Should I Be Testing My BG?
I was diagnosed with type 2 diabetes 16 years ago. Over those years, I have been a patient at a local medical practice. Because of staff turnover, I've had three different physicians in that time. All three have discouraged home testing, saying that the A1C test is far superior. They have shown no interest in my own fingerstick test results. I have my A1C test, followed by an appointment with my doctor, quarterly. My blood glucose is well controlled and I am not overweight. I have none of the classic diabetes symptoms. I have gone from testing daily, to testing occasionally, to testing rarely. Should I be testing regularly, even though my doctors don't believe in it and don't want to know the results? William Cameron, North Wales, Pennsylvania
Paris Roach, MD, responds: The frequency at which you should monitor your blood glucose will depend on how you plan to use the information. People who take multiple daily doses of insulin or use insulin pumps need to monitor at least 3 or 4 times daily to stay safe and to adjust insulin doses for high or low glucose levels. Those not on insulin but who are in the process of having their medications adjusted should monitor often enough to guide the medication adjustments, usually 2 or 3 times a day. If you're on medications that can cause hypoglycemia, like sulfonylureas, you should have a working blood glucose meter and test strips on hand so you can conduct a blood glucose check if you feel low, if you're planning to engage in physical activity, or if you have to miss or delay a meal.
Even if you're not on a medication that can cause hypoglycemia, and have achieved your glucose control targets, it may be a good idea to perform spot checks of your glucose at least a few times a week for your own information. You should also perform a "glucose profile" (checking your blood glucose before and 2 hours after each meal) once or twice every month or so to see if your glucose patterns are changing over time. This information can help you double-check the general accuracy of your A1C test results. You should check your blood glucose more frequently if you experience an illness or if you have symptoms that you think may be related to your blood glucose level.