Home blood glucose monitoring has been a silent but a landmark revolution in the management of the global diabetes epidemic. It empowers the patient. The patient using this beautiful tool can check the status of his blood glucose control any time of the day, can have a better understanding of his/her disease state, and know how his/her body reacts to different food items with regards to blood glucose fluctuation, helping the patient in making a more educated diet regimen planning
Studies have consistently shown that diabetes patients who regularly monitor their blood glucose at home, have a better glycemic control, feel more empowered, confident and happy in life, have a lesser incidence of depression, and overall having a positive impact on the quality of life.
However patients should be aware of potential small issues and challenges associated with glucometer use at home. This article intends to highlight those challenges and how to get over them:
- Ideally one shouldbe fully trained how to use a glucometer by his treating endocrinologist before starting its use
- It is always preferable to stick to one glucometer, not to frequently swap glucometers during day to day use. Different brandsmay give different results.
- One should use only the test strips listed by the manufacturer for the particular device.
- Every time one starts to use a new pack/box/container of glucose test strips, one should make sure to calibrate the glucometer and check thestrips are within their expiry date. One will find theexpiry date printed on the container.
- Make sure that the lid of your test strips is sealedtightly, as moisture from the air may affect theaccuracy of the result.
- In India we commonly record blood glucose measurements in mg/dl. Some glucometers may give values in mmol/L which is commonly used in Europe and USA. We should convert it to mg/dl by changing the setting of the device of by a simple calculation. 1mmol/L of glucose is equal to 18mg/dl of glucose
- Make sure to wash and dry your hands beforetesting.
- Do not squeeze your finger when taking ablood drop sample.
- Apply the correct amount of blood to the teststrip. The instructions for use will tell you thecorrect amount. Too little blood sample application on the strip can result in errors. The amount of blood sample needed by each glucometer is different. Hence reading the manual carefully is of utmost importance
- Blood glucose meters are sensitive to temperatureand altitude differences. In these conditions, don’tignore any symptoms you may have even if youobtain a normal reading
- Pay attention to any error codes that your bloodglucose meter may show on the display window. Ifthese persist, you should contact the manufacturer’scustomer care line for customer support and contact your endocrinologist immediately.
- Follow the advice given by your endocrinologist on disposing sharps (for example needles) safely.
- Make sure that you complete the warranty cardsand return them to the manufacturer. This registersyour device and means that you can be contacted ifyour device needs to be changed, for example if itneeds to be recalled for safety reasons.
- Self checking of glucometer calibration is very easy. Its advisable that atleast once in 6 months, patient should carry the glucometer with himself to the testing laboratory. The patient should get his fasting and 2 hour post meal blood glucose checked using a venous blood glucose sample, and when the venous samples are obtained for testing, the patient at the same time should record the blood glucose values using his glucometer, and compare the same with the laboratory results. Normally a difference of up to 20mg/dl is acceptable. Anything more than this should be considered significant and the patient should contact the manufacturer of the device
- It must be remembered that glucometers are most accurate for blood glucose values between 60-160mg/d. The readings tend to be less accurate for very high and very low blood glucose values
- Timing of blood glucose testing is of utmost importance. The glucometer should be used ideally for checking blood glucose in the fasting state, immediately premeals of 2 hours post meals. Also blood glucose should be checked and recorded whenever hypoglycemia or hyperglycemia is suspected. Otherwise routine testing of random blood glucose is of little significance.
Dr. Deep Dutta (Venkateshwar Hospital, Dwarka)
MBBS (JIPMER), MD (Medicine) (CMCH), DM, DNB, (Endocrinology) (IPGMER), MNAMS, Specialty Certificate (Endocrinology & Diabetes) (MRCP, UK), Fellow of American College of Endocrinology (FACE)
Consultant & Head, Department of Endocrinology, Diabetology & Metabolic Disorder, Former A. Professor Endocrinology, Member Ethics Committee & Institutional Review Board, PGIMER & Dr. RMLH