How Often Should Patients Monitor their Blood Glucose?

By Lorena Drago, MS, RDN, CDN, CDCES

Blood glucose monitoring can help determine if patients are reaching their glycemic target and it’s an important part of their diabetes self-management and care. When persons with diabetes learn to interpret the value of blood glucose monitoring, they gain a broader understanding of how food, physical activity, medication, illness, and other factors affect glucose levels. This insight allows them to make adjustments and optimize their diabetes care plan.    

Monitoring blood glucose is an essential and effective therapy for persons with diabetes who take insulin.

The American Diabetes Association Standards of Care in Diabetes recommends that individuals using insulin check their blood sugar during the following occasions:  

• Fasting
• Before meals
• Before snacks
• After meals
• At bedtime
• Before engaging in exercise
• If hypoglycemia is suspected
• After treating low blood glucose levels until they are normoglycemic
• When hyperglycemia is suspected
• Before engaging in certain risky activities such as driving, boating, etc.

What are the recommended target A1C and blood glucose levels? 

• A1C less than 7% for non-pregnant adults without significant risk of hypoglycemia
• A1C less than 8% for persons with limited life expectancy and higher risk of hypoglycemia
• Blood glucose levels 70-130mg/dl fasting or before meal.
• Blood glucose levels less than 180mg/dl 1-2 hours after beginning of the meal.

Should Persons with Diabetes Monitor their Blood Glucose? 

Absolutely. They should monitor their glucose and they should be comfortable using a meter even if they choose to wear a continuous glucose monitor (CGM). Every patient should be assessed based on the therapy, circumstances and preferences. The recommended target blood glucose levels and A1C should be established and set on the device.

Healthcare professionals should instruct patients what the glucose results mean and how to interpret the results. This is crucial to the treatment and management of the patient’s health.

Do persons with diabetes need to monitor blood glucose if they take oral medications and/or non-insulin injectables (and do not use insulin)?   

The benefits of blood glucose monitoring include indicating when the glucose is too low 
(hypoglycemia) or too high (hyperglycemia). They also include gaining an understanding of how the various factors listed below may affect blood glucose values.  

• Nutrition
• Physical activity
• Medication
• Illness

Summary 

Educating patients about how to manage their diabetes is critically important. Patient-centered care is vital in helping persons with diabetes select the right technology to monitor their blood glucose. Under the guidance of their healthcare team, they should learn how to interpret glucose results and make appropriate modifications to improve glycemic control. Ultimately, helping reduce the risk of short- and long-term complications.