2What is Monitoring? Finger-stick blood sugar testing Like a “snapshot” A record of finger-sticks shows a trendTrends show what needs to be changedHemoglobin A1c is like a summary of 2-3 months of finger-stick readings
3“Snapshot” vs. “Summary” Example:Finger sticks average 200 : A1c will be about 8%Finger sticks average 150: A1c will be about 6.4%Non-diabetic finger sticks ; A1c is between %
4Why Check Blood Sugar? To help make good food choices To know how exercise or illness affect blood sugarTo help you know if your blood sugar is too high or too lowTo help understand symptoms
5Monitoring Goals Fasting: 70-130 Two hours after a meal: less than 180 Before a meal: about 100 (70-130)Bedtime: (snack if less than 100)2:00-3:00 a.m.:Hemoglobin A1c: 6%-7%
6Putting finger sticks to work! Did I eat too many carbs at a meal?Check FSBS 2 hrs after mealMore than 180…YES, too many carbs!I am feeling “funny.” Is my blood sugar too low or too high?Check FSBS:Less than 70, drink ½ cup juice or non-diet soda;If , go to hospital!
7Putting finger sticks to work! Is my liver making too much sugar at night?Check FSBS at 3:00 a.m. several times a week and tell provider resultsIs exercise really making a difference?Check FSBS before and after exercise
8When to Test Blood Sugar No one set timeTest at different times of dayTest more often if sickGeneral testing times:Before breakfast (no food for 8 hours)2 hours after each mealBefore a mealAt bedtimeAt 3:00 a.m. occasionally
9FSBS Record123456789101112131415161718Fasting(before breakfast)2 hrs after breakfast2 hrs after lunch2 hrs after supper3:00 A.M.
10What if…My fasting and bedtime finger sticks are at goal, but my A1c is too high?What is happening after meals?When was the last time A1c was checked?How old is the meter?Are the strips expired?Let’s brainstorm here…What might be some reasons why fasting and bedtime FSBS are at goal ( ) but A1C is say at 8% (meaning average blood sugar is about 200)?What is happening after meals? Check 2 hrs after meals to see if the blood sugar is rising too highIs the meter working properly? If meter is >2 yrs old, it is time to replace it! Check expiration dates on strips.If using insulin, what injection sites are you using?Fastest from the abdomen (stomach)A little slower from the armsEven slower from the legsSlowest from the buttocksRotate sites, but use the same general area each day for injections given at a specific time of day. Ex: at night, always give your long-acting insulin in the thigh.If you are getting ready to exercise, do not inject insulin in a muscle that you will be working out.
11Let’s Review! True or false: fasting blood sugar should be about 160. Give 3 reasons why checking blood sugar is important.True or false: If you are not taking insulin, you do not really need to check your blood sugar.When should you check your blood sugar?
12How to Test Blood SugarKeep all supplies in safe place with log book and penMake testing part of your routineGet a good drop of bloodWash handsDangle fingers below waistGently squeeze finger until it is redPrick the sides, not the middleThumbs and pinkies have better blood supply
13More Tips Try to always use sides of fingertips Warm your hands first if it is coldDon’t share equipment with othersCalibrate (set up) your meter with each new box of test stripsMake sure the test strips are not expired
14Things that affect reading A dirty meterMeter/strips that are too cold or too hotAn outdated test stripAn outdated battery in meterA drop of blood that is too smallTouching the strip on the electronic sectionNot getting “sipping” action of blood into strip; need a “hanging drop”
15Let’s Review! Which fingers have a better blood supply? How often do you need to calibrate or set up your meter?Which part of the test strip should not be touched: the part where you place the blood sample or the electronic part?
16Bring your meter and log book to every appointment!