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    Learning About Your Health

    Diabetes: Monitoring

    Regularly checking your blood glucose tells you how food, exercise, medication or illness affects your diabetes. Knowing this helps you better control your blood glucose levels.

    There are two different tests to check your blood glucose:

    1. Self-monitoring blood glucose test

    2. A1C blood test

    Self-Monitoring Blood Glucose

    In order to test your blood glucose you need a blood glucose meter, test strips, and lancets (needles used to poke your finger). Using a small drop of blood from your finger, the meter tells you how much glucose is in your blood at the time of the test. Health insurance plans usually cover glucose testing supplies with a prescription signed by your doctor. You can generally find these items at any pharmacy. Depending on your health plan, you may need to get them through a mail-order pharmacy.

    Steps for Testing Your Blood Glucose:

    1. Make sure you review the instructions that come with the meter.

    2. Wash your hands in warm, soapy water and dry them.

    3. Insert a test strip into the meter.

    4. Poke your finger with a lancet to get a blood drop.

    5. Apply the blood drop to the strip.

    6. The meter then gives you your blood glucose result.
    Note: Use a different finger each time and adjust the lancet device to the lowest setting that will still allow you to get enough blood. You may use all ten fingers. This minimizes pain from the lancets.

    If You Are Not Getting Enough Blood:
    • When washing hands, use warm water to increase blood flow to your hands.

    • Gently shake your arm down to get more blood into your fingers.

    • Press the lancet firmly against the side, not the center, of your fingertip and push the button to poke your finger.

    • Massage your finger after you poke it to get a bigger drop of blood.

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    Taking Care of Your Glucose Meter and Test Strips

    • If you have questions, call the toll-free number on the back of the meter.

    • Glucose meters run on batteries. Have spare batteries available.

    • Keep test strips covered, dry and in the packaging until you use them.

    • Do not use test strips after the expiration date.

    • Keep test strips at room temperature, below 86° Fahrenheit. Do not refrigerate.

    • Do not put used lancets in the garbage! Throw them away in a sharps container.
    Quality Control

    To check if your meter is working correctly, use the control solution that comes with your meter to do a control test. You can get more information on how to do this by reading the instruction book, or by calling the 24-hour, toll-free number printed on the back of the meter.

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    Keep a Log Book of Your Blood Glucose Results

    Tracking your blood glucose levels over time tells you how well your diabetes plan is working for you. Many meters come with a log book to track your results. Every time you check your blood glucose, record the result in your log book. Bring your log book and meter to all of your health care appointments.

    Other Things to Track:

    • Any changes in how you feel, including illness or stress.

    • Unusually low or high blood glucose readings.

    • Your diabetes pills and/or insulin.

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    When to Check Your Blood Glucose

    There are recommended routine times during the day to check your blood glucose. Each plan listed below shows different times when blood glucose should be checked. Your health care provider will decide which plan is best for you. Also, be sure to test if you feel symptoms of low or high glucose.

    Plan 1

    • Every morning on an empty stomach

    • Before main meals

    • Bedtime

    • 3:00 AM, as needed
    Plan 2
    • Every morning on an empty stomach

    • Before dinner

    • 2 hours after a meal (do this twice a week)
    Plan 3
    Choose one meal for the day and check your glucose:
    • Before the meal

    • 2 hours after the meal (do this twice a week)
    Note: Choose a different meal each day.

    Examples of when to do which plan:
    • Plan 1 if on insulin

    • Plan 2 if on pills

    • Plan 3 if on a controlled diet

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    Target Blood Glucose Values

    Your health care provider defines your target blood glucose values. The goal is to keep your blood glucose level as close to your target value as possible to achieve or maintain overall health.

    Target home blood glucose values recommended by the Center for Diabetes Services are:

    • Fasting and before meals: 70 - 120 mg/dL

    • Two hours after the start of a meal: under 160 mg/dL

    Note: During your hospital stay, glucose targets may differ. To prevent hypoglycemia while adjusting diabetes medication in the hospital, the blood glucose targets are generally, 80-150 mg/dL. Certain populations may have individual targets (for example, children, the elderly, people with kidney disease, pregnant women).

    Once you leave the hospital and are feeling better, it may take several days to gradually lower glucose into the target range listed above, and may require further medication adjustment. Discuss your target glucose values and medication plan with your health care provider.

    It is important to know what to do if your blood glucose is outside your target range. Refer to Problem Solving to treat low and high blood glucose values.

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    A1C Blood Test

    The A1C is a laboratory test that measures your average blood glucose levels over the last 2 - 3 months. It measures overall control and shows if a person is at risk for complications. This is an important test for people with diabetes.

    The usual A1C goal for most people with diabetes is a value below 6.5 - 7%. This is the range shown to prevent, delay, and in some cases, reverse complications. Certain individuals, like the young and the elderly, or those with unique situations may have a slightly higher A1C goal to prevent low glucose. Work with your doctor or diabetes educator regarding your personal A1C goal. The normal value for people without diabetes is less than 5.7%.

    The American Diabetes Association (ADA) recommends an A1C blood test at least two times a year for people who have reached target goals. For people with uncontrolled diabetes, the ADA recommends the A1C test four times a year.

    ADA Goal

    • A1C = 6%; Average Glucose = 135mg/dL

    • A1C = 7%; Average Glucose = 170mg/dL
    Action Suggested
    • A1C = 8%; Average Glucose = 205mg/dL

    • A1C = 9%; Average Glucose = 240mg/dL
    Immediate Action Suggested
    • A1C = 10%; Average Glucose = 275mg/dL

    • A1C = 11%; Average Glucose = 310mg/dL

    • A1C = 12%; Average Glucose = 345mg/dL
    Ask your doctor for a copy of your lab tests.

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    Blood Pressure, Cholesterol and Weight

    Many people are unaware of the importance of monitoring blood pressure, cholesterol and weight, and their impact on diabetes health. They are just as important as your glucose values. You can protect yourself against the most common complications of uncontrolled diabetes (heart attacks and strokes) by knowing these targets and working with your health care provider to meet your goals.

    Your Goals:

    • Blood pressure: less than 130/80 mmHg

    • Total cholesterol: less than 200 mg/dL

    • HDL (high-density lipoprotein):

      • For women: more than 50 mg/dL

      • For men: more than 40 mg/dL
    • LDL (low-density lipoprotein): less than 100 mg/dL (ideal is less than 70 mg/dL)

    • TG (triglycerides): less than 150 mg/dL

    • Weight: A healthy weight can help reduce your risk of high blood pressure, coronary heart disease and stroke. It can also help improve your blood glucose control. Speak with your health care provider about a healthy weight target value.

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    Sharps Containers

    Lancets and syringe needles are called sharps. Used sharps must be put into special sharps containers and then taken to a safe needle disposal site. This helps protect people from needle-sticks that can infect them with diseases like hepatitis or HIV/AIDS.

    It is illegal to throw needles in the garbage!

    San Francisco Safe Needle Disposal Program

    San Francisco has a Safe Needle Disposal Program at Walgreens pharmacies. If you do not have a sharps container, you can get one free at Walgreens.

    • Put all of your used sharps in this container.

    • Close and lock the lid when the container is full.

    • Bring the full container back to Walgreens to get a new one.
    Other Programs

    Produced by the staff and physicians at California Pacific Medical Center in association with the Center for Patient and Community Education. Last updated: 12/11

    Funded by: A generous donation from the Mr. and Mrs. Arthur A. Ciocca Foundation.

    Note: This information is not meant to replace any information or personal medical advice which you get directly from your doctor(s). If you have any questions about this information, such as the risks or benefits of the treatment listed, please ask your doctor(s).

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