Guide to Type 2 Diabetes and Insulin

Monitoring Your Blood Sugar

Balancing blood sugar through self-checks of blood glucose levels can help you live healthier with diabetes.

You might think of diabetes as a disease that requires constant attention with finger pricks throughout the day to monitor your blood sugar levels. But there’s a lot more that goes into balancing blood sugar.

The number of times you need to check your blood sugar will vary depending on how advanced your diabetes has become and the steps you're taking to treat it. For instance, if you're able to control your diabetes through diet and exercise, you may not even have to check your blood sugar.

"Many people with diabetes don’t take any medication, and those people don't have to check their blood sugar," says George Grunberger, MD, chairman of the Grunberger Diabetes Institute in Bloomfield Hills, Mich., a clinical professor of internal medicine and molecular medicine and genetics at Wayne State University School of Medicine in Detroit, and vice president of the American Association of Clinical Endocrinologists.

On the other hand, if your doctor does recommend checking your blood sugar levels, those self-tests can provide you with many clues about how to balance your blood sugar better — and how food, physical activity, and stress might be affecting your blood sugar.

Why Monitor Your Blood Sugar?

If you require insulin or take medication to stimulate insulin production, keeping your your blood sugar balanced is a must. Too much insulin can cause hypoglycemia, or dangerously low blood sugar. On the other hand, if you aren't getting enough insulin, your blood sugar levels can spike, which can lead to chronic damage of vital organs.

People with type 1 diabetes, who aren’t capable of producing insulin, have the greatest need to monitor blood sugar levels, says Robert Ratner, MD, chief scientific and medical officer for the American Diabetes Association. They may need to self-test 7 to 15 times a day.

Those with type 2 diabetes, however, have more flexibility. Their bodies can produce insulin, but either it's not enough or the body has become resistant to insulin. If that describes you, Dr. Ratner says, guidelines for monitoring blood sugar depend on your treatment plan:

  • If you take insulin, test 2 to 4 four times a day, or more often if you're operating heavy machinery or in other situations where an insulin reaction could put you in danger.
  • If you take diabetes medication, test at least once a day. You may need to increase the frequency if you've had recurrent bouts of hypoglycemia.
  • If you're managing your blood sugar levels through lifestyle modifications like diet and exercise, you may not require a daily test. In fact, you may only need the quarterly hemoglobin A1C test performed by your doctor.

However, don't decide on your own how often to monitor your blood sugar. "This must be done in conjunction with your doctor based on your individual situation," Ratner says.

How to Monitor Your Blood Sugar

A blood sugar check is a simple procedure:

  • Wash your hands.
  • Slip a test strip into your meter.
  • Lance your fingertip to get a drop of blood.
  • Touch the test strip to the blood.
  • Read your blood sugar level on your meter's display.

Blood sugar is usually tested before meals and at bedtime. People who need to test more often to balance their blood sugar might perform a self-check before and after exercise, after eating out, during stressful events, and whenever they feel ill.

Also, keep a log of every blood sugar check. This will come in handy if you need to consult with your doctor because you're having trouble balancing your blood sugar. Be sure to note the time of day and your specific blood sugar levels. You might also want to note the amount of carbohydrates you've eaten, the amount of exercise you've performed, the type and dose of your diabetes medication or insulin, and any unusual events that might contribute to fluctuating blood sugar.

Just as guidelines for monitoring blood sugar vary, so do the guidelines for best interpreting the results of a blood sugar self-test. Generally, your blood sugar should fall between 70 and 130 mg/dl before a meal and less than 180 mg/dl an hour or two after a meal. However, blood sugar targets are actually very individualized. Your doctor will help you set your target for the best balance of blood sugar based on factors such as:

  • How long you've had diabetes
  • Other health problems you may have
  • If you have diabetes-related complications
  • If you have a hard time recognizing hypoglycemia
  • Your age and life expectancy
  • Other personal lifestyle considerations

"For example, the target blood sugar level for a 22-year-old woman who wants to become pregnant is far more intense than it would be for a 7-year-old girl," Ratner says. "All of this is individualized based on the situation of the person with diabetes."

Last Updated: 03/19/2014