What Are The Target Ranges
Blood glucose targets are individualized based on:
- duration of diabetes
- conditions a person may have
- cardiovascular disease or diabetes complications
- hypoglycemia unawareness
- individual patient considerations
The American Diabetes Association suggests the following targets for most nonpregnant adults with diabetes. A1C targets differ based on age and health. Also, more or less stringent glycemic goals may be appropriate for each individual.
- A1C: Less than 7%A1C may also be reported as eAG: Less than 154 mg/dL
- Before a meal : 80130 mg/dL
- 1-2 hours after beginning of the meal *: Less than 180 mg/dL
What To Do When Blood Sugar Readings Vary
Have you ever double-checked your blood glucose level immediately after an initial reading, only to find completely different numbers? Although it may be impossible for these measurements to be perfect, taking steps to ensure they are as accurate as possible is important for effective control. Below are a few steps you can take to get the most accurate reading the first time around.
How Are These Tests Different
Personal meters measure your blood glucose using a sample from your fingertip , and then analyze the whole blood, including red blood cells and all.
In a lab test performed by clinical staff, the sample is typically drawn from a vein in your arm and processed to remove red blood cells, so only the plasma is tested.
Virtually all home glucose meters factor in the difference of using a whole blood sample while providing a test result that is considered plasma equivalent.
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Monitoring Your Blood Sugar Level
Last Updated February 2021 | This article was created by familydoctor.org editorial staff and reviewed by Robert “Chuck” Rich, Jr., MD, FAAFP
If you have diabetes, its important to monitor your blood sugar at different times of the day and throughout the year. There are 3 tools that can help you do this and, therefore, manage your diabetes: A blood test done every three months, blood tests taken every day, and a system that constantly monitors your blood glucose.
The 3-month blood test is called an A1C test. This test reflects your blood sugar control over the past 2-3 months. Testing your A1C level every 3 months is the best way for you and your doctor to understand how well your blood sugar levels are controlled. Your doctor will likely be the one who orders an A1C test. However, you can also purchase over-the-counter A1C testing kits that you can use at home. Your A1C goal will be determined by your doctor. However, the goal is generally less than 7% or 8%, depending on your age.
The daily blood test is done with a blood glucose monitor . This is also called a home blood sugar meter, a glucometer, or a glucose meter. This type of testing is often referred to as self-monitoring of blood glucose. Your doctor may prescribe a BGM, especially if your blood sugar fluctuates. They will show you how to use it.
Not Getting Enough Blood
The most common mistake is not getting enough blood on the test strip. After using dozens of different blood glucose meters since a doctor told me 21 years ago that I have diabetes, I know from my own experience that when I dont get quite enough blood on the test strip, the result the meter reports will be off.
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Take The Medication Unless Your Doctor Tells You Otherwise
Your doctor isnt medicating you for the sake of it. There are certain health problems that will require medication to help you control your levels. This is the case with diabetes.
Its important to visit your doctor regularly. Arranged for morning appointments when you have your checks to get your morning levels recorded on a regular basis. This way your doctor can see if your medication is still needed and whether there are other things you can do instead.
Only stop taking your medication if your doctor tells you so. Youll get a good idea by your glucose levels. Track them yourself to see if theyre getting lower one week to the next. If you see a significant drop, talk to your doctor about your options for cutting back or out your medication and trying more holistic options.
If you believe you need a second opinion, dont be afraid to get one from someone reputable. Just follow the advice from those who have the degrees!
Testing Your Child’s Blood Sugar
Good diabetes management is important both for your childs day-to-day health and to help prevent any diabetes-related problems in later life. Regular testing of your childs blood sugar level is a key part of this.
Your paediatric diabetes team will give you a blood glucose meter, used to check your childs blood sugar levels. Normally, there are a few to choose from and your diabetes team will help you and your child make the right choice. Your meter comes with a finger-pricking device and an initial supply of lancets and testing strips . Your diabetes team will also explain to you how to get further free supplies of these on prescription from your GP.
Many parents worry or are anxious about testing their childs blood sugar levels. Pricking their fingers can be painful, especially at first, and no parent wants to hurt their child. Then theres the anxiety about what the levels will be. Youll be told your childs target levels to aim for, and it can be frustrating and even scary if youre not meeting these.
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Speak To Your Physician
Make sure you speak to your physician and healthcare team about making dietary and lifestyle changes.
And, if you think your morning levels are way too high, or no matter what you do you cant get them down, talk to your physician or health practitioner to see if you might need to alter your medication.
When it comes to lowering morning blood sugar levels, it really is a combination of things that can help.
Start with the apple cider vinegar and cheese before bed and see how that goes. Then, try working on all the other things in this list.
Give it some time and no doubt you will begin to see some great improvements.
Have you tried something else that worked? Have some comments youd like to add? Leave them below and lets chat about it.
Why Are We Testing And Monitoring Blood Sugar Levels
Anyone diagnosed with gestational diabetes should regularly test their blood sugar levels.
Sometimes ladies that are higher risk or classed as borderline, or those that have had gestational diabetes in previous pregnancies may also be advised to test and monitor levels. This is the best way to see what is happening with your blood sugar levels and how much glucose is remaining in your blood after eating and therefore being passed on to your baby.
Its just a guide
These capillary tests are a guideline only and not 100% accurate. The only way to get an accurate blood glucose test result is from a blood test which has been analysed in a sterile laboratory environment. Therefore if you test multiple fingers, one after another, you could get different readings each time. Many ladies get frustrated when they hear this and think what is the point if the tests are not 100%, but for a mobile device they do a pretty good job of building up a good picture as to whats happening and a guide is much better than not be aware at all. If you feel there are any inaccuracies with your test monitor then please consult your healthcare professional. Large differences in readings may mean that your machine is faulty or could need calibrating.
Test times and targets
- one hour post meals
- pre meals and one hour post meals
- alternating days between pre and post meals
- random testing so many times a day or week
NICE guidelines for testing blood sugar levels:
Test from first or last bite?
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How To Test Your Blood Sugar
Whether you test several times a day or only once, following a testing routine will help you prevent infection, return true results, and better monitor your blood sugar. Heres a step-by-step routine you can follow:
Food Taken At The Previous Night
A diabetic patient has to follow a strict diet. The number of carbohydrates and sugar cannot exceed the doctors prescribed amount.
A blood sugar spike in the morning can occur if the patient takes more food than the medications can handle. Try to remember the last meal that you took before going to bed.
You have most likely taken more food than what your endocrinologist advised you to have.
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Upswing: Steroids And Water Pills
People take corticosteroids, such as prednisone, to treat rashes, arthritis, asthma, and many other conditions. But they can boost your blood sugar, and may even trigger diabetes in some people. Diuretics that help high blood pressure, also called water pills, can do the same. Some antidepressants also raise or lower blood sugar.
Enzyme Vulnerability & Consistency
Enzyme vulnerability refers to several variables and environmental issues that can be inconsistent when youre checking your blood sugar. Some you have control over, others you dont.
For instance, when a test strip is created in the manufacturing plant, a reactive enzyme is sprayed across the inner page of the test strip, then other details of the strip technology are added. When your blood is applied to the strip, it reacts with that enzyme as a key part of producing a blood sugar result. If the test strip material wasnt covered thoroughly in the enzyme spray, it can affect the accuracy of your results.
Other environmental variables include things like how the strips are stored, the conditions they endure during shipping, whether they are kept in an extremely hot and humid area versus cold and dry, and so on.
While the manufacturers of test strips generally have highly controlled storage environments for their product, they cant control these details once the product ships and shows up at your door or at the pharmacy.
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Eat Protein In The Morning
To help bring blood sugar levels down eat something when you get up but make sure its a protein or a protien/ veggie breakfast.
If you go and eat loads of carbs for breakfast toast and cereals being the worst offenders when your blood glucose is already high, it will only push it up further.
Try eating a delicious veggie egg scramble, egg muffin cups, or a quick berry protein smoothie.
What If I Cant Get A Drop Of Blood For A Fingerstick
If you want to get blood from your fingertip, try washing your hands in hot water to get the blood flowing. Then dangle your hand below your heart for a minute. Prick your finger quickly and then put your hand back down below your heart. You might also try slowly squeezing the finger from the base to the tip.
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Different Readings Same Meter Different Fingers
freddyfry said:I noticed the recall of some testing strips due to they showing too low BG. Fortunately the ones I use are not on the list .However, being a bit obsessive and curious about anything I am involved with, I decided to try testing 3 fingers .My readings were from 115 to 110. What do I do with this? It was within 2 hours of eating. Should I do the tests with FBG? Or should I not worry about it.I do have 3 meters although I have never tried the other 2. I have used the testing reagent but it seems to me the “range” for the meter to be acceptable is pretty wide. So far, my testing has come out to 126 – smack dab in the middle of the range. I have done that 3 times so far.Also, what is your opinion of the home A1C testing meter?Sorry for all the questions… but I am determined to come out on top of this T2!My kindest regards,
Why Is Your Diabetes Meter Inaccurate
Starting with the strip, the chemical process involved relies on an exact amount of blood entering the reservoir in a prescribed amount of time, at a pre-determined temperature and an educated guess assigned to the composition of the blood itself. Not only will one persons blood differ from anothers in chemical makeup and red blood cell count, contagions on your skin AND the presence of water or alcohol after cleaning can affect the results.
For the strip to have a chance at giving a perfect result you need to use the same amount of blood and fill the strip in the same time frame every time your blood and the enzyme in the strip needs to be at consistent temperatures. If you think that using two drops of blood from the same lancing site should be more accurate, youd actually be wrong. The first drop of blood will have more extracellular fluid content than proceeding drops.
Known Variables to Interfere with Test results
- Meter not calibrated regularly
- Storage and handling of test strips
- Not properly cleansing the test site
- Testing site damp from alcohol prep or water
- Not enough blood applied to test strip
- Altitude, temperature, and humidity
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What Is The Dawn Phenomenon
Your body uses glucose for energy and it is important to have enough extra energy to be able to wake up in the morning. So for a period of time in the early morning hours, usually between 3 a.m. and 8 a.m., your body starts churning out stored glucose to prepare for the upcoming day.
At the same time, your body releases hormones that reduce your sensitivity to insulin. In addition, these events may be happening while your diabetes medication doses taken the day before are wearing off.
These events cause your bodyâs blood sugar levels to rise in the morning .
Using Test Strips That Are Too Old
Researchers from the U.S. Centers for Disease Control and Prevention found that old test strips give inaccurate readings, particularly if they are beyond their expiration date. While some meters will reject expired strips, not all of them will. And none of them will reject strips that are nearing their expiration dates, and that too, the CDC researchers told me, can give us inaccurate test results.
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How To Choose An Accurate Meter
Independent testing, like the study done by the Diabetes Technology Society, is helpful to compare the performance of top commercially available glucose meters. This study tested meters and test strips which were independently purchased from stores across the country, and representative of what a consumer would purchase.
After testing the products over 300 times at three different clinical sites, the results showed that over 66% of the top meters on the market today didnt pass the rigorous study.
A surprising number of name brand meters did not pass all studies. Check the list below to see the 12 meters that failed one or more study.
The following devices passed the test and received the Diabetes Technology Societys Seal of Approval:
Testing Too Soon After Eating
Knowing when to test and why that information is useful can help you better control your diabetes. “Often, people will test blood sugar half an hour or an hour after they eat,” says Uelmen, but this is sooner than experts recommend.
Testing too soon after you’ve had a meal or a snack will give you results that are probably too high. The solution for better diabetes control: Test fasting blood sugar, and test every time before you eat. Wait two hours after eating to get the best reading.
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Why Is My Glucose Meter Giving Different Readings
Just like most diabetics, I have checked my blood glucose levels twice in a short period of time out of curiosity to find that my glucose meter gives different readings. At first I thought I may have had a faulty meter, but for me and my personal needs a 10% margin of error is not a big deal. Since then I have learned a lot about how different meters work, improvements in the technology used in home testing supplies, government controlled standards for accuracy and the general needs of different kinds of diabetic patients through my work and community engagement.
The short answer regarding meter accuracy is that the technology currently used in home diabetes testing supplies are only capable of testing within a 10-20% +/- margin of error. The FDA mandates minimum accuracy standards for testing supplies in the US, currently following the ISO 15197:2013 standard of 95% of tests must be within +/- 20% for results above 75 mg/dl and +/-15% for results below 75 mg/dl. This standard was issued in 2013, and the majority of manufacturers have redesigned their meters for better accuracy, increased consistency and ease of use since then.