Friends with diabetes, do you know how to measure your blood sugar?

This is the 3626th article of Da Yi Xiao Hu

Self-blood glucose monitoring by patients using a blood glucose meter is a basic form of blood glucose monitoring. It can reflect the patient's real-time blood glucose level, evaluate the impact of factors such as diet, exercise, mood and stress, as well as disease and medication on the patient's blood glucose, and can also help doctors develop reasonable blood glucose-lowering plans and evaluate the blood glucose control status of diabetic patients. It is an important means of comprehensive diabetes management.

The 2021 edition of the Chinese Guidelines for the Clinical Application of Blood Glucose Monitoring clearly recommends that all diabetic patients should undergo blood glucose monitoring to assess their own blood glucose changes.

If the user operates the blood glucose meter improperly, squeezes the blood excessively during blood collection, draws insufficient blood, or stores the test strip improperly, the accuracy of the blood glucose test value will be affected.

So, fellow diabetics, do you test your blood sugar yourself?

1. Let us first understand what the commonly mentioned fasting blood sugar, pre-meal blood sugar, 2-hour post-meal blood sugar and random blood sugar refer to and when are the blood sugars measured?

Fasting blood sugar

The blood sugar level is measured after at least 8 hours without eating calories (water is allowed). It reflects the patient's blood sugar level in the basic state (i.e., non-meal state).

Pre-meal blood sugar

Including blood sugar levels before breakfast, lunch, and dinner, which reflect the continuity of the secretory function of pancreatic β cells.

Blood sugar 2 hours after meal

The blood sugar value measured 2 hours after the first bite of food reflects the patient's postprandial blood sugar control status.

Random blood sugar

Blood sugar levels at any time of the day, regardless of the last meal.

2. Under what circumstances should blood sugar be monitored?

When is the best time to measure your blood sugar?

Applicable situations for monitoring blood sugar at several time points:

Pre-meal blood sugar

When fasting blood sugar is high or there is a risk of hypoglycemia (the elderly, those with good blood sugar control)

Blood sugar 2 hours after meal

Those whose fasting blood sugar is well controlled but whose glycosylated hemoglobin is still below the standard; those who need to understand the effects of factors such as diet and exercise on blood sugar

Blood sugar before bed

Patients who take insulin, especially those who take insulin before dinner

Nighttime blood sugar

Patients whose blood sugar level is close to the target after treatment, but whose fasting blood sugar level is still high; or patients who are suspected of having nocturnal hypoglycemia

Other time points

When symptoms of hypoglycemia occur, blood sugar should be monitored promptly; blood sugar should be tested before and after strenuous exercise

3. Principles of capillary blood glucose monitoring

When choosing the capillary blood glucose monitoring plan and frequency, an individualized monitoring plan should be formulated based on the patient's condition and actual treatment needs.

Those who adopted lifestyle intervention

Blood sugar monitoring can be used to understand the effects of factors such as diet and exercise on blood sugar, and to make corresponding diet and exercise adjustments.

Those taking oral hypoglycemic drugs

Fasting or postprandial blood sugar 2-4 times a week, or monitor blood sugar for 3 consecutive days in the week before the visit, monitoring 7 blood sugar segments every day (before and after breakfast, before and after lunch, before and after dinner, and before bedtime)

Those taking insulin

Patients using basal insulin should monitor fasting blood sugar

Patients who use premixed insulin should monitor fasting and pre-dinner blood sugar levels.

Patients who use mealtime insulin should monitor their blood sugar levels before and after meals.

When hypoglycemia is suspected, blood sugar should be tested at any time.

4. Several key points of blood sugar operation

Before testing, wash and dry your hands. (This step is very important, otherwise the blood sugar level will be affected if the hands have been in contact with sweets.)

Disinfect the blood collection site with 75% medical alcohol cotton pads or cotton balls, and then draw blood after it dries.

Blood was collected from the sides of the fingertips on both sides, avoiding areas with scars, edema, infection and poor peripheral circulation.

Do not squeeze the blood collection site excessively to obtain a blood sample (otherwise tissue fluid will mix in, diluting the blood sample and causing a deviation in the blood sugar value).

Do not press or move the blood glucose meter and test strip while waiting for the blood glucose meter to report the blood glucose value.

After the test, promptly record the date, time and results of the blood glucose test in the blood glucose registration book.

If you have doubts about the test results (blood sugar levels are too high, too low, or inconsistent with your feelings), it is recommended to retest. If there are still abnormalities, please consult a medical staff in time.

Please store blood glucose test strips according to the instructions:

The test strips should be kept dry, dark and sealed to avoid direct sunlight. Remember not to store the test strips in a high temperature or humid environment.

Pay attention to the validity period of the test strips. You can mark the opening date and expiration date on the test strip tube to ensure that it is used up before it expires. (Do not use expired test strips for any reason, otherwise it will cause deviations in blood sugar test values).

Make sure unused test strips are always stored in their original tubes.

After taking out the test paper, please test it in time and quickly close the bottle cap to prevent moisture from affecting the accuracy.

References:

1. Chinese Medical Association Diabetes Branch. Guidelines for the prevention and treatment of type 2 diabetes in China (2020 edition) [J]. Chinese Journal of Diabetes, 2021, 13(4): 317-411.

2. Chinese Medical Association Diabetes Branch. Guidelines for the Clinical Application of Blood Glucose Monitoring in China (2021 Edition)[J]. Chinese Journal of Diabetes, 2021, 13(10): 936-948.

Author: Huangpu Branch of the Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine

Deputy Director of Nursing Department, Head Nurse

Qiu Wei

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