People with diabetes should check their blood sugar levels frequently. Additionally, modern technologies such as continuous glucose monitors (CGMs) have made checking more frequent than ever.
But what if I’m using a glucometer, a lancet device, or a test strip? How often, and perhaps more importantly, when should you check your blood sugar levels?
This article outlines the importance of checking your blood sugar levels, and the need to check for frequent and indeed improvements in diabetes management.
Why is blood glucose checking important?
If you live with diabetes, blood glucose checks are paramount to good control. Without knowing your blood sugar levels, you won’t be able to properly administer insulin, treat hypoglycemia, eat food, or exercise easily.
Think of blood glucose checks as a litmus test. The numbers are not good or bad. It just gives diabetes feedback about what you need next.
If the numbers are too high (and always talk to your doctor about the target range that best suits you and your lifestyle), you are telling them to take insulin or exercise, but if the numbers are too low, you should treat them with sugar or other forms of glucose.
If your number is satisfied, you can proceed with the day as planned.
Checking your blood glucose levels is also important to track long-term goals such as the HBA1C test, to see if you are reaching or exceeding those goals.
Also, checking your blood sugar levels regularly will give you feedback on what is working and what is not. Some foods may not function due to management goals, and types of exercise, such as yoga, have also helped meticulously improve my blood sugar levels.
It’s a good time to check in yourself and adjust your management team and know that this can and will change over time.
How often do I need to check my blood sugar level?
Like most things about diabetes, this all depends on your particular body and lifestyle. Work with your care team and doctor to determine the appropriate number of times per day that your blood glucose should be checked.
Know that not only are everyone different, but people’s needs for more or less frequent checks can change throughout their lifetime.
For example, if someone is pregnant, the need for checks will rise significantly, and conversely, if someone with type 2 diabetes moves away from insulin, they should check less frequently, as they are less likely to have hypoglycemia without exogenous insulin in the system.
According to Mayo Clinic, people with type 1 diabetes need a minimum check of 4 to 10 times a day, while people with type 2 diabetes only need to check several times a day (with insulin) and may not be at all if they are not using insulin.
However, let’s be clear. You can check it as many times as you need. There’s no problem with checking more frequently.
When should I check my blood sugar level?
While everyone may have a different experience with diabetes, there are some good guidelines that most people should follow.
When I wake up
The best way for people with diabetes to start their day is to check their blood sugar levels. This helps to correct the course for highs and lows before food is eaten, exercise or work begins, and helps you get on the right track for the day.
Starting a new day without knowing your blood sugar level is like driving blindfolded!
Holding alcohol swabs at the meter, test strips, lancet devices and bedside serves as a good reminder to check your blood sugar levels the moment you wake up.
Before and after meals or snacks
If you eat your first thing in the morning, your first blood sugar check of the day will also count as a previous check, but if not, you will need to check it again before breakfast.
This will let you know how much insulin you need for your diet (insulin dependent). If you are running a little higher you will need to bolus an extra, but if your blood sugar is at the bottom edge, you can get a little less insulin due to the carbohydrates you eat.
Checking every meal and snack before you eat can help to suppress post-meal glucose excursions. Otherwise, it is also known as the stubborn hyperglycemia that can be experienced after eating a meal.
Ideally, you should check it two hours after meals as well. You need to determine whether your dietary bolus is appropriate, whether you have too much insulin, or if you need to adjust it to take more insulin.
Two hours is the recommended time frame as most carbohydrates are absorbed into the body and the fastest insulin is already at its peak.
When checking before a snack (dinner) you should calculate active insulin on board to overtreat highs to lower your lows.
Before and after exercise
This is very important. Because exercising at low range blood sugar levels can be dangerous, depending on the length and intensity of the exercise you plan to plan for.
Work with your doctor to determine your appropriate pre-exercise blood glucose levels. However, people usually want to sit a little higher than normal and get levels before starting intense cardiovascular exercise to prevent severe hypoglycemia.
Meanwhile, blood sugar levels in some people tend to rise during exercise, especially when they are exercising weightlifting or exercise that spike adrenaline levels in their bodies. It’s important to make sure your blood sugar levels are at the right level in case it rises during your workout.
They also don’t want their blood sugar levels to be too high before exercise. Mayo Clinic advises people with actual diabetes who exercise if their starting blood sugar is above 250 mg/dL.
This is due to the fact that if the body is exercising without sufficient insulin in the bloodstream, the liver and kidneys accidentally release more sugar into the body, increasing the risk of dehydration, ketones and even spiraling into diabetic ketoacidosis (DKA).
Always check your blood sugar levels after exercise, as some people need a post-exercise bolus to fight spikes for temporary pump settings with reduced basal rates.
Others need post-exercise snacks to develop blood sugar levels, especially after long or rigorous training.
Before going to bed
It is important to check your blood sugar levels before going to bed. Sleeping with low or low blood sugar (while having active insulin on board) is dangerous, but sleeping with higher than normal blood sugar levels can set you up when it comes to a very long, unpleasant thirst and frequent trips to the bathroom.
Dosing properly for dinner so that you don’t eat at least two hours before bedtime will help you ensure that active insulin on board is stable pre-bedtime blood sugar levels and is less likely to surge or crash.
Recommendations vary, but many people prefer to have night glucose levels of at least 100 mg/dl.
If you have basic tests, fasting blood tests, or if your blood sugar levels are unstable, you may need to set an alarm and check it several times throughout the night.
This is when continuous glucose monitor (CGM) is beneficial. This is to alert you to certain hyperglycemia and hypoglycemia levels, adjust insulin as needed, and treat low blood glucose events.
When you get sick
Blood glucose levels are more difficult to manage when you’re sick, so it’s more important than ever to check your glucose frequently when you’re exposed to the climate, from fighting the cold to the troublesome flu and even infections.
If you are sick, we recommend checking frequently every 4 hours.
- Your blood sugar level is above 250 mg/dL for a few hours and you have mild or moderate ketones
- Blood glucose levels cannot be 70 mg/dl for several hours
- It cannot suppress liquid
- You have a temperature above 101 f
- I have diarrhea and vomiting
Other important times to check your blood sugar levels
Other important times in your life may be that you should pay special attention to your blood sugar levels and check more frequently:
- When there is a change in drug therapy including insulin.
- On vacation or travelling (especially when changing time zone)
- During pregnancy (and after birth)
- If there is a change in your daily routine (for example, a new job)
- You have been diagnosed with a new health condition
- There have been dramatic changes in your diet (or you’ve gained or lost a lot of weight recently)
- You were under a lot of stress (like movement, breakup, or other stressors)
Conclusion
For those living with diabetes, it is usually a good time to check their blood sugar levels, but focusing on these important times throughout the day will greatly improve diabetes management, reduce blood sugar levels and A1C, increase energy, and increase health and happiness!
