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Monitoring blood glucose levels

Diabetes Canada recommends that people with diabetes who are using insulin self-monitor their blood glucose levels at least as many times as they use insulin in a given day. People with type 2 diabetes who are not using insulin should speak to their physician or primary health care provider about how often they should test. The frequency of monitoring depends on your treatments and how well your blood sugar is controlled. Diabetes Canada recommends that people with type 2 diabetes who are using lifestyle adjustments and/or diabetes medications outside of insulin, and who are meeting targets, check their blood glucose 1 to 2 times per week.

A blood glucose monitor, flash glucose monitor, or continuous glucose monitor can be used to test blood glucose at home and to determine whether blood glucose levels are in the target range. Many types of glucose meters and monitors can be obtained at pharmacies. Testing glucose levels helps put the person with diabetes in control and be more active in managing their condition. Using glucose monitors to determine the effects of certain foods on blood glucose levels can also help a person with diabetes to choose appropriate foods more carefully.

A person with diabetes should talk with their diabetes educator or pharmacist about which model of glucose meter is appropriate for them. Anyone using a glucose meter should receive proper training so that they can test their blood glucose levels properly.

Ask a diabetes educator about:

  • how and where to draw blood
  • how to use lancets and dispose of them
  • the size of the drop of blood needed and where to draw blood
  • the type of blood glucose strips to use
  • how to check if the meter is accurate
  • how to clean the meter

If you're using a flash glucose monitor or continuous glucose monitor, there are other considerations to keep in mind. Ask your diabetes educator about information relating to topics such as applying or replacing your sensors and how to obtain your blood glucose readings.

If a person with diabetes experiences symptoms of hypoglycemia (i.e., low blood glucose), they should check their blood glucose immediately. Common symptoms of low blood sugar include trembling, sweating, confusion, anxiety, and nausea. If a meter is not immediately available, the symptoms should still be treated with the following guidelines:

  • Eat or drink a fast-acting carbohydrate (15 g):
    • 3 to 5 glucose tablets (the exact amount will depend on the glucose content per tablet of the brand you have; check to make sure you are aware of this amount and take enough to make up 15 g of glucose)
    • 2/3 cup (150 mL) of juice or regular soft drink
    • 1 tablespoonful (15 mL) honey
    • 15 g fast acting sugar (e.g., 6 Life Savers® or 2 rolls Rocket Candy)
    • 3 teaspoons (15 mL) or 3 packets of table sugar dissolved in water
  • Wait 15 minutes, then check blood glucose again. If it is still low (below 4.0 mmol/L), treat with additional carbohydrates (repeat step 1), wait 15 minutes and check again.
  • Once the blood sugar reading is above 4.0 mmol/L and hypoglycemia has been reversed, if the next meal is more than one hour away, or if the person is going to be active, they should eat a snack containing starch and protein, such as a slice of bread with a piece of cheese or crackers with 2 tablespoons of peanut butter. If an individual is planning on driving after treating a low, ensure that they wait until their blood sugar is above 5.0 mmol/L before they start driving. The brain requires up to 40 minutes to recover before it is considered safe to drive.
  • Certain people at risk of severe hypoglycemia may be advised by their doctor to carry a prefilled 1 mg glucagon injection and make it readily available for emergency situations. Symptoms of severe hypoglycemia include difficulty speaking and unconsciousness. Glucagon is used to increase blood glucose levels rapidly.

Do-it-yourself tests for ketones are useful during times of illness when blood glucose levels can be unpredictable. Ketones are potentially dangerous acids that build up in your blood when you lack insulin. Ketone buildup is much more common if you have type 1 diabetes. Talk to your doctor or primary health care provider about how to test for ketones and develop a sick-day plan for diabetes.

All material copyright MediResource Inc. 1996 – 2021. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source:

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