Self-monitoring can help you keep diabetes in check, allowing you to stay healthy

Watching your blood sugar: self-monitoring can help you keep diabetes in check, allowing you to stay healthy

More than 10 million men in the U.S. have diabetes, a disease that causes too much sugar (glucose) to build up in the blood. Unhealthy blood-sugar levels can lead to serious complications, like blindness, and life-threatening ones, such as heart disease, high blood pressure and stroke.

Good control of diabetes, however, can greatly lower these risks. At-home blood-sugar testing, also called self-monitoring of blood glucose (SMBG), is one of the best ways to keep tabs on blood-sugar levels. Research has shown that when people with diabetes test often and keep good control of their blood sugar, they are more likely to stay healthy.

But, despite the importance of SMBG, many patients fail to do it as often as they should.

“People who are having trouble with symptoms do it well. Those who feel fine usually do it less often, and that can be dangerous,” said John P. Campbell, M.D., an endocrinologist and staff physician in The Cleveland Clinic’s Department of Internal Medicine.

Regular at-home testing is especially important if you take beta blockers, such as Toprol, for high blood pressure. Such medicine can block the symptoms of low blood sugar. People who do not take their blood sugar at periodic times can hit a critically low point that causes them to pass out.

Changes in your diet, medication, even exercise routine can cause swings in blood-sugar levels. High levels (hyperglycemia) can make a person feel drowsy and have concentration problems. The symptoms are similar to those caused by drinking too much alcohol. Low blood sugar (hypoglycemia) can cause sweating, sudden hunger, and lightheadedness. The symptoms get more serious as the blood sugar moves farther away from a healthy level.

The goal of blood-sugar testing is to keep blood-glucose levels close to normal. The American Diabetes Association recommends that people keep their pre-meal blood-sugar levels in the range of 80 to 120 mg/dl.

WHEN TO TEST

Who should test, and how often it should be done, can be confusing. A special report in The American Journal of Medicine indicated that people with Type 1 diabetes should test at least 3 times a day, while those with Type 2 need to check their sugar only once a day. However, some people, especially those with symptoms, may need to test more often. Some may be asked to check their blood sugar 2 hours after breakfast and supper. Others may need only periodic checks.

“People who take medicine for diabetes, particularly insulin or sulfonylureas, need at-home blood-sugar tests to make sure the medicine is doing its job,” Dr. Campbell said. “How often they test depends on how good their control is. If someone has good control, they may only need to check it once a week.”

Keeping a record of at-home blood-sugar results helps the doctor determine if the patient needs to make any changes in diet, exercise or medicine.

WHICH TEST TO USE

Many types of at-home blood-sugar testing devices are available. All are relatively simple to use and require only a tiny drop of blood. Certain models can remember previous test results. When buying test strips, always check to make sure they have not expired. Be sure to calibrate your device once in a while. You can do so by bringing it to the doctor’s office or lab that tests your blood-sugar levels. Some kits come with calibration strips. Make sure you check the expiration date on these strips, too.

Some new tests let you take blood from other parts of the body, such as the upper arm or leg, instead of the traditional finger prick. Dr. Campbell cautions against this type of testing.

“Fingers are more accurate,” he said. “The blood in the fingertips tends to show the most recent changes in blood-sugar levels.”

The results from at-home test kits can be off by 10 to 15 percent, compared with a test done in the lab. But, as long as the difference doesn’t push you into the wrong group, the variation is acceptable. For example, if your at-home test shows you have a blood-sugar level of 100, it really could be as high as 115 or as low as 85. But, you would still be in a healthy range.

TESTING YOUR BLOOD SUGAR

Ask your doctor when and how often you should check your blood sugar. Your doctor can also tell you the range for which you should aim.

Don’t force the blood out of your finger. Doing so can give you an incorrect result. If you get a result that is out of your target range, check your blood sugar again in two hours. If it’s low, it should go up with a glass of orange juice. If it’s high, steer clear of sugary foods. Also, make sure you write down your blood-sugar level every time you test.

If you have extremely low sugar levels and trouble walking and talking, or extremely high sugar levels and dizziness, call your doctor right away.

SOME TIPS FOR TESTING

* Ask your doctor when and how often you should check your blood sugar.

* Don’t force the blood out of your finger. doing so can give you an incorrect result.

* If you have extremely low sugar levels and trouble walking and talking, or extremely high sugars and dizziness, call your doctor right away.

* Write down your blood-sugar level every time you test.

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