Developing a Testing Schedule
When to test is a matter of debate. Some people test once when they wake up. Others test eight or more times a day — morning, night, and before and after meals. As a general rule, when your diagnosis is new and you're learning how different factors affect your diabetes, checking your glucose levels frequently is encouraged. The same holds true for monitoring any changes to your treatment routine.
People on insulin therapy may need to test more frequently, since they need to use the results to adjust insulin accordingly. And people with glucose levels that fluctuate widely, often without warning (a condition formerly known as brittle diabetes), may also need to test more frequently than others.
If you suspect a blood sugar low, you should always test yourself immediately. Treat yourself with 15 grams of fast-acting carbohydrate, wait 15 minutes, and then test again. If blood sugars are still not in a safe range, repeat the process. If your meter isn't around but you feel low, treat it first and test later.
When to Test
The ADA recommends that people who are on multiple insulin injection therapy or insulin pumps test at least two or three times daily. However, it is not unusual for people on these therapies to test much more frequently, as an accurate blood glucose number is essential to determining insulin dose and keeping blood sugars in a safe range.
There are no specific ADA recommendations for frequency of testing in type 2 diabetes patients who aren't on insulin, or for diabetes patients who are on once or twice daily insulin injections. But again, self-monitoring of blood glucose levels is the best available tool to provide immediate feedback on how food, exercise, medication, and other environmental factors are affecting blood sugars. Although the cost of testing supplies can sometimes be a barrier, self-monitoring should be performed as frequently as possible to help achieve blood sugar goals.
Postprandial, or after-meal, testing is also encouraged at one and two hours after eating. Testing after meals allows you to see how different foods and food combinations impact your blood sugar levels, and also is a helpful tool in revealing trends that can help to bring down a high A1C.
In the United States, home blood glucose monitors display readings as mg/dl (milligrams over deciliters). However, everywhere else outside the United States, the standard is mmol/l (millimoles over liters). Some monitors that are sold internationally may have an option for switching back and forth between mg/dl and mmol/l displays.
Overcoming Testing Barriers
It's natural to have some hesitation about sticking yourself on a regular basis. But it's important to realize that today's lancets, the needle-like devices used to prick your finger to obtain a blood sample, are extremely fine, easy to use, and virtually painless. Your diabetes educator can show you simple methods for drawing an adequate blood sample with minimal discomfort.
As mentioned, cost can have an impact on how frequently you can test. When determining a schedule for blood glucose testing with your doctor, make sure you discuss any financial or insurance issues that may affect your testing routine. Test strips are expensive (a package may cost more than the monitor itself), and some insurance plans put a cap on the quantity of testing supplies they will cover for a given time period. Find out what your insurer offers and work from there. In some cases, your provider may be able to offer you some free product samples to augment your supply.