Glucose Monitoring

1. A blood glucose meter
2. Glucose test-strips
3. Finger prick device (lancing device)

There are various types of blood glucose meters (glucometers) available in pharmacies. Your healthcare team can help you in selecting the most suitable meter for your needs and guide you on how to use it.

Some features you can look out for when choosing a glucose meter:

1. Ease of use
2. Small volume of blood needed
3. Accuracy of reading
4. Speed in obtaining reading
5. Cost of glucose test-strips

1. Wash hands with soap and water, and dry thoroughly.
2. Insert the test strip into the meter.
3. Squeeze your finger, then use the lancing device to prick the side of your finger.
4. Squeeze out a drop of blood. Ensure the drop is sufficient.
5. Place the drop of blood onto the test strip.
6. Take note of your blood sugar reading.

Performing blood sugar testing in a structured manner helps you identify patterns so you can better understand what needs to be changed to achieve better sugar levels.

Structured testing is more useful than random testing. For instance, taking a pre-meal blood sugar reading provides a baseline before eating, while a two-hour post-meal reading reveals how your blood sugar levels respond to the food consumed.

Some examples of timings are shown below. Discuss with your healthcare team the best schedule and frequency for performing finger-prick testing for you.

Additionally, you should check your blood sugar levels:

• When you experience symptoms of low blood sugar
• When you experience symptoms of high blood sugar
• Before, during, and after exercise or other important activities (e.g. driving), especially if you are prone to low blood sugar episodes
• When you are unwell

Everyone is unique, so your blood sugar targets may differ from others. Discuss with your healthcare team to determine your personal blood glucose targets, so you can work towards them safely.

An example of blood glucose targets for finger-prick testing -

Our top tips for a less painful finger-prick test include the following:

1. Choose a lancing device that you are most comfortable with. Consult your healthcare team for recommendations.
2. Adjust the penetration depth of your lancing device. Set it to the smallest number required to obtain a good drop of blood. 
3. Avoid pricking the thumb and index finger.
4. Use the side of the finger where there are fewer nerve endings, not the tips.
5. Test on a different finger or a different part of the finger each time. Rotate testing sites to allow time for healing.
6. Change your lancets regularly.

These devices measure sugar levels via a sensor placed under the skin. They monitor glucose in the interstitial fluid every few minutes, which reduces the need for frequent finger-prick tests.

Some sensors, such as continuous glucose monitoring systems (CGMs), automatically transmit blood sugar readings to a mobile device like a smartphone.

In contrast, flash glucose monitors (or intermittently scanned CGMs) display readings only when the sensor is scanned using a reader or smartphone.

Certain sensors may require calibration with daily finger-prick glucose testing. These devices offer real-time insights into glucose fluctuations throughout the day (Figure 1 below).

What is your target?

A key feature of these sensors is the ‘time-in-range’ metric, which indicates the percentage of time your glucose levels stay within the target range. To effectively track your time-in-range, ensure that you have entered the correct target glucose range into the system.

For example, your goal might be to spend more than 70% of the time within a target range of 4–10 mmol/L, and less than 5% of the time below 4 mmol/L (see table below).

Discuss your personalised targets with your healthcare team and work together to achieve them gradually.

How to increase Time-in-Range?

Here are some strategies to help improve your time-in-range:

Food

• Avoid sugar-sweetened beverages
• Reduce portion size of starchy foods
• Fill your plate with non-starchy vegetables

Exercise

• Incorporate movement into your day, especially after prolonged periods of sitting. 
• Aim for at least 30 minutes of exercise, such as brisk walking or jogging, five times a week.
• Consider taking a walk after meals, particularly those with the highest glucose peaks.

Medications

• Take your medications regularly.
• Set reminders to ensure you take your medications on time.
• Consult your healthcare team regarding possible adjustments to your medication type or dosage.

Keep a record of your diet, exercise, diabetes medications, and any unusual conditions, such illness or hypoglycaemia symptoms. You can maintain this diary using the glucose sensor app or a manual log sheet. 

Other tips

• Reflect on successful strategies: “What went well?”
• Identify areas for improvement: “What can I do differently?”
• Prepare queries for your healthcare team: “What questions do I have?”
• Share your diary and observations with your healthcare team during your consultation to enable them to support you more effectively.

HbA1c is a laboratory test performed at the clinic every three to four months. It is a reflection of your average blood glucose levels over the past three months and is reported as a percentage (%) or mmol/mol. 

HbA1c provides an indication of your blood sugar levels over the past three months. It enables you and your healthcare team to track your progress and determine whether you are achieving your health targets. 

HbA1c targets typically range from 6 to 7 per cent. Your healthcare team may set a higher target for you based on individual factors, or a lower target if you are planning for pregnancy.  

Achieving HbA1c targets means your blood sugar levels are well-controlled. This helps to prevent complications associated with diabetes.