Monitoring and recording

How does maintaining target blood glucose levels work day-to-day, and how can you keep track of whether you're getting the balance right? 


Why do you need to monitor and record?

Type 1 patient (P.J) holding and looking down at an iPad


Maintaining target blood glucose levels is a lot to think about at first – it requires constant attention to your diet, exercise and treatment, but the more you do it, the easier it becomes.

Unless you measure your blood glucose levels you won’t know how well you’re doing in terms of diabetes control; and unless you keep records, you won’t be able to notice changes or work out how things can be adjusted to help you manage better.

Monitoring and recording puts you in charge of your diabetes, and that’s important.


Tips

It helps to carry out your measurements and recording at the same time of day, and link it with your daily routine, e.g. before eating your meals or at bedtime perhaps. This way you will remember to do it, and can place your records in a convenient place for easy access

Try to record as soon as possible so that you remember the details

Sometimes it is also helpful to record all meals, snacks and drinks, time consumed, serving sizes, carbohydrate content, insulin/medication doses and blood glucose readings – be honest!

Look for trends in the records, such as high blood glucose after high carbohydrate meals, or reduced levels after physical activity

Recording details can be tedious. You might miss some records, but try and get as many completed as possible because the information is very helpful in managing your diabetes


Monitoring

If you have just been diagnosed with type 1 diabetes or if you are beginning to self-manage your condition, the following information will help you to understand why and how to monitor blood glucose.

Blood glucose is measured at home or when out and about, using a device called a glucometer. It involves a finger prick with a small needle to take a drop of blood for testing.

Your doctor or nurse will advise you on how often you need to test. It’s usual to increase testing frequency with the intensity of insulin dosing – this can be anything from twice a day to more than six times daily for those on multiple injections or insulin pumps.        

The more you test, the better your understanding of your glucose profile and the easier it will be to control levels. This can be particularly important in some circumstances such as illness, pregnancy, breast feeding, and sporting activities.

You’ll be asked to test before and after meals where possible, especially if your doctor/nurse is thinking about changing your treatment or if you are monitoring your diet. 

You might hear different phrases used for measurements taken at different times, for example:

Fasting – this is a measurement taken first thing in the morning before breakfast, when your blood glucose is at its lowest

Pre-meal – this is a measurement taken just before you eat. It is useful because you can compare it to the post-meal measurement to see how much your blood glucose levels change when you eat

Post-meal – this is a measurement taken one to two hours after a meal, when your blood glucose is peaking

Remember that blood glucose goes up and down throughout the day, and varies widely between individuals – get used to your personal range and values so that you know when you need to adjust your diet, activity or insulin dose.

A glucometer gives an answer in mmol/L, and HbA1c gives an answer as a percentage (or mmol/mol), so the two can’t be directly compared. 


Recording

There are lots of different ways you can choose to record your measurements, and it’s important to choose one that suits you because you’ll be more likely to stick to it.

You could use a diary – either a normal one, or a diabetes-specific one that your doctor or nurse might be able to give you – or you might prefer to use an app on your mobile or tablet, or computer software. Some of these packages will plot your results for you so that you get a picture of how you are progressing over time.

Keeping records as accurately as you can really helps with your diabetes management and with preventing health complications. It’s useful to record not just your blood glucose levels, but also what you ate and any exercise you did. This way, if there’s an unusual peak or dip in your levels, you will be able to work out what caused it.

Don’t regard the values as success or failure – just ask yourself what you can learn and how you might change what you are doing. Keeping records is the only way you have of tracking your progress – don’t put it off and think you will remember the day’s results later on – you probably won’t!


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