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If you’re wondering about how to use a blood sugar monitor, how often to monitor, or have a few questions about monitor choices, you’re in the right place. We’re going to cover all that and more.
When you’re newly diagnosed, the whole blood sugar testing thing can be a bit overwhelming. And even if you’ve had a little more experience you may have a few questions about using your monitor effectively.
Whatever the situation, you should know that monitoring blood glucose levels is one of the most important elements of good diabetes management and good diabetes control. It is key to knowing how well your condition is managed and how best to treat it.
And, those numbers provide data that you and your healthcare team can use to make informed decisions in the future!
Purchasing a Blood Sugar Monitor
You can purchase a blood sugar monitor at very low cost or even get them free in some cases. And you can use the monitor daily at home to record your numbers.
The needles and test strips that go with blood sugar monitors can be more expensive and often have to be prescribed by physicians to get them at a reduced cost.
And if you’re new to this you should also know that a monitor can be called several things:
- glucose monitors
- blood glucose meters
- glucose meter
- blood glucose monitors
These are all the same thing – a small device used to test your blood glucose/ blood sugar.
There are many different brands of devices available:
- Bayer
- One touch
- OWell
- Accu-chek
- Freestyle lite/ Freestyle freedom lite
- Abbot
- Aviva
- and others
In general, all of these function in the same manner.
For those on insulin therapy, continuous glucose monitoring may be beneficial. Continuous glucose provides constant monitoring to inform you of when to take insulin and also to avoid hypoglycemia.
Getting to Know Your Blood Sugar Monitor
Getting started monitoring can seem overwhelming, but once you get the hang of it, it’s as simple as brushing your teeth, trimming your nails or anything else you do on a regular basis.
First things first, your machine comes with 2 main parts:
- the lancing device (piece that pokes your finger, which often looks like a pen)
- the monitor/ meter itself (where you insert strips to get a reading)
These 2 parts are both reusable for many years as long as they are working properly and cared for correctly.
All of the meters and lancing devices work in the same basic way, but have slightly different mechanisms.
Then you have the 2 parts that help perform the tests:
- the needles (lancets)
- the test strips
Though you can purchase lancets and test strips at the pharmacy, they will be more expensive if not on prescription. Whereas if you physician orders them, the cost is greatly reduced. Just be sure your physician knows what kind of meter you are using as the lancets and strips are not interchangeable.
The lancets and strips must be disposed of after each use. One needle and one strip per use. Got it?
How to Monitor
Okay, so what you’ll do first is set up your lancing device – the device that often resembles a pen.
Follow the instructions in your package for inserting the needle to the device. There is often a few settings you can select for needle depth. I recommend starting somewhere in the middle. You can go as low as you like as long as you’re able to get a good drop of blood.
Once you have the needle in the device, put the safety cap back on and be sure it’s primed, ready to poke you. There should be a “hold” setting, which retracts the needle, then when you place the device on your finger and press the button it will release the trigger mechanism and the needle will get inserted. So your first step is to prime the device on that “hold” setting.
Now that this is ready, turn on your meter. Most meters will turn on with the press of a button, but some turn on when you insert a test strip. Initially, you may have to go through some settings (date, time etc), but after that you just turn it on and insert the strip.
The part of the test strip that looks “computerized” should be inserted while the part that has a smooth line or semicircle (which suctions the blood) should hang out. Follow the instructions for your device.
Once the glucose test strip is inserted, most machines will recognize the strip and then display a droplet indicating it’s ready for the drop of blood.
Place the lancing device to the side of one of your fingers and press the button. Squeeze down your finger until there is a decent size drop, then touch the “vortex part” of the test strip to your drop of blood and it will suck it right up and display your reading in a few seconds.
Some test strips have a “display area” that is a different color or has a grid-like pattern where you place your drop of blood.
So the process is:
- Load the needle to the device
- Prime the device
- Load the test strip
- Use the device to “poke” your finger and draw blood
- Place your drop of blood on the test strip
- Get your reading
All monitors work in the same fashion, but you should follow the instructions for loading the needles and test strips to your individual device.
How Often to Monitor
Most people monitor 1-2 times daily – fasting and 2 hours after the biggest meal.
But there is wide variability on how often to monitor depending on the state of your diabetes and treatment.
For instance, those taking mealtime insulin will have to check their sugar at least 3-4 times per day as numbers may determine the amount of insulin given. While others with much better control may only check a few times per week.
If you’re newly diagnosed or trying to gain better control, it can be helpful to monitor more frequently.
One thing that is helpful with mealtimes is “monitoring in pairs.”
The idea behind this is to detect the impact something has on blood sugars, particularly a meal.
To monitor in pairs you check your levels before, then 2 hours after a meal. It’s a great way to get an indication of the effect of foods and the amount of carbs you’re consuming.
If there is more than a 40 (2.2) point rise, you can determine that you’ve eaten too many carbs or the wrong type of carbs for your body or insulin to handle.
And of course, your overall goal is to get those numbers to normal healthy blood sugar levels, which you can do by reducing your carb intake, along with modifying other factors such as stress, sleep, exercise, and medication if needed.
Monitoring Safeguards
Meter Care
It’s important that your meter is well cared for or it will not work correctly. Meters should not be left in extremely hot or cold environments (ie. left in the car during summer or winter), and you need to avoid getting them wet.
Meters can be off by as much as 20 (1.1) points so if there is a slight variation in your readings, for instance, 105-110-115 (5.8-6.1-6.3), don’t put too much thought into it. The goal is that sugars are “generally” trending in goal range.
Handwashing
Be sure to wash your hands before you stick yourself.
Not only will this help prevent bacterial infections, but it will also help with a more accurate reading. If there is residue of various elements (chemical or natural), the strip will detect it.
If you were just cutting up some fruit that morning and still have pineapple juice on your hands, you may end up with a reading of the pineapple juice rather than your blood.
There is no need to use alcohol–this will only dry out your skin. Just wash your hands with warm water and soap and dry them thoroughly with a clean towel or paper towel.
Needle Disposal
Do not use needles more than once. Please. Do not use needles more than once–they should be used for blood glucose monitoring just one single time only, then disposed.
Once a needle is contaminated with blood it is a biohazard–a breeding ground for bacterial growth.
If you stick yourself with a needle that is not sterile you are risking infection, which is something those with diabetes are already at high risk for.
So what should you do with the contaminated needle? What you should NOT do it just toss it in the trash. This puts yourself and others, including a garbage man, at risk for getting a fingerstick wound and infection.
First, cap the needle off with the cap it came with, whatever you took off the tip after putting it in the lancing device. Then place the needles in a used jar with a screw on lid. It will probably take a super long time to fill this up but once it’s full you can dispose of it correctly.
Most cities have occasional biohazard pickups and collections and if not, you can take it to a medical facility to dispose of it properly for you.
Troubleshooting
Pain
Ok, lets address the elephant in the room. While some of us have a stronger tolerance than others, no one likes getting stabbed with a needle.
While it’s not possible to get a drop of blood completely pain-free, there are a couple tips and tricks to minimize the pain.
For one, use the sides of your fingers rather than the centers where there are more nerve endings. However, avoid using other sites such as the upper arm, forearm or hands etc. The capillary blood flow is best to fingertips so using these alternate sites might provide inaccurate readings.
Secondly, be sure to rotate fingers–people tend to have a favorite finger, but with 10 fingers (yes your thumb counts!) and 2 sides to each, you have 20 different options. By the time you get to the same site, there will have been plenty of time for healing.
Needle Phobia
Some people have a real fear of needles. The nice thing is that with most lancing devices nowadays, the needle is hidden and never visible (except when putting it in or taking it out), which helps a little.
Next, take a few deep breaths, which will help calm down the ‘hyperarousal’ state that develops with anxiety and phobias. Remind yourself that this is just a small poke, much less than you’d get from a splinter or a cut.
Finally, if you are still having trouble, you can ask a spouse, relative or friend to lance for you until you get the hang of it a bit more.
Getting a Good Blood Drop
There is nothing more annoying than wasting a strip and needle just to get an “error” message because there wasn’t enough blood – this can especially happen when first getting started.
While you don’t need a lot, you do need an actual drop, not just a small smear. So here’s a few tricks.
Be sure to get your lancing device all ready before you put your strip in so it doesn’t time out on you.
Drink a sip of water first and swing your arms back and forth and in large circles to help circulate blood.
Sometimes it helps to plump up your fingertip as you lance, then hold it down (below your heart) and stroke your finger in the direction of the tip to force blood out.
Wait 3-5 seconds and this should give you a nice drop–touch it to the inserted strip and you’re good to go!
Remembering
Actually remembering to test is really a tough challenge for a lot of people, but it doesn’t have to be.
Until glucose monitoring becomes part of your daily routine (like brushing your teeth or showering), you’ll probably have to incorporate something to help establish a habit. The easiest way to do this is to streamline it with something you already do every day. So if we use the example above, set your meter right by your toothbrush.
Another idea is to set a cell phone alarm to go off at certain times when you should test.
Finally, getting organized and writing it down is a good idea. Keep a daily/weekly log of your numbers so you can assess where you’re at now and your progress over time.
If you live with a spouse, roommate or kids, if you ask them, they can often be helpful in keeping you accountable to monitoring.
Meter Accuracy
Home blood sugar monitors are not meant to be 100% accurate, but to give you a general idea of what your glucose levels are. The FDA allows a 20 (1.1) point variance that meters can fall within and still be considered accurate.
So don’t freak out if your blood sugar is 115 (6.3) one day and 120 (6.6) the next. You may not have done anything differently, the readings may be the same because the meters aren’t flawless.
If you are getting significant fluctuations despite consistency in diet and other variables, you may want to test your meter’s accuracy.
This is super simple to do as most meters come with a calibrating solution. Simply place a drop on the test strip and see if the reading falls within the acceptable limit on the bottle.
If the reading is accurate and your numbers still look sporadic, schedule an appointment with the person helping you with your diabetes care – physician, diabetes educator, endocrinologist, or other health care provider – as you may need to evaluate a few things.
How to Track Blood Sugar Levels Using Our Spreadsheet
This video will show you how to track your numbers using the spreadsheets we gave you and provide a few tips on monitoring in pairs.
Glucose testing isn’t difficult to do but it can take a little getting used to. Using all these tips and tricks, you should now be a blood sugar monitor pro!
Please pin, tweet or share this info to help others. Thanks!
Christine
I thought you could get a meter that doesn’t prick your finger. Is that true and if yes, are these as good as the ones that prick you finger? Thank you!
Malorie: Dietitian (MS, RD, CLT)
Hi Christine,
Yes, there are non-invasive ways to check your blood glucose. These are referred to as continuous glucose monitors and are typically used for individuals that are on insulin therapy and need 24-hour monitoring of their glucose levels.
Beverly Smith
Thank you for all your info. My question: I just received a new test kit, Accu check, my previous meter was Bayer. My results from Accu check is 20 points higher than Bayer. I compared using same drop of blood from morning prick. Accu check was 132. Bayer was 114. Which is correct, seems like a big difference. I had used Bayer for 6 yrs. purchased Accu check because it was covered by Medicare . What do you think?
Malorie: Dietitian (MS, RD, CLT)
Hi Beverly,
The variance between meters can be very frustrating. You can read more about why your numbers my be different here and which monitors are best. I would suggest sticking with one meter to make it easier.
Beverly
Hi Malorie, Thank you for your response re: the difference in the numbers when testing my a.m. Blood. My concern is that the new meter is higher than previously. So should I assume the higher numbers are correct and change my eating habits? I thought I was on a good routine but now confused.
Thanks for help. Beverly
Malorie: Dietitian (MS, RD, CLT)
Hi Beverly,
Yes, if your numbers are trending higher then I would revisit your eating habits and other lifestyle factors that may be contributing to higher blood sugars- stress, sleep, exercise, etc.
Jedha: Nutritionist (MNutr)
Hi Beverly, just wanted to add that this is a really tricky situation because meters can vary quite a lot. We’ve covered meter variation before over here. Depending on the type of meter, certain types of Bayer and Accu-check are in the same field but the problem is they are only calibrated to themselves and can’t be compared. I wouldn’t panic, keep doing what you’re doing and like Malorie said, it never hurts to revisit your eating habits to see what more you can do. Hope that helps 🙂
Marlene
BS before lunch 6.3
Stir fry consisting of roast turkey breast, onion, cauliflower, carrot, celery, cherry tomatoes, soy sauce and 1/4 cup white rice.
BS 2 hrs later a shocking 9.2
I guess it was the rice and I forgot and drank a cup of coffee with a splash of cream prior to testing after lunch.
I thought my stir fry was a good choice but obviously it wasn’t.
However, it was satisfying and I am not hungry 3 hrs after eating.
Jedha: Nutritionist (MNutr)
It would be interesting to see the result without the rice. No doubt it would have been a lot different!
Rose
I was diagnosed with type 2 diabetes just 3 weeks ago. It runs in my dad’s family.
He gave me the meter, test strips, etc. to test myself.
At the time I was diagnosed, it was 366. It shocked me and I went right back to eating right! I was always a fan of eating well and exercising. With an occasional cheat. 🙂. I did check it every 3 or 4 days and I’m currently taking no meds. Haven’t started exercising yet but that starts this weekend. I have started checking at different times of the day. It seems every morning it is high at 150 to 178. After I eat, it will be lower at around 121. I did check it last night before bed and it was 77. I am giving myself 1 month to see if I can make good changes and am under a Dr’s care. I was just wondering why it is so high upon awakening? I can’t seem to get that number lower. Any suggestions? Thank you. This is a great site and you’re giving me great info. 👍
Jedha: Nutritionist (MNutr)
Read this info on morning blood sugar levels, it will help explain things. If you keep improving your overall daily levels your morning numbers will improve. There are also some additional tips on that info link. Keep up the great work Rose!
Ron Judd
I presume lack of response to my several attempts to download your nice free gifts is because I live in Queensland Australia. Can we pay any excess postage costs, so that we can still receive those free gifts?
Ron Judd,
Jedha: Nutritionist (MNutr)
Hi Ron, we have subscribers from around the globe, and many from Australia. I took a look and you have been added to our email list. Please check your junk mail folder for our emails as they sometimes land there. And make sure you move them to the inbox so they don’t go there again. If you continue to have issues, contact support.
Kavindu tharuka
Thankyou so much.great job….
jim
How long do most meters last? Should we anticipate 3 to 5 years or longer?
I use an empty pill bottle for my used strips and needles. I have discussed with the attendant at our recycling center what I’m doing and they are fine with it.
I have Medicare with a pretty good supplement that covers supplies as long as the Dr. prescribes them. If you are testing 2 times a day my pharmacy says I should send record of my readings to my Dr. incase Medicare wants it.
Elizabeth
Good questions–it’s really variable. As long as it’s still reading accurately, you can continue to use it. I know people who have been using the same meter for over 20 years and it still works fine. Whereas others poop out in less than a year (this isn’t common if the meter is well taken care of).
I would not recommend taking used needles in any form to a recycling center because they are a biohazard. Most clinics or healthcare settings will take them and dispose of them for you (or often the city will have a collection every so often).
Medicare is a great insurance option–they are often more likely to cover services when they know patients are taking ownership complying with recommendations as you are.
Brewster
I monitor 4-5 times a week, sometimes daily if I’m having a bad food day. Our health care plan pays for 200 strips yearly and looking at them on Amazon they are crazy expensive for the ACCU-CHEK AVIVA which I’m using. I’ll run out before the year ends, how does everybody pay for these things.
Patricia Kay Alexander
I purchased the Reli-On system from Walmart and have found no problems with it. Thanks to the new Walmart Grocery program, where you can order on-line and pick up the next day, I can purchase my strips and needles easily. 50 test strips are $9 and 200 Ultra-Thin Lancets are $2.52. (The Ultra Thin Lancets are the best & smallest gauge.) A lot of the monitor companies will give you the monitor but you have to purchase the strips and lancets – this is where they make their money back. My doctor is okay with the results I get and, to me, that’s really all that counts. Good luck and God bless you!
Elizabeth
Awesome! Yes the Reli-On Walmart brand is a very affordable choice!
Elizabeth
Hi Brewster–see some of the other comments for suggestions. The ReliOn meter from Walmart may be your cheapest out of pocket option. The first thing I would do is call your insurance company and see what their preferred meter is and ask them your lowest cost option. Accucheck is a great meter, but not the best coverage. Contour is often covered well and if you have medicare, freestyle light is a good meter. Also, if you see a diabetes educator, they may have coupon cards for free or discounted strips or needles that they get from reps (I know because I have a bunch).
Eric
Great info, particularly for beginners…
Miriam Gravatte
Why is it recommended to monitor BS 2 hrs after the start of a meal rather than 2 hrs after completion of a meal?
Elizabeth
It’s simply how we calibrate based on the physiological changes expected which start when you take your first bite of food–your hormones and enzymes start to go to work digesting, absorbing and processing the meal. From the time insulin begins to activate to process glucose from a given meal, 2 hours is the expected time it would take to bring levels back down to <140.
kenneth stephen Rheault
Your info was very helpfull
Elizabeth
Thanks! Glad you found it helpful 🙂
Suhail
A great service. God bless you.
Lisa
Thank you so much for all the information. It has been so helpful and has helped me gain control of my diabetes.
Elizabeth
You’re very welcome–so glad it has been helpful for you!
Valerie
I was diagnosed with pre-diabetes. A montering system was prescribed, with instructions to test, once a day. I was also prescribed Metformin. I do my testing between 10pm-10:15pm every night. Is this a good time to test? New system so just started last week. Levels have ranged between 95-122 every night so far. Just wondering if before bed is a good time to test? My theory is, after all day, this should be the ultimate reading? Thank you for your time.
Sue
My Diabetic educator told me to test at various times. The system she has me on is to test each day, once. So I have to do before breakfast, next day 2 hours after breakfast; same for lunch and dinner on subsequent days, then on the 7th day I do before bed then start again with the before breakfast reading. Different times sometimes get different readings and apparently one can have a high or low at different times so she wanted me to do that system for 3 months, that way she could see where my problem areas were and we could discuss what to do if needed. Also this system keeps me very aware of my successes (rare failures) and gives me a really good idea of what foods I am reactive to. Hope that helps.
Elizabeth
Very good–I’m so glad you are working with a Diabetes Educator and it sounds like she has helped you develop a system where your numbers are meaningful and providing you with information you can use. Great job!
Elizabeth
I would vary the times you test. There isn’t really an ‘ultimate’ reading time as blood sugar fluctuates throughout the day and night depending on many factors. For people with well balanced meals and smart diet choices, blood sugar is often higher in the morning than in the evening. I would vary your testing times between: Fasting, 2 hours after each of your meals, and bedtime and start looking for trends & patterns.