better understand of the impact of food, exercise, and medicines on blood sugar
When and How Often to Check Levels
How often you should test your child's blood sugar levels each day — and
when — depends on a number of things and can even change from day to day. In
general, most kids with diabetes test their blood sugar levels before breakfast, lunch,
and dinner, and at bedtime.
They may need to check more often when they're sick or if there are changes in
their diabetes treatment or daily habits. They may also need to check more often if
they use an insulin pump
or have a management plan that aims for very close control of blood sugar levels.
The diabetes health care
team can advise you on how often and when to check.
Sometimes parents need to check their child's blood sugar levels in the middle
of the night. For example, kids having problems with hypoglycemia episodes may need
middle-of-the-night tests. And those who've just been diagnosed with diabetes may
need more frequent tests while they and their families are learning how insulin or
other diabetes medicines affect blood sugar levels.
How to Check Blood Sugar Levels
Blood glucose testing is easier, less painful, and more accurate than ever. Blood
sugar levels can be tested with a blood glucose meter, a computerized device that
measures and displays the amount of glucose in a blood sample.
To get a blood sample, a small needle called a lancet is used to prick the skin
(usually on a finger or the forearm) to draw a drop of blood. The drop of blood is
placed on a testing strip that goes into the glucose meter, and the blood glucose
reading appears on a screen within a few seconds.
Many types of glucose meters are available with different features. But most people
choose the type of equipment covered by their insurance plans.
When choosing a glucose meter, consider:
Cost: Most insurance plans cover the cost of glucose meters and
test strips, but may limit the number of test strips they cover (and test strips are
the most expensive part of monitoring blood sugar levels). Make sure you know what
your insurance will cover before investing in a glucose meter.
User-friendliness: Choose a glucose meter that is easy to use
and maintain. One that doesn't need large blood samples might be better for young
kids, for example, while an easy-to-calibrate meter might be better for teens taking
on more of their own diabetes care. Glucose meters that take less time to give results
may also be preferred.
Special features: Glucose meters are available in both large,
easier-to-handle sizes as well as small, more portable sizes. Other features may include
memory storage and the ability to record other information like date, time, food intake,
and exercise. Being able to download glucose readings into a computer program is an
attractive feature for many families.
New technologies make it easier to keep track of blood sugar levels. Adjustable
lancets can make finger pricks less painful by changing the depth to which the needle
enters the skin. Some glucose meters can use blood drawn from a forearm or other body
parts that may be less sensitive than a fingertip.
You or your child's doctor might want to get an even more detailed look at blood
sugar level changes. Continuous glucose monitors (CGMs) are wearable
devices that measure blood sugar every few minutes throughout the day and night via
a sensor inserted under the skin. By providing a more detailed profile of a child's
blood sugar levels, CGMs can help some kids with diabetes do an even better job of
"fine-tuning" their blood sugar control.
The diabetes health care team will help you choose the best equipment for your
The glycosylated hemoglobin
(hemoglobin A1c or HbA1c) test will give you an overall picture of
what your child's blood glucose control has been over the 2 to 3 months before the
test and is usually done during regular clinic visits with the diabetes health care
Hemoglobin is the substance inside red blood cells that carries oxygen to the cells
of the body. The higher the glucose level is in the blood, the more it sticks to the
hemoglobin. And once hemoglobin picks up glucose, the glucose stays on it for the
life of the red blood cell, which is about 2 to 3 months.
The most commonly measured type of hemoglobin in the blood that has glucose attached
to it is called HbA1c. In general, the lower (and closer to the levels seen in people
without diabetes) your child's HbA1c, the better controlled the blood sugars have
been over the last 2 to 3 months. Having lower HbA1c levels over years is associated
with a lower risk of future health problems related to diabetes.
Another important test checks for ketones,
chemicals that show up in the urine (pee) and blood after the body breaks down fat
for energy. The body will break down fat when it can't use glucose; for example, when
there isn't enough insulin to help the glucose get into the cells or not enough food
has been eaten to provide glucose for energy (such as when a child is ill).
Having lots of ketones in the body can put a child at risk for a major diabetes
emergency called diabetic
ketoacidosis, which can make kids very sick. So it's important to test for ketones
when necessary before they build up in the body. It's an easy test to do at home.
The diabetes health care team will let you know how and when to test for ketones
(usually when your child is having consistently high blood sugar test results or is
ill with vomiting or other symptoms of diabetic ketoacidosis). They'll also teach
you how to interpret the results as part of your child's overall treatment plan.
While glucose meters can help keep track of your child's blood sugar tests, writing
down the results
or reviewing downloads/printouts of blood glucose monitor data will make it easier
for you and the diabetes management team to see patterns and trends.