From the Guidelines
The recommended frequency for checking blood sugar levels at home is up to 6-10 times daily for individuals with type 1 diabetes on intensive insulin therapies, including before meals and snacks, at bedtime, and occasionally after meals. This frequency may vary depending on individual needs, medication regimen, and recent blood sugar control 1. Factors that influence testing frequency include insulin use, recent blood sugar control, illness, lifestyle changes, and pregnancy. More frequent monitoring is needed during illness, stress, or when experiencing symptoms of high or low blood sugar.
Key Considerations
- The purpose of regular testing is to help individuals understand how food, physical activity, stress, and medications affect their glucose levels, allowing for timely adjustments to maintain target ranges and prevent complications.
- A database study of almost 27,000 children and adolescents with type 1 diabetes showed that increased daily frequency of blood glucose monitoring was significantly associated with lower A1C and fewer acute complications 1.
- For type 2 diabetes patients on insulin, testing is usually recommended 2-3 times daily, while those managing with oral medications might test once daily or several times weekly.
- Healthcare providers should establish a personalized testing schedule based on the individual's specific situation and treatment goals.
Important Evidence
- A study published in 2023 in Diabetes Care found that increased daily frequency of blood glucose monitoring was associated with lower A1C and fewer acute complications in individuals with type 1 diabetes 1.
- The American Diabetes Association recommends that individuals with type 1 diabetes on intensive insulin therapies should assess glucose levels using blood glucose monitoring and/or continuous glucose monitoring prior to meals and snacks, at bedtime, and occasionally postprandially 1.
From the Research
Checking Blood Sugar at Home
- The recommended frequency for checking blood sugar levels at home for individuals with diabetes is not explicitly stated in the provided studies, but it can be inferred that regular monitoring is necessary to maintain good blood glucose control 2, 3, 4, 5, 6.
- According to a study published in 2003, the optimal time to measure peak blood glucose values after a meal is about 1 hour and 15 minutes after the start of the meal, with 80% of post-meal blood glucose peaks observed at less than 90 minutes after the start of the meal 4.
- Another study published in 2003 suggests that the need for and composition of a bedtime snack depends on the blood glucose level at bedtime, with no snack necessary at levels above 10 mmol/l, any snack advised at levels between 7 and 10 mmol/l, and a standard or protein snack recommended at levels below 7 mmol/l 3.
- A study published in 1987 found that the capillary blood glucose concentration at 10:30 P.M. is a significant predictor of nocturnal hypoglycemia, and that the ingestion of an extra snack at bedtime for capillary blood glucose values below 120 mg/dl has the potential to minimize this risk 6.
Factors Affecting Blood Glucose Levels
- The rise of blood glucose in normal and diabetic subjects after meals varies markedly and depends on many factors, including the source of the carbohydrate, its method of preparation, and the composition of the total meal 2.
- The natural sugars in fruit and fruit juices raise blood glucose approximately as much as does sucrose and less than do most refined starchy carbohydrate foods 2.
- The optimum amount of sugars in the diet is not known, but undue avoidance of sugars is not necessary for blood glucose control and is not advised because it may result in increased intakes of fat and high-glycemic-index starch 2.
Importance of Blood Glucose Monitoring
- Diabetes mellitus results from the failure of the endocrine system to control the blood glucose levels within the normal limits, and regular monitoring is necessary to maintain good blood glucose control 5.
- Nocturnal hypoglycemia may be a considerable problem during continuous subcutaneous insulin infusion therapy, even if the basal infusion rate is adjusted in the hospital on the basis of nocturnal blood glucose concentrations 6.