Blood sugar and glucose monitoring


October 29, 2021


If you or your care recipient are pre-diabetic, or have diabetes, you want to keep blood glucose levels within a healthy range. Target levels differ for different people, so it’s best to ask you doctor what range is best for you. In this post we’ll review both high and low blood sugar, different types of monitoring, and how to track your levels. 

Hyperglycemia and Hypoglycemia

Sometimes blood glucose levels get too high; this is called hyperglycemia. Sometimes levels are too low; this is called hypoglycemia. The causes of hyperglycemia and hypoglycemia include:

  • too little medication, including insulin (can cause hyperglycemia), or too much (can cause hypoglycemia)
  • missing or skipping meals (can cause hypoglycemia)
  • too little food, especially carbohydrates (can cause hypoglycemia), or too much (can cause hyperglycemia)
  • too little physical activity (can cause hyperglycemia), or too much (can cause hypoglycemia)
  • illness, infection, or surgery (usually causes hyperglycemia)
  • emotional stress (usually causes hyperglycemia)

The symptoms of high and low blood glucose are often the same! It is important you learn to recognize the symptoms, take action, and know when and how to seek medical help. 

Although it is important to learn to recognize how you feel when your blood glucose is very low or high, feelings are not a reliable way to manage diabetes. Many people do not have symptoms until their blood sugar is very high or low. Some people with diabetes are not aware of of symptoms or may not link the symptoms to their blood glucose levels. This makes it very difficult to stay within their appropriate blood glucose range. If you don’t know your actual blood glucose level, you don’t know if your levels are too low or too high, so you won’t know what to do. The only way for you to know your blood glucose level is to monitor it.

Blood Glucose Monitoring

Management of diabetes involves keeping blood glucose in a safe range. The only way to tell if your blood glucose level is in a safe range is to monitor it. Monitoring is not a treatment. It is a tool to find out how you are doing. If you know our levels, you can make any needed day-to-day changes in diet and exercise, as well as changes in your medications, as recommended by your health care team. 

Depending on your medications, your type of diabetes, and what you want to know, blood glucose monitoring can be done in different ways. Be sure to get instructions on how to monitor your sugar levels and what equipment you will need. This will ensure accurate reults. Get specific instructions from your health care provider or diabetes educator. 

These are the ways to monitor blood glucose levels:

  • Home blood glucose monitoring.
    This is done by obtaining a small drop of blood (usually from a prick of a fingertip), placing the drop on a blood glucose strip, and putting the strip in a glucose meter to assess the glucose level. This self-check is easy to do at home or almost anywhere. It may be done a few times a week, once a day, or from 4 to 6 times per day, depending on how your diabetes is being managed. A glucose meter is about half the size of a cell phone or even smaller. You can carry one with you wherever you go. 
  • Continuous glucose monitoring and flash glucose monitoring for people using insulin and insulin pumps.
    In this type of monitoring, a glucose sensor under the skin provides ongoing glucose measurements. These sensors generally need to be replaced every 7 to 14 days. How often you replace your sensor depends on the type you are using. Some monitors have a separate reader and others let you check your glucose using your cell phone. Some let you avoid finger sticks. It is especially helpful to have a doctor, nurse, pharmacist, or diabetes educator (also known as a diabetes care and education specialist) observe your technique and give you tips. There is also a system that works with an insulin pump to help you control your blood sugar. Stay in contact with your health care team, as there are constant changes and improvements in this area. 
  • A1C Blood test.
    Your health care provider orders this test. The test is done in a doctor’s office or a laboratory. The results show your average blood glucose levels over approximately 3 months. For people with diabetes, a reasonable A1C goal may be 7 or lower. For people with several chronic conditions, and some older people, a higher A1C target – such as under 8.0% or 8.5% – may be appropriate. In come cases, a doctor may want to set a target of A1C 6.5% or lower. Talk to your doctor about the best target for you. 

Blood glucose monitoring is an important tool to help you manage your diabetes. It can help you learn more about:

  • if you think you might have low or high blood glucose
  • if you want to know how diabetes medication or insulin, changes affect your blood glucose
  • if you want to know how eating, exercise, and emotions affect your blood glucose
  • if you are sick and not sure what is happening with your blood glucose
  • if you want to know how you are doing day to day

Monitoring shows you how your eating, exercise, medication, stress, illness, and infections affect your blood sugar. Checking your own blood sugar gives you and your health care provider more flexibility when you are making decisions about how to control your blood sugar levels. Checking your blood sugar also helps you evaluate and take action if your blood sugar is too high or too low. 

Blood sugar levels change often throughout the day and night. Blood sugar naturally rises and falls during the day. It is usually highest an hour or two after you eat. A typical target range is likely from a low of about 80 mg/dL (first thing in the morning) to a high of 180 mg/dL after meals. Do not be concerned if your blood sugar fluctuates within YOUR target range. 

Recommended times to track

One way to learn more about your blood sugar is to track measurements. On two days – one weekday and one weekend day – monitor your blood glucose five times. Take measurements at the following times:

  • first thing in the morning before eating
  • before a meal
  • 2 hours after a meal
  • before exercising
  • after exercising

While this is a lot of finger pokes, the data you collect will help you and your doctor make an appropriate plan to manage your blood sugar. 

Reference: Living a Healthy Life with Chronic Conditions; published 2020 Bull Publishing Company

We hope this information is helpful to you in the important work you do as a family caregiver.
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