Keeping a track of your numbers

Blood sugar monitoring

Routine checks for diabetes are very important especially if you have any of the risk factors (check the booklet on Knowing your diabetes). If you think that you are at risk of diabetes and you are also experiencing some symptoms, please visit your doctor right away. Diagnosing diabetes is pretty simple. All you need are a few basic blood tests.

Diabetes Symptoms

Do a little self check to see if you are experiencing these symptoms:

Diabetes numbers

For diagnosing diabetes, you need to check the levels of sugar in the blood. The following are the routine tests done:

Fasting blood glucose (FBG) test:

This test helps to find out if you have diabetes or pre-diabetes. For this test, your doctor will ask you not to eat or drink anything except for water for 8 hours before the test. It would be more convenient for you if you do this test early in the morning.

Fasting blood glucose level	Interpretation
<99mg/dL	You do not have diabetes.
100-125mg/dL	Indicates prediabetes. You need not be scared if your sugar levels fall within this range. Your doctor may recommend certain dietary measures and physical activities which would help you to delay diabetes or also to prevent diabetes. You need not take any medications to control blood sugar levels.
> 126 mg/dL	Indicates diabetes. Usually a retest is done to confirm the finding. If your sugar levels are high, your doctor would prescribe medications, exercises and diet modifications to improve blood sugar control.

The oral glucose tolerance test (OGTT):

This test is a slightly less convenient test to check for pre-diabetes and diabetes than the FBG. Nevertheless, this test results are more reliable. For this test too, you need to fast for around 8 hours. First, a fasting blood sample would be taken. Then, you would be asked to drink a sugary solution containing 75 gm of glucose dissolved in water. After drinking the solution, you would be asked not to eat/drink anything. Two hours after taking the solution, your blood sample would be taken again. If your findings are abnormal, your doctor may do a retest.

With OGTT, not only diabetes and pre-diabetes, but even gestational diabetes can be assessed. However, for checking gestational diabetes, 100 grams of glucose will be added to the solution instead of 75 grams.

The results of OGTT:

Blood glucose levels between 140 -199mg/dL in the second hour of the test suggests pre-diabetes.
Blood sugar above 200mg/dL in the post 2-hour test sample indicates diabetes, even if your fasting blood glucose test was normal. This is because your body is not able to handle the sugar challenge.
FBG of 95mg/dL and above or OGTT value of 155mg/dL at 2 hrs or above, in pregnant women indicates gestational diabetes.

Random blood glucose (RBG) test:

This test is less reliable than the FBG test or OGTT as the blood sample is tested anytime irrespective of the food intake. If your RBG test shows glucose levels to be 200mg/dL or above along with symptoms such as unexplained weight loss, increased thirst, and increased urination, it indicates diabetes. Your doctor would however, do an FBG test or an OGTT test to confirm the diagnosis.

HbA1c (glycated haemoglobin test):

This test is especially important for people who already have been diagnosed with diabetes. This test helps to find out the average blood sugar levels over the past 2-3 months.

When the sugar levels in the blood go high, they start getting bound to the haemoglobin present in the red blood cells (hence the name glycated haemoglobin). The HbA1c test helps to find out how much sugar is bound to the haemoglobin. As the average lifespan of the red blood cells is 3 months, this test helps to predict the average blood sugar levels in the past 3 months.

Hb A1c levels	Interpretation
< 5.6	Normal
5.6- 6.4	Pre-diabetes
> 6.4	Diabetes

For diabetics, the target range of HbA1c levels is less than 7. The higher the HbA1c levels, the greater are the chances of having diabetes complications. People who have diabetes should take the HbA1c test once every three months to find out if their sugar levels fall within the target range.

Importance of Early Diagnosis of Diabetes

Poorly controlled diabetes causes severe complications like heart and kidney problems. It also affects the eyes, blood vessels, skin, nerves, teeth and gums. If diagnosis of diabetes is made early and the treatment is started without delay, then the possibility of you developing these complications is reduced. So, if you are at increased risk of developing diabetes, it is important that you do periodic screening for diabetes, rather than waiting for symptoms to occur.

Testing @ Home

Why is home glucose testing required?

Once you have been diagnosed with diabetes, you need to keep a regular check on your sugar numbers. This helps you to prevent long term complications of diabetes. Plus, keeping a log of your blood sugar levels also helps to find out whether your medications, exercises, diet is helping to maintain blood sugar levels.

The procedure:

Wash and clean your hands thoroughly
Put the test strip inside the glucometer (follow the instructions given in the user manual).
Wipe your test finger with an alcohol wipe or wash with soap and water.
Prick the fingertip with the lancet.
Gently squeeze your finger till you get a drop of blood.
Hold the test strip so that its edge touches the blood drop.
Remove your finger and wait for a few seconds. Your blood sugar levels would be displayed on the glucometer.

After the test: Clean the glucometer as per the instructions given in the user manual.

Recording your test results:

Nowadays there are digital glucometers in which you could save your reading and view it on the computer when required. They also give you alerts if the blood sugar levels seem too high.

If you are manually logging your results, record the following:

Carry these records whenever you go to your doctor.

Identify behaviors that has caused your blood sugar levels to spike up:

Some tips for accurate home testing:

Read the user manual well before you start.
Only the test strips designed for your glucometer should be used. Check the expiry dates of the test strips.
Prick the sides of the tips of the fingers, not the fleshy part- it would be more comfortable for you.
Keep changing the location of the prick after every test. Use all of your fingers.
Press the finger from the base to the tip to get a good drop of blood.
Hold your fingers pointing down when you put the blood on the test strip.
The lancets and the test strip should be disposed properly (check the user manual).
Never ever share the needles.
Your glucometer should always be clean.

ABC’s of Diabetes

There are three check points for diabetes- commonly called as ABC. The A of diabetes stands for the A1C test which shows the blood sugar level in last 3 months. The A1C reading for a diabetic should be below 7. The B of diabetes stands for blood pressure that has to be around 120/80mmHg. The C of diabetes stands for cholesterol. The LDL or bad cholesterol value should be less than 100mg/dL while the HDL or good cholesterol value should be more than 40mg/dL. A report regarding your ABC should be maintained by you for careful monitoring of your condition with the help of your health care team. Over eating Being a frequent couch potato Stress Missed medication 8