Diabetes: Managing Your Condition

Blood glucose meter is used to test blood glucose at home and determine whether blood glucose levels are in the target range.

In recent guidelines, the American Diabetes Association (ADA) suggests that all people with type 1 and type 2 diabetes should self-monitor their blood glucose levels. The ADA also recommends self-monitoring for most people using medications to control type 2 diabetes, and even for those who are managing their type 2 diabetes through diet and exercise alone.

A blood glucose meter is used to test blood glucose at home and determine whether blood glucose levels are in the target range. Meters can be purchased at most pharmacies. Testing glucose levels helps put the person with diabetes in control and be more active in managing their condition. Using blood glucose meters to determine the effects of certain foods on blood glucose levels can also help a person with diabetes to choose appropriate foods more carefully.

A person with diabetes should talk with their diabetes educator or pharmacist about which model of glucose meter is appropriate for them. Anyone using a glucose meter should receive proper training so that they can test their blood glucose levels properly.

Ask a diabetes educator about:

• the size of the drop of blood needed
• the type of blood glucose strips to use
• how to check if the meter is accurate (the meter should be checked at least once a year)
• how to code the meter
• how to clean the meter

If a person with diabetes experiences symptoms of hypoglycemia (i.e., low blood glucose), they should check their blood glucose immediately. If a meter is not immediately available, the symptoms should still be treated with the following guidelines:

1. Eat or drink a fast-acting carbohydrate (½ ounce):
• 3 to 5 glucose tablets (the exact amount will depend on the glucose content per tablet of the brand you have; check to make sure you are aware of this amount and take enough to make up 15 g of glucose)
• ¾ cup of orange juice
• 8 Life Savers^® OR 5 hard candies
• 1 tablespoon of honey
2. Wait 15 minutes, then check blood glucose again. If it is still low:
   • treat again
   • if the next meal is more than one hour away, or if the person is going to be active, they should eat a snack, such as a half-sandwich or cheese and unsalted crackers (something with ½ ounce of carbohydrate and a protein source)

Certain people at risk of hypoglycemia may be advised by their doctor to carry a pre-filled 1 mg glucagon injection and make it readily available for emergency situations. This medication is intended to increase blood glucose levels from 3.0 mmol/L to 12.0 mmol/L within an hour.

Do-it-yourself urine tests for ketones are useful during times of illness or for diabetes that occurs during pregnancy (gestational diabetes). Ketones are potentially dangerous acids that build up in your blood when you lack insulin. Ketone build-up is much more common if you have type 1 diabetes.

When performing a ketone test, collect a sample of your urine and place a test strip in the urine. Wait for the strip to change color, and then compare it to a color chart showing the amount of ketones. Medium or large amounts are a sign to call your doctor immediately. Small amounts may mean that a build-up is starting and you should test again in a few hours.