Do Type 2 Diabetics Need To Check Blood Sugar

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More than half of the people testing their blood sugar at home didn’t need to do this, accounting for 14 percent of the total study population, researchers reported Monday in JAMA Internal Medicine.

“Many Type 2 diabetes patients not using insulin or other medications at risk of rapid changes in blood sugar levels are testing far more often than they need to be,” said the lead study author, Dr. Kevin Platt of the University of Michigan in Ann Arbor.

“This needless behavior causes unnecessary pokes, worry and costs,” Platt said by email. “More is not always better when it comes to medical care.”

Type 2 diabetes, the most common form of the disease, is linked to obesity and aging and develops when the body can’t properly use or make enough of the hormone insulin to convert blood sugar into energy. Left untreated, it can lead to complications like blindness, kidney failure, nerve damage and amputations.

Many patients can keep their blood sugar in a healthy range with oral medications and don’t need insulin. Unlike insulin, which immediately affects blood sugar and requires regular testing to ensure that blood sugar is in a healthy range, those on oral medication for diabetes don’t require regular testing because the pills don’t cause rapid shifts in blood sugar, Platt said.

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Half of the patients taking unnecessary blood sugar tests at home took these tests at least twice a day, and half of them had testing supply costs of at least $325 a year, the study said.

The study wasn’t a controlled experiment designed to prove whether or how home testing directly affected blood sugar levels in people with diabetes.

And some patients might still need to test at home, even if they don’t need to do this multiple times daily, said Sheri Colberg, a professor emerita at Old Dominion University in Norfolk, Virginia, who has studied and treated people with diabetes.

“Even if checking routinely may not change outcomes like overall blood glucose management, the benefit of having glucose testing strips available is that individuals â even non-insulin users â are then able to check their blood glucose when their usual routines vary, during times of illness, or whenever other events may negatively impact their blood glucose,” Colberg, who wasn’t involved in the study, said by email.

How And When To Test

In order to get the maximum benefit of testing blood glucose, studies have shown that it needs to be done in a structured, systematic way, one which provides information which can be useful in monitoring a persons diabetes and also in providing specific feedback.

SMBG should not be conducted at random or too frequently tests require fingers to be pricked to draw some blood and lots of tests within a short space of time cannot only make fingers quite sore but the information could be overwhelming so health benefits may be missed.

If you have type 2 diabetes and are interested in structured testing of blood glucose, make sure you consult your GP first.

Support and guidance from your doctor and diabetes care team will be needed in order to discover the true health potential of blood glucose testing.

For example, results and information from your structured testing could be used to help them make better and more informed decisions for your personal diabetes care plan.

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When Is Regular Blood Glucose Testing At Home Recommended

For people with type 2 diabetes, regular testing of blood glucose levels at home using a blood glucose test meter is generally not needed unless you are:

• starting or already taking glipizide, gliclazide or glibenclamide this is because the risk of hypoglcaemia is higher with these medicines
• starting or already taking insulin
• at risk of frequent episodes of low blood glucose
• planning a pregnancy or are pregnant.

Are High Blood Glucose Levels Dangerous

• Sometimes, your blood glucose levels may be high and you may not understand why.
• If you have type 1 diabetes and your blood glucose levels are high, or if you are sick, itâs important to check for ketones in your blood or urine. If you have ketones or are unwell, itâs important to seek medical attention.
• Long-term diabetes-related complications can occur if blood glucose levels are above the target range over a long period of time. If your blood glucose levels are high on a regular basis, ask your doctor or diabetes health professionals for advice.

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The Surprising Percentage Of People Who May Test Their Glucose Unnecessarily

Dr. Platt decided to look at the frequency of home testing after noticing that some patients who didnt need to test kept precise notes on their daily blood sugar measurements over long periods of time. The researchers, including senior author A. Mark Fendrick, MD, a professor in general medicine at the University of Michigan, reviewed national insurance data from 370,740 people with type 2 diabetes. They reviewed data from January 1, 2013, to June 30, 2015 after several medical societies issued guidelines to curb unnecessary home glucose testing. The data reflected patients with private insurance or Medicare Advantage plans who were not taking insulin and who filled prescriptions for packets containing 90 test strips three or more times a year. This pattern of prescribing suggests the patients were monitoring their blood sugar levels regularly.

The study found that 14 percent of people who likely didnt need to perform glucose monitoring were using an average of two test strips a day.

We were pretty surprised at how prevalent this was, Platt says. We also found that almost 25 percent of people were filling at least three prescriptions for at least 90 strips which is 180 strips in a given year. These were not people who were checking their blood sugar for a month or so. This was regular usage over a period of time.

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How To Use A Blood Sugar Meter

There are different kinds of meters, but most of them work the same way. Ask your health care team to show you the benefits of each. In addition to you, have someone else learn how to use your meter in case youre sick and cant check your blood sugar yourself.

Below are tips for how to use a blood sugar meter.

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The Big Picture: Checking Your Blood Sugar

Blood sugar monitoring is the primary tool you have to find out if your blood glucose levels are within your target range. This tells you your blood glucose level at any one time.

Its important for blood sugar levels to stay in a healthy range. If glucose levels get too low, we can lose the ability to think and function normally. If they get too high and stay high, it can cause damage or complications to the body over the course of many years.

The logging of your results is vital. When you bring your log to your healthcare provider, youll have a good picture of your body’s response to your diabetes care plan. To help keep track of your levels, we have a glucose log. We also have a blood glucose log available for purchase that is smaller so you can carry it with you.

Random Plasma Glucose Test

A random blood sugar test looks at blood glucose levels regardless of when you’ve last eaten for a snapshot of your blood sugar status. This test is usually performed when healthcare professionals want to take a look at your blood sugar without having to wait for you to fast and so it can be performed at any time. While a diagnosis of diabetes can be made with the help of this test, it is not usually used to diagnose prediabetes.

If your glucose is over 200 mg/dl, then a diagnosis of type 2 diabetes is likely. Again, your healthcare provider will usually perform this test on two different occasions before a confirmed diagnosis is made.

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What Are Blood Sugar Targets

A blood sugar target is the range you try to reach as much as possible. These are typical targets:

• Before a meal: 80 to 130 mg/dL.
• Two hours after the start of a meal: Less than 180 mg/dL.

Your blood sugar targets may be different depending on your age, any additional health problems you have, and other factors. Be sure to talk to your health care team about which targets are best for you.

Who Should Monitor Blood Glucose

If you’ve been diagnosed with type 1 or type 2 diabetes, or you’re pregnant and have developed gestational diabetes, a form of the disease that occurs during pregnancy and goes away after a baby is born, testing your blood glucose levels regularly and at specific times throughout the day will be a key aspect of managing your disease.

The American Diabetes Association recommends that, for ideal use and implementation, anyone prescribed continuous glucose monitoring should receive robust education, training, and support and should be able to perform self-monitoring of blood glucose in order to calibrate their monitor and/or verify readings if they don’t represent their symptoms.

It will be helpful to keep a log of your results, as well as details about what you’ve eaten throughout the day and how much physical activity you’ve gotten. With this information, you and your healthcare provider can get a grasp on how certain foods or activities affect your blood sugar and what adjustments you should make to meet your target goals.

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What Are The Symptoms Of Type 2 Diabetes

Symptoms of Type 2 diabetes tend to develop slowly over time. They can include:

• Urinary tract infections and bladder infections.

Rarely, Type 2 diabetes leads to a condition called diabetic ketoacidosis . DKA is a life-threatening condition that causes your blood to become acidic. People with Type 1 diabetes are more likely to have DKA.

How Do Carbs Affect Blood Sugar

Carbs in food make your blood sugar levels go higher after you eat them than when you eat proteins or fats. You can still eat carbs if you have diabetes. The amount you can have and stay in your target blood sugar range depends on your age, weight, activity level, and other factors. Counting carbs in foods and drinks is an important tool for managing blood sugar levels. Make sure to talk to your health care team about the best carb goals for you.

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Free Prescriptions For Diabetes Medicine

The HSE Long term Illness scheme offers everyone with Type 2 diabetes a Long term illness card. There is no means test for the scheme. You’ll be able to get diabetes prescription medicines and some appliances free of charge.

Also covered on the scheme are:

• some medicines that affect diabetes management such as cholesterol or blood pressure lowering medicines
• insulin pens or syringes
• blood glucose testing strips and lancets
• some hypo treatments

A range of hypo treatments are available through your pharmacy. If your hypo treatment is prescribed by your GP or clinician it may be available under the LTI scheme. Check with your pharmacy what is currently available under the LTI scheme.

For more information on these and other entitlements visit the cost, schemes and allowances website.

When Should I Call My Doctor

Its important to monitor diabetes very closely if youre sick. Even a common cold can be dangerous if it interferes with your insulin and blood sugar levels. Make a sick day plan with your healthcare provider so you know how often to check your blood sugar and what medications to take.

Contact your provider right away if you experience:

• Confusion or memory loss.
• Nausea and vomiting for more than four hours.
• Problems with balance or coordination.
• Severe pain anywhere in your body.
• Trouble moving your arms or legs.

A note from Cleveland Clinic

Type 2 diabetes is a disease where your body doesnt make enough insulin and cant use sugar the way it should. Sugar, or glucose, builds up in your blood. High blood sugar can lead to serious health complications. But Type 2 diabetes is manageable. Regular exercise and a healthy diet can help you manage your blood sugar. You may also need medication or insulin. If you have Type 2 diabetes, you should monitor your blood sugar at home regularly and stay in close communication with your healthcare provider.

Last reviewed by a Cleveland Clinic medical professional on 03/25/2021.

References

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Are You Leading An Active Lifestyle

Type 2 diabetes: when to check blood sugar for athletes and active people? Its said that activity helps control blood sugar levels and fight the disease. Your body becomes sensitive to insulin, and you may need more checkups when leading an active lifestyle. Its better to consult your doctor on this issue.

Blood Glucose Monitoring Fact Sheet

This fact sheet is available in two formats.

You can download and print out the PDF version.

Or you can read it as a website page below.

Regularly checking your blood glucose levels can help you manage your diabetes. Your diabetes health professionals can help you with information and advice about blood glucose monitoring.

Regular monitoring can help you see the effects of food, exercise, medication and illness on your blood glucose levels. It can also help you identify any patterns or changes that you should discuss with your doctor or diabetes health professionals.

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How To Test Your Blood Sugar At Home

Follow these steps:

Do You Need To Test Your Blood Sugar At Home

Research over the past decade has provided strong evidence that home glucose testing is not of value for many patients, says Guillermo E. Umpierrez, MD, a professor of medicine at Emory University and the section head of diabetes and endocrinology at Grady Health System in Atlanta. Dr. Umpierrez was not involved in the study. About 80 percent of people with type 2 diabetes take metformin or other medications not associated with daily fluctuations in blood sugar levels, he says.

The benefit of home glucose monitoring has been found to be of questionable significance in several studies during the past decade, Umpierrez says. In patients with type 2 diabetes when not taking insulin, the use of home glucose monitoring has very little impact on improving glycemic control. Several other studies have shown the same thing.

Three medical societies the American Academy of Family Physicians, the Society of General Internal Medicine, and the Endocrine Society have all issued guidance on home glucose testing. Those recommendations were based on a 2012 study by the Cochrane Database System Review that analyzed 12 randomized clinical trials of more than 3,000 participants. The meta-analysis showed no differences in glycemic control or hypoglycemic events between patients who do not self-monitor multiple times a day and those who do.

The guidelines are reflected in the Choosing Wisely initiative, an effort to reduce wasteful healthcare spending.

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How Do I Check My Blood Sugar

You use a blood glucose meter to check your blood sugar. This device uses a small drop of blood from your finger to measure your blood sugar level. You can get the meter and supplies in a drug store or by mail.

Read the directions that come with your meter to learn how to check your blood sugar. Your health care team also can show you how to use your meter. Write the date, time, and result of the test in your blood sugar record. Take your blood sugar record and meter to each visit and talk about your results with your health care team.

If You’re Diagnosed With Diabetes

What the GP will discuss with you during your appointment depends on the diagnosis and the treatment they recommend.

Generally, they’ll talk to you about:

• what diabetes is
• what high blood sugar means for your health
• whether you need to take medicine
• your diet and exercise
• your lifestyle for example, alcohol and smoking

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