CHECKING YOUR BLOOD SUGAR Blood Sugar

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1 CHECKING YOUR BLOOD SUGAR Blood Sugar It's really important to check your blood sugar regularly to make sure it stays in a healthy range. Because this gives you a lot of control over how diabetes affects your health, today and in the future. A1C If you're already getting your A1C checked at your doctor's office, that's great. It's really important to do that at least 2 times a year (and more often if your doctor tells you to). It tells you how well your blood sugar was controlled over the past few months. If you ever get a high A1C result (like a 7 or more), that's a sign to talk to your doctor about making some changes. But the A1C test alone cannot tell you WHAT you need to change. Know your blood sugar To make changes, you need to know exactly what your blood sugar is at specific times, like: When you wake up Before or after you eat When you check your own blood sugar, you get specific information you can use in daily life. It can tell you things like: What foods or amounts of food might not work for you. If you need to take more of a medication or a different kind of medication. If you take insulin, it can tell you and your doctor if you need to change the amount or kind of insulin you take. When to Check When it comes to checking blood sugar, the first thing you and your doctor need to talk about is your blood sugar targets for certain times, like: Before meals 2 hours after you eat Right before bedtime During the middle of the night (which is important if you take insulin) Sample starter schedule Very few people check their blood sugar before and after every meal and every night

2 before bed. So once you have your blood sugar targets, you and your doctor should come up with a schedule for checking that's right for you. You may have already done this. But if you don't have a schedule yet, here's one way to get started checking just 2 times a day: Day 1 - Check your blood sugar before and after breakfast (then you're done for the day) Day 2 - Check before and after lunch (that's it) Day 3 - Check before and after dinner Day 4 - Start all over again with breakfast After a month, you and your doctor will have a pretty good understanding of how most of your favorite meals (and how much you eat) affect your blood sugar all from checking before and after just 1 meal a day. And you can always check more often. In fact, if you have Type 1 diabetes or you inject insulin more than once a day, you'll definitely need to check a few times every day. You should always check more often when: Any of your medications change You take over-the-counter decongestants or diet pills You're sick You become more or less active Your diet changes You're under a lot of stress All of these can affect your blood sugar. So you want to keep an especially close watch at these times. The blood glucose meter There are 2 things most meters have: Tools You'll Use 1. The slot where you insert the "test strips" - Test strips contain chemicals that help the meter read the strip. And some meters take cartridges that hold many strips, so you don't have to insert a new strip each time. 2. The display - This is where the results of your reading show up. Beyond that, you can pick the meter that's right for you based on a few options.

3 Meter size - Depending on where and when you'll test most often, you may want a meter that's small and easy to carry. Display size - Some displays show bigger numbers and text for people who might not see as well. Audio results - Some meters can read results out loud. Reminders - An easy way to remember when to check your blood sugar. Memory - Some meters can save results from a week up to several months. Long-term results - Some of the meters that save results can take that information and tell you how well your blood sugar was controlled over a week or the past few months. Download (send) results to computer - This makes it really easy to share your results with your doctor. Alternative-site testing - This just means you can do some blood sugar checks in other places, like your palm or forearm. Test strip size - If you find small strips hard to handle, you might want to choose a meter that takes bigger strips or uses strip cartridges. To make sure your results are as accurate as possible, use a meter that's less than 2 years old. Does your insurance cover the meter and testing strips you plan to use? Find out, because it will save you money. Lancing device Along with your meter, you also need a lancing device. These sometimes look like pens. But when you click this pen, a really small needle (lancet) pops out to prick your skin. This may sound scary, but: The lancet is really tiny. It only goes in a little bit. Since most meters only need a very small drop of blood, you can get even smaller, shorter lancets. Sometimes you can also adjust how deep the lancet goes. You and your doctor can figure out what works best for you.

4 How to Check Each time you start a new batch of test strips, you need to code and calibrate your meter. This is to make sure the new strips will give you accurate results. How to code your meter It's basically a simple 2-step process. 1. Check the strip container for the code number. 2. Enter that number into your meter. Just so you know, some newer meters code automatically, which lets you skip coding. How to calibrate (adjust) your meter 1. Put a test strip into the meter. 2. Instead of putting a drop of blood on the strip, use a drop of control solution (which comes with each set of strips). 3. The number the meter shows should be between the 2 numbers printed on the strip container. If your meter saves results, make sure it does NOT keep this reading. Coding and calibrating may seem like a hassle. But remember: The only time you need to code is when you start a new set of test strips. Most of the time, the same goes for calibrating. (Your doctor can tell you other times you might need to do this.) Checking your blood sugar

5 1. Wash your hands - If you wash them in warm water, it helps get the blood flowing. This makes it easier to get that drop of blood. Another trick to get more blood to your fingertips: shake your hand at the wrist. You can also massage your finger to push blood toward the tip. 2. Put a new test strip or strip cartridge in the meter - Then it's time to prepare the lancing device. 3. Take the cap off the lancing device 4. Insert a new lancet into the device 5. Carefully remove the protective cover from the lancet - But keep it handy. You'll need it again. 6. Put the cap back on the device 7. Check the depth setting for the lancet 8. Cock the device - This may have already happened when you inserted the new lancet. 9. Prick your finger - No one likes needles. But most likely you'll discover that pricking your fingers really isn't that bad, especially if you do it on the side of your finger (see image). If the thought of pricking yourself scares you right now, soon it'll just be another thing you do.

6 10. Once you have a drop of blood, touch your finger to the end of the test strip - The test strip just pulls in the blood. 11. Wipe your finger with a cotton ball or a tissue 12. Take the cap off the lancing device - Watch out for the lancet's sharp tip. 13. Carefully stick the lancet into the protective cap 14. Eject the lancet from the device 15. Throw away the test strip and the lancet - Do this after each blood sugar check. Never reuse lancets or strips. It'll mess up your results. But most important, it's just not safe. Throwing away lancets Don't just throw lancets away in the trash. You need to use something called a sharps container to hold your used lancets. You can usually get sharps containers at a drug store or medical supply store. Some hospitals have programs that give them away for free.

7 You can also use an empty laundry detergent or bleach bottle. Any kind of container made out of heavy plastic should work. Just make sure you keep the lid on between uses. Once you need to get rid of it, use duct tape to make sure the lid won't come off. Also, mark the container as "Medical Waste." No matter what kind of container you use, make sure you throw it out the right way, too. Most communities will NOT let you throw sharps containers away with the regular trash. So talk to your care provider or pharmacist, or contact your local public health department to find out what to do with home medical waste. You can usually find them online or in the "Government" section at the front of the White Pages. Also, the hospitals that give out free sharps containers will usually take them back when they're full. Record your results This is really important. Your meter may do this for you, or you may need to write your results in a notebook. But the number isn't the only thing you need to keep track of. You also need to record: What you ate before checking If you exercised (and how much) What medications you took (including insulin) How you were feeling (like if you were stressed out) These details are especially important if the results you get aren't what you were expecting. Why keep your results? You need to share them with your doctor at each visit. It's how the 2 of you will make decisions about your care. Based on how your numbers go up or down, you may need to change some things, like: The amount or kind of medication you take What you eat (or how much) How active you are

8 But the only way to know what changes to make is to check your blood sugar regularly. It's also how to tell if the changes you make are working. Doctor's appointments Whenever you go to your doctor's office, take your meter with you. That way, they can make sure you're doing everything right, and maybe even give you a few pointers. Call your doctor right away if: Your blood sugar is high a lot (don't wait until your next appointment to let your doctor know) You start getting low results (low blood sugar can quickly become an emergency) Keep in mind From time to time you're going to see numbers you won't like. The key is to not let 1 or 2 bad results every now and then get you angry or upset. And if you start to feel overwhelmed, talk to your doctor or someone else on your diabetes care team. They can help. And remember: every result, good or bad, is information. And that's always good to have. Because when it comes to your health, information is power.