Diabetes

Blood Glucose Monitoring

Type 1 diabetes

◦Fasting

◦Pre-meals, pre-snacks, bedtime

◦One hour post-meals (rotating

◦Prior to sports/exercise

◦Hourly during prolonged sports/exercise

◦Every 2-3 hours during illness

Close monitoring of blood glucose can help patients to better modulate their diet, exercise, and medications and is important for the prevention of complications.(7,8,17,18,19) Glucose meters are used to measure blood glucose levels through a small drop of blood. There are different monitoring recommendations according to type and treatment. Here is a recommendation for monitoring type 1 diabetes:

Routine monitoring includes testing blood sugars and matching insulin needs to meals and snacks. Glucose levels should also be monitored closely before and during sports or exercise to prevent hypoglycemia. During illness, blood sugars tend to rise and may be harder to control. In patients with type 1 diabetes, close monitoring of blood sugars will be crucial.

Type 2 diabetes: insulin-using (basal and bolus)

◦Fasting

◦Pre-meals, pre-snacks, bedtime

◦Prior to sports/exercise or driving

◦One hour post-meals (each meal once/week)

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•Type 2 diabetes: insulin-using (basal only)

Twice daily, prior to meals

◦Rotating test times for fasting and pre-meal

◦Post-meal once weekly for each mealtime

•

Patients with type 2 diabetes who use insulin will also need to monitor blood glucose closely to match insulin dose and timing with meals. For patients using both long and short-acting insulin, the schedule will include more testing around mealtimes. For those using long-acting insulin only, there may be intermittent testing to assure blood glucose control at fasting and prior to meals. Testing on a rotating basis will help to identify any need for changes in meal or insulin routines.

Type 2 diabetes: non-insulin-using

◦Once daily

◦Rotate test times

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•Continuous Glucose Monitoring (GCM)

For non-insulin using type 2 diabetes, the patient may not need to monitor blood sugars quite as closely once their routine for diet, exercise, and medications are set up and comfortable. Glucose monitoring can be rotated and conducted when there is a change in diet and exercise routine.

Continuous glucose monitoring or GCM systems work using a sensor under the skin to test glucose levels. These devices are approved by the FDA and are available by prescription. Users still need to confirm glucose levels with a glucose meter before making changes in their treatments.