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FALLBROOK- Linda Nunes, a Type 1 diabetic and employee of CCS Medical, a home delivery company of diabetes supplies, was the speaker at the April 25 Fallbrook Diabetes Support Group. Linda has a great deal of knowledge about meters for testing blood glucose, through her own personal experience and from being in that field of work. With great enthusiasm and an entertaining style, Linda gave an insightful presentation to the Fallbrook group!

What affects blood glucose levels

• Food – what you eat, amounts, when you eat, the combinations of food all have varying affects on your blood glucose, making them go up.

• Activity level – the more active you are, the more benefit to keeping blood glucose in control, although excessive or abnormal amounts of activity may make your blood glucose go too low.

• Medications – diabetes medications make your blood glucose go down, other medications may make your blood glucose go up or down.

• Stress – emotional and physiological stress can make blood sugars go up or down, although typically will make them go up.

Why blood glucose levels should be monitored

Self-monitoring of blood glucose (SMBG) is an important part of taking care of yourself when you have diabetes. The goal of SMBG is to collect information about blood glucose levels at different points in time so that a personal glucose profile can be determined. Blood glucose levels change constantly throughout the day, as it is affected by the different aspects noted above. When you know how your blood glucose is affected by these factors, you can make changes to keep your blood glucose at the most optimal level for you. Blood glucose control helps to prevent complications from diabetes, such as heart disease, kidney failure, nerve problems and bad circulation.

What blood glucose levels should be

Optimal blood glucose levels should be individualized for your needs and be determined with the help of your physician or diabetes educator. Typically a range is given rather than an exact number. You’ll want to keep track of your levels in a log book and take it to your physician or diabetes educator at every visit. General guidelines for optimal blood glucose levels from the American Diabetes Association are:

• before meals 80-130mg/dl

• after meals < 180mg/dl

How often and at what times you should test

Recommendations for the best time of day to test your blood sugar depend on your medicine, mealtimes and blood glucose control. Again, this is an issue decided upon with your physician or diabetes educator.

Some people test 7-10 times a day, usually if they are using insulin. They will test before and after each meal. In addition, they may test if they feel like their blood sugar is going too high or too low, or before driving or exercise when it is vital to know what level their blood glucose is at.

For people who control their diabetes with diet and activity only, testing once or twice a day may be all that is needed. It it usually the most beneficial for these people to vary their test times. For instance, one day take it before and after breakfast, the next day take it before and after lunch and the next day before and after dinner. By testing before and after the same meal, you will be able to determine how your blood glucose changes with food intake as well as activity, stress and medication.

You will want to test before meal blood sugars right before you eat or take medication. Test after meal blood sugars about 2 hours after the first bite of food – this is when your blood glucose will potentially be at its peak.

Where to go from here

If you do not have a meter to test your blood sugar, if your meter is over two-years-old or if you want a new meter, contact your physician or diabetes educator. Meters can very easily be obtained from these health professionals. You will then need a prescription for strips to put your blood sample on and lancets to obtain the blood sample. Be sure you get the meter with matching prescription that your insurance will pay for. Some insurances have a preferred brand. You can go to your local pharmacy or have diabetes supplies delivered by mail, whichever is the most convenient for you.

If you are not sure how to use your blood glucose meter or when to test, see your physician or diabetes educator.

To find out more about diabete s, see your physician or diabetes educator. You are also welcome to attend the FREE Fallbrook Diabetes Support Group. Our May 2007 meeting will be held on Wednesday, May 23rd from 1-2 pm at Fallbrook Hospital in Conference Room B. The topic will be “Diabetes Medications” and our speaker will be Gerald Hammond, PharmD, CDE. If you have any questions, please contact the hospital’s Education Office at 760-728-1191 extension 8246.