Ways to monitor your blood sugar

One of my girlfriends is a doctor whose husband is a young, insulin-dependent diabetic man who doesn’t like to keep track of his blood sugar levels.  She’ll sneak a peek at how often he checks them and is regularly dismayed when she realizes that it’s not very often.  Not surprisingly his blood sugar levels are all over the place and his diabetes is not under optimal control. 

Keeping diabetes under control, especially if you are insulin dependent, requires measuring blood sugar levels regularly. This process traditionally involves pricking your finger to get a small blood sample, which you dab onto a strip. The strip is inserted into a monitor that reads your glucose level. Newer self-monitoring equipment measures glucose levels continuously through a small catheter (or tube) that is inserted under the skin.

If you’re taking insulin, monitoring your blood sugar level is crucial because it varies throughout the day and you may not always realize when it dips too low or spikes too high. Regular monitoring lets you know if your blood sugar levels are in the healthy range. Close monitoring can also help you adjust the timing and amount of insulin doses, which must be balanced with food intake and exercise.

Besides helping you reach your glucose goals, self-monitoring can help with prevention and treatment of low blood sugar if you take insulin or one of the other drugs that can cause hypoglycemia, such as the classes of diabetes drugs known as sulfonylureas or glinides. Even if you’re not taking insulin or one of these other drugs, self-monitoring may occasionally be useful to show how you’re doing. Frequency of testing varies. Some people may need to check their blood sugar levels only once a day or when suffering from a brief illness, such as a stomach flu; others may have to do so four or more times a day. Your doctor can help you determine how often, and when, to check your blood sugar levels.

Because traditional blood glucose monitoring requires considerable effort, many people with diabetes (like my friend’s husband) test themselves less frequently than recommended. The good news is that several new devices may make it easier for people, particularly those who have unstable blood sugar levels and frequent hypoglycemia, to test themselves more often. These devices provide a glimpse into the future of less-invasive glucose monitoring, when testing will be effortless, automatic, and continuous.

Continuous glucose monitoring devices use a sensor inserted just under the skin to record glucose levels continuously for up to three days. The sensor samples the fluid between your cells every one to five minutes to provide a more complete profile of your blood sugar levels. Both the person wearing the device and his or her physician can then review the glucose profile and determine how sugar levels fluctuated in response to diet and activity levels and medications.

This technology is particularly helpful for patients with hypoglycemia unawareness, who are at high risk for severe hypoglycemia. Continuous monitoring can warn them of impending low glucose levels. Currently available continuous glucose monitoring systems include the DexCom STS, the Medtronic Guardian, and the Medtronic MiniMed Paradigm (the latter incorporating an insulin pump into the system as well).

Researchers are further investigating several noninvasive strategies, including the use of near infrared spectroscopy or implantable sensors. Continued advances in monitoring research should result in improved devices.

No matter what equipment you choose, your medical team will explain how to use it properly and how to keep a log of blood glucose readings, insulin shots, and food intake. By keeping a daily record of your blood tests, you can tell how well you’re managing your diabetes and, with the advice of your health care team, make adjustments in your treatment plan.

Since my friend is a doctor who has seen the many potential complications of diabetes, which are usually more pronounced in people who don’t pay attention to their blood sugar levels, she knows that her husband is not doing himself any favors by not paying close attention to his levels. With new technology, it’s becoming easier and easier to pay attention, so if you have diabetes, keep tabs on your blood sugar levels and if they are not under good control, talk to your doctor.

How do you monitor your blood sugar? What methods have you tried? Nearly 21 million Americans suffer from diabetes, and as anyone who has been affected by the disorder knows, it is about much more than a statistic: it means a new way of life. Diabetes: A plan for livingis a special report from Harvard Medical School that will help you learn how to better understand and manage your diabetes, including type 1 and type 2, as well as other variations of the disease. This report will show you that it’s not just possible to live with diabetes; it’s possible to live well. 

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