Finding a Time and Place for Monitoring
Blood glucose monitors are as small as a cell phone. Typically only a small drop of blood is needed for results within seconds, allowing patients to easily find the time and place to check their blood sugar levels.
Ideally a bathroom or kitchen is the best place to perform proper hygiene before testing and for equipment -- the monitor, the lancet or small, sharp instrument, and test strips -- to be placed on a stable surface. The used lancet and test strip should be safely disposed of afterward.
How Frequently Should Blood Sugar Levels be Monitored?
The American Diabetes Association recommends blood glucose testing at least three times daily for patients with type 1 diabetes who require the use of insulin -- an injected or inhaled medicine. The frequency for testing levels includes before and after meals, when performing exercise and at bedtime. Daily testing is still required for insulin users who also use oral medications.
Research is less clear for blood glucose testing for patients with type 2 diabetes. Patients who control their diabetes with diet or by using oral medications only may not require regular testing as with those who use insulin.
In addition, all patients with type 1 or type 2 diabetes should have periodic testing of A1C levels. An A1C test shows the patient's average blood glucose level for the last three months. This is useful in monitoring long-term glucose management.
Urine glucose testing isn't reliable for establishing glucose control and is not recommended. However, urine testing for ketones -- acids in the blood -- at times of illness, stress or extremely high blood sugar levels (>240 mg/dL) can help to identify ketoacidosis, which is a serious complication of Type I diabetes from a build up of acid in the bloodstream as a result of high blood sugar levels. If this occurs, immediate medical treatment is required.
Finding the "Right" Device With a Choice of Different Monitors
Blood glucose monitors are available to address special needs, including vision impairment and the need to carefully track blood glucose readings over time. For example, some glucose monitors have large visual displays for easier reading and some use audible cues for people with more significant visual impairment.
Other monitors save detailed data that can be downloaded to a personal computer. This can be useful for people who must maintain careful records of blood glucose readings, but may have difficulty remembering to consistently enter readings on a log. This type of monitor may also be useful for children and adolescents with diabetes, by preventing them from altering unfavorable blood sugar readings.
Some monitors feature other functions, such as the ability to draw blood from multiple sites on the body and extensive memory capacities to record up to hundreds of blood glucose readings.
Standard blood glucose monitors require a small, one-drop blood sample drawn from the skin to measure blood glucose levels.
The FDA has now approved a noninvasive glucose monitor that uses electrophoresis, or a small electrical current to draw body fluid through the skin without using any needles or poking through the skin. This fluid is analyzed for glucose content by providing data similar to standard blood glucose monitors.
Once a monitor is chosen, it is important to calibrate it with the first use for routine maintenance with new test strips. Sometimes it is recommended that patients have their monitors checked for proper use and calibration during clinic visits.
Continuous Glucose Monitoring Devices
New developments are being made on glucose monitoring devices that continuously monitor blood glucose levels. These measurements are taken using a small needle, an implantable monitoring device, or iontophoresis, which is an electrical current used to enter the skin.
Currently, continuous glucose monitoring is costly and unavailable to many patients. Further research and product refinements are being sought for the future to allow more widespread use of less expensive continuous glucose monitoring devices.
McCulloch, David K. "Blood Glucose Self-Monitoring in Management of Diabetes Mellitus." UpToDate.com. 2007. UpToDate.com. 21 Sept. 2007 (subscription).
McCulloch, David K. "Patient Information: Self-Blood Glucose Monitoring." UpToDate.com. 2007. UpToDate.com. 25 Sept. 2007 (subscription).
"Noninvasive Blood Glucose Monitors." National Diabetes Information Clearinghouse. NIH Publication No. 04-4551, Oct. 2003. National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health. 19 Nov. 2007.