American Diabetes Association Complete Guide to Diabetes. American Diabetes Association

on the specifics of insulin in chapter 13.

      Other Times for Extra Checks

      • Before you drive (if you take insulin)

      • When you are more physically active than usual

      • When you have lost or gained weight

      • If you start taking a medication for another condition that affects blood glucose levels or your ability to recognize low blood glucose warning signs

      • If you have hypoglycemia at night or wake up with high blood glucose levels

      • When your levels have been outside your target range more often than in your range

      • If you don’t feel well. Checking helps you determine whether your glucose level needs attention

      • If you’re pregnant

      Extra Checks during Stress

      Everyone seems a little stressed out these days—and living with diabetes can add even more stress to your life. Stress can produce hormones that raise blood glucose levels. Stress can also be a hidden contributor to unexpected swings in blood glucose levels.

      Therefore, you’ll want to check your blood glucose more often when you’re experiencing stress. The effects of stress on your blood glucose can’t be measured as easily as units of insulin or calories burned during exercise. However, stressful situations could be throwing your blood glucose out of range (for example, if you have a bad day at work), so make sure to check your blood glucose when you feel stressed.

      When you can’t figure out why your blood glucose level is so high despite “doing everything right,” think about the stresses in your life and how you respond to them. Do you eat when you are under stress? These extra calories, plus stress hormones, could raise your blood glucose.

      Extra Checks during Illness

      Being sick is another kind of stress on your body that can raise blood glucose. Your body releases hormones to fight the illness, but these hormones also counteract the effect of insulin and raise blood glucose. Sickness can cause your diabetes to go out of control. Extremely high blood glucose levels caused by illness can also lead to diabetes emergencies, including coma and death.

      Blood glucose monitoring is especially important during any illness. Even if you have type 2 diabetes and only monitor once a day, you may want to check more often during times of illness. In general, you’ll want to check your blood glucose every 3–4 hours. Read more about handling sickness under the “Illness” section in chapter 8.

      Tips on Using Results of Self-Monitoring

      Throughout the book, you’ll find more advice about using the results of self-monitoring. Your results will help you develop your diabetes management plan, including your goals for meals, physical activity, and treatment.

      Sometimes, you’ll need to take immediate action based on a blood glucose reading, while many other times you’ll use the information to interpret a pattern and make future adjustments. This is particularly true for people who are not taking multiple, daily injections of insulin.

      Self-monitoring is also important for identifying blood glucose emergencies. Chapter 8 will describe some common blood glucose emergencies and how to handle them.

CHAPTER 7

      Self-Monitoring Tools

      • Lancets

      • Test Strips

      • Blood Glucose Meters

      • Continuous Glucose Monitors

      • Logbooks

      • Ketone Tests

      • Where to Buy Supplies

      Now that you’ve read about the importance of monitoring your blood glucose, you probably want to know exactly how to measure your blood glucose. There are a handful of tools that will help you accurately and easily measure your blood glucose every day. These tools are now smaller and more sophisticated than anyone would have dreamt of 30 years ago.

      New products are always being developed, so keep in mind that this chapter just covers the most essential tools. Every year the American Diabetes Association’s magazine Diabetes Forecast publishes a Consumer Guide for patients that describes the latest devices, as well as most devices currently on the market. The Consumer Guide is published in print and online, and it is a patient’s best resource for researching blood glucose monitoring tools (http://forecast.diabetes.org/consumerguide).

      Essential Tools

      Lancet: A device that pricks the skin with a small needle to obtain a blood sample.

      Test Strip: A strip (with a blood sample) that is inserted into a blood glucose meter.

      Blood Glucose Meter: A small, portable machine used to display blood glucose readings on a digital display.

      Blood Glucose Log: A record of your blood glucose readings over time. Some people prefer a paper log, whereas others prefer a digital log.

Lancets

      Lancets allow you to take a sample of blood with minimal discomfort and optimal discretion. The spring-loaded device contains a needle or lancet, a way to select how deep the needle goes, and a release button. You’ll want to use the shallowest poke possible to draw blood. This hurts less and causes less scarring on your fingers.

      Many blood glucose meters come with lancing devices. However, there are quite a few lancets on the market, so shop around if you don’t like the one that came with your meter or if you want more than one. Some allow you to prick sites other than your fingers. Others are designed for people who have trouble drawing blood or who have sensitive or calloused skin. Still others have retractable needles or easy disposal systems. Different lancets produce different sizes of blood drops. Make sure the device you are considering will help you get a drop of blood that is large enough for your meter.

      Lancets are sterile the first time only, so don’t share lancets or lancing devices. Lancets can become dull after multiple uses, making future fingersticks more painful, so change them when needed to fit your comfort level.

      Not all lancets fit all devices, so do your homework. Make sure that you can easily get replacement lancets to fit your device. Check the prices for replacement lancets as you compare devices.

Test Strips

      Test strips are disposable strips that take a sample of blood. You insert a test strip into a meter to get a digital reading of your blood glucose level. Test strips are made to work with specific meters, so you’ll need to buy the appropriate brand and type.

      Here are some things to consider when purchasing a meter and test strips. Some test strips are designed with a curve to help patients guide their fingers more easily to the application site. Other test strips are extra large to make them easier to handle. The packaging of the test strips may also be an important consideration for you. Some come packaged in a vial, whereas others are individually wrapped in foil. The foil wrappings