Monitoring and recording

On the blood glucose, insulin and HbA1c page, we discussed how maintaining target blood sugar levels is a like balancing act. So how does this work day-to-day, and how can we keep track of whether we’re getting the balance right?


Why do you need to monitor and record?

Type 2 patient (Zhao) at a table with pencil in hand

Learning how to take care of your diabetes to achieve target blood sugar levels is a lot to think about at first – it requires attention to your diet, activity and medication, but the more you learn and take action to control your diabetes, the easier it becomes.

Watch our video to see how Gerald, who has type 2 diabetes, realised that managing his diabetes properly and paying attention to lifestyle changes was really important to stay healthy and happy.

Unless you measure your blood sugar levels you won’t know how well you’re doing in terms of diabetes control; keeping records helps to understand how you are doing, and how your food, activity or medications affects your blood sugar. Checking your blood sugar and recording will help you to find patterns and be able to work on making the right changes to help you manage better.

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


Monitoring

In the early stages of type 2 diabetes, it may not be necessary to monitor your blood sugar. In fact, many people may be advised by their doctor that they do not need to start monitoring until they start insulin therapy or medication that might cause you to have low blood sugar.

Blood sugar 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 to check.

Your doctor or nurse will advise you on how often you need to test. Once or twice a day may be sufficient if your diabetes is well controlled, but you may be asked to test more often, including before and after meals where possible, especially if your doctor or nurse is thinking about changing your treatment.

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 sugar 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 sugar levels change when you eat and how well the medication taken before your meal, including insulin, manages your blood sugar

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

 

Blood sugar levels go up and down throughout the day, and vary widely between individuals. Here we can see average ranges for people with and without diabetes at pre- and post-meal. 

It’s important to remember that these readings are not the same as the HbA1c test taken by your doctor or nurse. A self-test with a glucometer shows what your blood sugar levels are at the time of the test; HbA1c gives an average of what your levels have been over the past three months. A glucometer gives an answer in mmol/L, and HbA1c gives an answer as a percentage, 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 will really help with your diabetes management and with preventing health complications. It’s useful to record not just your blood sugar 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 do to change them. 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!


Tips and tricks

It helps to carry out your measurements and recording at the same time of day, and link it with your daily routine, e.g. taking a shower, cleaning your teeth. 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

Record all meals, snacks and drinks, time consumed, serving sizes, carbohydrate content and blood sugar readings – be honest!

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

Recording details can be tedious. You might miss some records, but try and get as many completed as possible because the benefits for you are huge


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