at 3 a.m. if you are on insulin and changes are being considered.

All patients are encouraged to test three times or more per day for best results. However, if there have been no changes made to your regimen, your blood glucose level is stable and you have met your goals, you may test less often.

When you are ill, you will need to test blood glucose more often and may need to test ketones as well (see Sick Day Rules):

1. Test your blood sugar every 4 hours (or as medically advised) until stable and you are feeling better.

2. Test for ketones in your urine when you are ill or not feeling well.

3. Test for ketones whenever your blood glucose is > 250 mg/dl.

4. Rest and get plenty of fluids (water), if permitted. Call your health care provider if:

1. Your blood glucose is > 240 mg/dl for more than two days,

2. Your blood glucose is < 70 mg/dl more than twice a week or

3. If you have moderate to large ketones for over 24 hours.

When you call your health care provider, be sure you:

1. Have your log book and glucose records handy so you can tell them the dates, times and values.

2. Know which medications you have taken or may have missed.

3. Provide as much information as possible so your doctor or educator can make a wellinformed decision regarding what is happening to your glucose control. Test your blood sugar whenever you do not feel well. Note on the comment section of the logbook any related symptoms, circumstances or treatments that may have occurred. For example: if you ate a particularly large meal, if you forgot to take your medications, if you had a low blood glucose reaction, etc. Every time you go to see your physician or diabetes educator, be sure you take your log book, meter, and medications along so that they can review your glucose results, check that your meter is working properly, and make sure your medications are still current and correct.

REMEMBER: The more often you check your blood sugar, the more opportunities you will have to change the course of your diabetes.