Diabetes patients are suggested to monitor their blood glucose level regularly for more effective control of blood glucose level to reduce complications. Self-monitoring of blood glucose can help understand factors affecting blood glucose level which are important for adjustments on medication, diet and exercise in a way for effective blood glucose control.
Target of blood glucose control
Glycated haemoglobin (HbA1c)
- The target level of glycated hemoglobin (HbA1C) should be less than 7% is generally appropriate, which has shown to reduce complications.
- However, for some younger diabetes patients who has short diabetes history and without significant cardiovascular disease, they can set the optimal HbA1C value at 6.5% if achievable with simple drug regimen, no hypoglycaemia or adverse outcome.
- The HbA1c target at 7 – 8% or greater, may be appropriate for patients with advanced diabtes complications, especially those with severe hypoglycemia in the past.
Fasting and postprandial blood glucose level
Fasting or preprandial blood glucose target level: 5-6 mmol/L
2 hours postprandial blood glucose target level: 7-8 mmol/L
You should remember the “5678” as blood glucose target level!
Frequency and timing of self-monitoring of blood glucose
- Both frequency and timing of testing blood glucose should be individualized depending on a variety of needs, patients should set self-monitoring blood glucose plan with healthcare professionals
- How often?
- Fasting blood glucose – means fasting for at least 8 hours overnight, taken first thing in the morning before you eat or drink anything.
- Checking before meals (including breakfast, lunch, dinner)
- Checking after meals – 2 hours of post-meal, the clock for when to check starts counting down at the first bite of the meal.
- Random check – anytime in a day, or just before sleep, midnight or suspect hypoglycemia checking also counted.
- Patients need more frequent blood glucose checking, if you are:
- In a plan for pregnancy or during pregnancy
- Being sick e.g. infection
- Blood glucose level is not in control, and fluctuate frequently
- A change in daily routine such as traveling, physical activity or diet plan
- Changing dosage of medications
Advice for Self-monitoring blood glucose:
What you need to prepare for blood glucose test:
- Alcohol swab
- Blood glucose meter
- Test strip
- lancet
- lancet device
4 Steps of Self-monitoring blood glucose
Step 1:
Prepare a lancet and the glucose meter
Put the lancet into the lancet device and select the blood collection depth that needed.
Insert a new test strip into your meter. The meter will show a number code, check if the code is match with the number code on the package of the test strips.
Step 2: Use an alcohol swab to sterilize the puncture site, let the site dry before testing. Prick your finger with the lancet to get a small drop of blood.
Step 3: The blood goes on the test strip you inserted into the meter which will analyze the blood, then show you the blood glucose reading on its display automatically.
Step 4: Record the blood glucose reading in a log book
Hints for Self-monitoring blood glucose:
- If you are using an alcohol wipes to sterilize your fingertips, remember to let it completely dry before you prick the puncture site. Otherwise, the blood glucose reading may be affected.
- Use the sides of the fingertips instead of the tip to relieve finger discomfort and pain.
- Make sure you have proper amount of blood for a reading. Round blood drops are preferred.
- Please do not over-squeezing your fingers to avoid squeezing too much tissue fluid to affect the results.
- Test strips should be stored in closed vials to be protected from moisture. Please do not use test strips that are beyond their expiration date or being exposed to moisture, as the results might not be accurate.
- In winter, try warming your hands up on a warm mug or wash hands with warm water before doing your test, blood is more likely to flow out.
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