Blood Glucose Monitoring
Self-monitoring of blood glucose (SMBG) is used on a day-to-day basis to manage diabetes effectively, and is considered a cornerstone of diabetes care.1 This is because it provides useful information that will allow you and your physician to2:
- Judge how well you’re reaching overall treatment goals
- Understand how diet and exercise affect your blood glucose levels
- Understand how factors like stress or illness affect your blood glucose levels
- Monitor the effect of diabetes medications on blood glucose levels
- Identify blood glucose levels that are dangerously high or low
People who may benefit from checking blood glucose include those3:
- taking insulin
- that are pregnant
- having a hard time controlling blood glucose levels
- having low blood glucose levels (with or without the usual warning signs)
- have ketones from high blood glucose levels
How to Test
Step One: Wash your hands thoroughly. 
Step Two: Insert a test trip into your meter.
Step Three: Use the lancing device on your fingertip to get a drop of blood. 
Step Four: Hold the edge of the test strip to the drop of blood, and wait for your blood glucose level to appear on the meter’s display.
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Note that all meters are different, so you should refer to your user manual for specific instructions.
Frequency of Testing
You can check your blood glucose level up to ten times each day–before breakfast, lunch, and dinner; at bedtime; 1 to 2 hours after meals; and during the night.8 For patients with Type 1 Diabetes, 3-10 times a day is recommended. These times are typically before each meal, and at bedtime. For patients with Type 2 Diabetes, 1-4 times a day is recommended. These times are typically before breakfast, before the largest meal of the day, and two hours after the largest meal of the day.3 Check with your doctor for a monitoring plan that fits you best.
Target Blood Glucose Goals
Mahan and Escott-Stump, 2004.
The American Diabetes Association recommends that your preprandial (before meal) blood glucose be between 90-130 mg/dl. Your postprandial (after meal) blood glucose should be less than 180 mg/dl.
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Please note that depending on your age, duration of diabetes, and preexisting conditions, your specific target goals may vary from the recommendations. Consult your physician for more information.
Testing Accuracy
The accuracy of your results are user and meter dependent. It is important that you consult your physician to assess your monitoring techniques regularly. In some cases, your physician may compare your self-test results with laboratory values to ensure accuracy.
Logging Your Results
It is crucial that the results of your self-tests be written in a log book, to have a better picture of your body’s response to your diabetes care plan. Below is a sample log that includes comment sections for physical activity, as well as other daily activities.9
When starting your log, it is important to understand what trends in your results may mean. It is also very important to keep a comments section for activities unrelated to diet. This is because additional factors like stress, infection, and illness have been shown to increase blood glucose levels, and therefore should be taken into account.8 Of course, consult your physician regularly to ensure that your diabetes treatment plan is effective.
References
1. http://care.diabetesjournals.org/content/26/suppl_1/s106.full
2. http://www.mayoclinic.com/health/blood-sugar/DA00007
3. http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/checking-your-blood-glucose.html
4. Image: http://www.flickr.com/photos/fairfaxcounty/sets/72157631668872015/
5. Image: https://wiki.engr.illinois.edu/display/BIOE414/One+Touch+Ultra+2+Glucometer
6. Image: http://1.bp.blogspot.com/-zekO6BeivkY/UV3r8OGb11I/AAAAAAAAC_s/XKn37Dfg9Ok/s1600/multiclix2_l.png
7. Image: http://en.wikipedia.org/wiki/File:Blood_Glucose_Testing.JPG
8. L. Kathleen Mahan and Sylvia Escott-Stump. 2004. Krause’s Food, Nutrition, and Diet Therapy. 11th edition. Philadelphia: Saunders Publishing.
9. Image: http://www.flickr.com/photos/72132109@N00/3865957999/sizes/o/in/photostream/
