The key to managing your diabetes and living a normal life is to keep your blood glucose levels as close to normal as possible. One key aspect of this is to closely monitor your blood glucose levels and in order to do this, you must test your blood glucose regularly.
However, testing your blood glucose comes with several challenges. If you want to manage your diabetes effectively, you need to be aware of these common problems of blood glucose testing so you can overcome them.
Blood glucose testing can be expensive. Before buying any meter, check with your diabetes center, local hospital, HMO or company health program. They may recommend or pay for only specific meters or have a limited cost allowance. When you purchase a meter, bear in mind the cost of the test strips. The meter that seemed like a great bargain deal may be a major burden if the test strips are too expensive. If you want to use generic strips, which are cheaper, make sure that you buy a meter that can use them.
The trick is getting a drop of blood that is big enough for your meter without causing you too much pain. Automatic lancets are the quickest and easiest to use. With an automatic lancet you can better produce a uniform size drop of blood from either hand. Automatic lancets also allow you to adjust how deeply you poke your finger. The shallowest poke hurts less and cause less scarring of your fingers.
When you purchase an automatic lancing device, you will need to purchase the lancets separately. Make sure that you can get replacement lancets to fit your device. Consider the cost of the replacement lancets when buying your lancing device. Also make sure that the lancet you use produces a drop of blood big enough to get an accurate reading on your blood glucose meter. You can either use the first or second drop of blood produced without altering your measurement.
If you have trouble with small hand and finger movements, you may want to consider using a larger meter. Some glucose meters are about the size of a credit card and some are even as small as a pen, but these can be difficult to use if you have dexterity problems. If you choose a large meter, make sure it will not be too cumbersome to carry around. Some strips come individually wrapped in foil. If you find this type of wrapping difficult to remover, avoid brands that use this type of strip. Also, lancets can pose dexterity problems. You will probably want to use an automatic lancing device that resets easily with a simple push-pull movement.
Consider how well you can see the readings before you buy any meter. If you have any vision loss, try to enlist the help of a family member to help you read and record your results. Make sure they know how to use all your diabetes supplies and equipment. If you have any degree of color blindness, try out different models to make sure you can read the digital display. Some meters have black and gray displays while others feature red or green numbers that may be difficult to read.
What happens if you open a new batch of test strips and suddenly all your readings are much higher or lower than they used to be? The problem may be due to miscalibration. Whenever you open a new batch of strips, you need to standardize or calibrate your meter to make up for variations from batch to batch. Some machines calibrate all by themselves. Make sure to know how your machine works and recalibrate according to manufacturer’s instructions if necessary.
Another thing you can do is to ensure meter accuracy is check your meter each month to see that it is measuring glucose levels accurately. Meters themselves can sometimes drift. To do this, place a drop of standard ‘control’ solution of glucose (this should come with your meter or can be purchased at your pharmacy). The reading on the meter should match the concentration of glucose in the control solution. If not, call the manufacturer of your meter. Make sure that the problem is not caused by old or damaged test strips. Check with the manufacturer to see if your strips have expired, and check them for damage before you use them. Your measurement may be compromised by usage of deteriorated test strips, which may result from inappropriate storage, mechanical stress, or usage after the expiry date.
To further ensure accurate readings, bring your glucose test system with you to your doctor’s appointment or meeting with your diabetes educator. Perform the test in front of her and have her verify that you are doing it right. You may also want to have your doctor test your glucose using her equipment and compare results. Also, when your blood glucose levels are measured in the laboratory, compare your results to the lab results. For some meters, your results should be within 15% of the lab results. For example, if the lab measures your blood glucose level at 150mg/dl, your own measurement should be within 127 to 173 mg/dl. If your result is out of this range, then you may want to go over your techniques with your diabetes educator or doctor.
All the finger-poking in the world won’t do you any good unless you keep a good record of your test results. Record all your test results in the logbook that came with your glucose meter or ask your diabetes educator for a new logbook if you don’t have one. Or consider creating your own customized logbook. You will want to make sure you have room to record the date, time, actual meter reading and any unusual circumstances or notes about your general wellbeing. Bring your logbook to your regular medical appointments. You and your healthcare team will find the logbook helpful when reviewing your progress, especially if you have been experiencing any problems.
Sources and References
The Diabetes Problem Solver: Quick Answers to Your Questions About Treatment and Self-Care by Nancy Touchette
Interference and Limitations in Blood Glucose Self-Testing: An Overview of the Current Knowledge by Michael Erbach, Oliver Schnell, Ralph Ziegler et al
Deciding between Using the First or Second Drop of Blood for the Self-Monitoring of Blood Glucose by Li M, Wang X and Shan Z
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