Now that you’ve learned all you can about controlling diabetes, you are probably wondering how exactly do I measure results, and how do they all tie in to give me a big picture of how well my diabetes is controlled?
Here are some of the most common tests you will be taking as you manage your diabetes:
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Self-monitoring of blood glucose is an important part of diabetes management. Many people think they can tell what their blood sugar is by how they feel. Some people can feel "high" when their blood sugar is low, and some can feel "low" when their blood sugar is normal or high. The only way to know for sure is to test your blood sugar. Testing also lets you see how behaviour like exercise or overeating affects blood sugar.
Educating yourself about the types of testing you should be doing, how often you should be doing them, and adopting a "take-charge" attitude towards managing your diabetes can help you stay healthy.
Self-monitoring of blood glucose (SMBG) shows you how your body reacts to daily events, foods, and physical activity and helps you decide how best to manage your blood sugar as a result.
SMBG allows you to answer questions like, “what happens to my blood glucose:
Your healthcare team will help you decide when to test and how often. This might include:
It is a good idea to do extra tests when:
CONTOUR®NEXT meters are designed to be easy to use. Below is a brief overview of the basic steps involved in testing. This is just a guideline, however. Be sure to read and carefully follow the instructions included in your CONTOUR® meter kit before testing.
Before you test
Prepare the MICROLET®2 Lancing Device
Insert the test strip with the grey square end facing the meter. Insert firmly until the meter beeps.
Obtaining blood sample
Ejecting and disposing of used MICROLET® Lancet
CONTOUR®NEXT control solution testing is done to ensure that your CONTOUR®NEXT meter and test strips are working properly. You should perform a control test when:
How to perform a control test:
Your CONTOUR®NEXT control solution can also be used to practice on the system.
Blood tests taken at different times help identify the effect that certain foods, exercise, and lifestyle factors can have on your blood glucose. For instance, periods of stress or sickness can cause blood glucose readings to be lower than usual, while a large meal (or several large meals, such as during the holiday season) can cause blood glucose levels to be much higher than usual. Knowing your blood glucose readings at specific times can help you make informed decisions about adjusting your lifestyle and/or medication/insulin (never adjust medication/insulin without first talking to your healthcare professional, however).
GLUCOFACTS®DELUXE Diabetes Management Software can help you make sense of the numbers by quickly identifying patterns and trends over time. GLUCOFACTS®DELUXE is free to ContourCare members. If you prefer paper-based logbooks, CONTOUR® also has free Clinilog® booklets for ContourCare members.
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Many people with diabetes don’t know that Canadian industry standards have an acceptable error range of ±15%* between the meter reading and the lab reading on the same blood sample.† This means that your blood glucose meter reading could actually be 15% higher or 15% lower than the true value of the glucose in your blood.
CONTOUR®NEXT meters go above the industry standard by providing blood glucose readings that are within ±10%† of the lab reading. This means that the reading you get from CONTOUR®NEXT meters will be closer to the lab results. This is important because accurate readings can help you make the right decisions when they matter most.
For example, you rely on your meter to:
To have confidence that you are making the right decisions based on accurate readings, you need the values on your meter to reflect your actual blood glucose as closely as possible. A reading that is off by 15% vs. a reading that is off by only 10% could mean that you inject too much insulin or eat too little carbohydrate, which could put you at risk for a hypoglycemic episode.
* Current regulation based on Health Canada recognized ISO 15197:2013 standard requires results within ±15% range, specifically: ≥95% of results must fall within ±0.83 mmol/L for blood glucose concentrations <5.55 mmol/L and within ±15% for blood glucose concentrations ≥5.55 mmol/L. † CONTOUR®NEXT meter meets ±10% accuracy vs. laboratory method, specifically: >98% of results within ±10% for blood glucose concentrations ≥5.55 mmol/L, and ±0.56 mmol/L accuracy vs. laboratory method for blood glucose concentrations ≥5.55 mmol/L.
Yes, keeping records of your blood glucose readings is important. It allows you to look for patterns and trends that help you decide how and when to adjust your treatment. Record the date, time and whether the glucose test was done before or after eating. Make note of any symptoms you experience that could indicate high or low blood sugar. You may also want to record carb intake, physical activity and medications, including insulin, as these all affect blood sugar. Always bring your record book when you visit your healthcare team.
Some meters, like CONTOUR®NEXT, have built-in logbooks that store your information right on the meter. They also help you note information about diet, exercise, medication and how you are feeling.
Many people using CONTOUR® meters find GLUCOFACTS®DELUXE software to be helpful. GLUCOFACTS®DELUXE is a time saving blood glucose management system that quickly and seamlessly integrates and displays your stored meter readings, data, display settings and meal markers.
GLUCOFACTS®DELUXE helps you make sense of your tests results. You can quickly identify patterns and trends and get a sense of how food, physical activity, blood glucose readings, and medication all come into play to give you an overall picture of how well your diabetes is managed. GLUCOFACTS®DELUXE is free to ContourCare members. Paper-based Clinilog® booklets are also available for ContourCare members who prefer to log data the old-fashioned way.
Not a ContourCare member? Join today!
Follow the directions that came with your CONTOUR®NEXT meter to ensure that you are using it properly. You can also ask your healthcare team about your meter and get their professional advice on the best way to self-test. Here are some other quick tips:
If your blood sugar is too high, you may experience symptoms such as: blurry vision, headache, increased thirst, increased urination, irritability, tiredness and unexplained weight loss. Think about why your blood glucose level might be high and make a note of it in your blood glucose log.
To help bring your blood glucose down, consider the following:
The more you test, the more you will know about your blood glucose management. Ask your healthcare professional about what your levels should be.
You test your blood glucose levels at different moments of the day to make sure your diabetes plan is working. However, your blood glucose levels change a lot from moment to moment and self-testing alone does not give you the whole picture.
There is another test that can tell you your average blood glucose level over the last 3 to 4 months. This laboratory test is called A1C. You may hear a few different names for it, including HbA1C and glycated hemoglobin testing.
Hemoglobin is a protein inside your red blood cells. It is the part of the red blood cell that carries oxygen from your lungs to the rest of your body. Hemoglobin also carries glucose, because glucose can stick to all kinds of proteins in your body. Once glucose sticks to hemoglobin, it is stuck there for the life of the red blood cell, about three or four months. The more glucose there is in your blood, the more will end up stuck to the hemoglobin.
A1C is a measure of the amount of glucose that is stuck to your hemoglobin. Your A1C reading tells you and your healthcare team what your average blood glucose level has been over the last 3 to 4 months.
If your average blood glucose has been high for the past few months, then your A1C will be high. You should talk to your healthcare team about your daily blood glucose tests AND your A1C results.
This chart is an example of how average blood glucose compares to A1C. Taking action depends on your own plan, and your results and action steps should be discussed with your team. Some labs use different ways to test and have a different “normal” range.
|A1C reading||Average blood glucose level||Your blood glucose management strategy|
|An A1C ≥8.5 is considered poorly managed. Action should be taken right away to lower it to target.|
|8%||10.2 mmol/L||Under certain circumstances, a target of 7.1% to 8.5% may be considered in people with type 1 or type 2 diabetes. Generally, tighter targets are recommended.|
|7%||8.6 mmol/L||The target for most people with type 1 or type 2 diabetes is ≤7%.|
|Some patients with type 2 diabetes may have a more stringent target of ≤6.5%, but this must be weighed against the risk for hypoglycemia.|
The Canadian Diabetes Association recommends that most people with type 1 or type 2 diabetes aim for an A1C of 7% or less to lower their risk of certain complications, including eye disease (diabetic retinopathy), kidney disease (diabetic nephropathy) and damage to the nerves in the hands and feet (diabetic neuropathy).
If your A1C is high, your healthcare team may change your diabetes plan to help you to better manage your blood glucose. Changes in your plan should be expected from time to time and will help bring your A1C closer to normal.
Research shows that managing blood glucose levels well may lower your risk of major health problems including:
Most people will go to a medical lab for this test. A few physicians or medical clinics will be able to do the test by taking a drop of blood from a finger stick. If this is the case, you can wait for the results and talk about them with your physician right away.
Home A1C test kits are also available. Speak to your healthcare team about sourcing a home A1C test kit from a reputable company if you are interested in testing from home.
The Canadian Diabetes Association recommends that people with diabetes have the A1C test done every 3 months when blood glucose targets are not being met and when diabetes therapy is being adjusted. This can be stretched out to every 6 months in situations where blood glucose targets are consistently being met. A1C is now also being used for diagnosing diabetes.
A 1% reduction in A1C has been shown to lower the risk of many diabetes complications by 37% in people with type 2 diabetes.
To achieve an A1C at or below 7%:
If your A1C level is over 7%, it is important to talk to your healthcare team to determine why. Achieving your blood glucose targets and A1C values can help you stay healthy and reduce the risk of long-term problems from diabetes.
Ketone testing involves checking how many ketones, or acids are in your blood or urine. Testing for ketones gives an early warning of a medical emergency, called ketoacidosis, which can lead to coma or death.
Ketones are a type of acid that is left over when your body burns some of its own fat for fuel. Your body burns fat if it can't get enough glucose to use for energy. When your body burns too much fat too quickly, there may be ketones in your blood. Ketones pass from your bloodstream into your urine.
Glucose is the first fuel your body burns for energy. To help move glucose from your bloodstream into body cells for fuel, your body needs insulin. Insulin is a hormone that is made in the pancreas. If there is too little insulin in the bloodstream to help the glucose get into cells, the body looks for other kinds of fuel to burn. When the body burns stored fat, ketones begin to build up in the body. Too many ketones in the bloodstream can lead to a serious problem called ketoacidosis. Without proper treatment, this can lead to coma or death.
People with type 1 diabetes and women with gestational diabetes develop ketones more easily than people with type 2 diabetes.
Type 1 diabetes:
Gestational diabetes (GD):
Type 2 diabetes:
Ketone testing is very important. Contact your physician or healthcare team if you find ketones in your urine when you are ill or have high blood glucose levels, as this could be a sign of trouble.
Your healthcare team will tell you when you should test for ketones. Generally, you should test if:
Dip a test strip into a sample of your urine and if the colour changes, there are ketones present. Use Ketostix® Reagent Strips for ketone-only testing. Use Keto-Diastix® Reagent Strips for testing for both glucose and ketones.
If the results show trace or small amounts of ketones:
If the results show moderate or high ketones:
Ketoacidosis can quickly develop into a very serious problem. Be sure to contact your healthcare professional if tests stay high or if you have any of the early signs of diabetic ketoacidosis (DKA).
Early signs of DKA include:
If you have any of these symptoms and ketones in your urine, call your healthcare professional or go to the emergency room.