Checking in Pairs

Checking In Pairs: How To Get The Most From Your Blood Sugar Checks

Often when you are diagnosed with diabetes, you are given a prescription for a glucometer and told to monitor your blood sugar. But you leave the doctor’s office with more questions than answers. How often should I check? What is a good number? What do I do if my blood sugar is high? How do I even use this meter? Can you relate to that? Unfortunately, physicians have limited time to spend with you answering questions or explaining things in-depth. So I wanted to provide you guys with a comprehensive guide to strategically monitoring your blood sugar by checking in pairs.

How to Use a Glucometer

Before we can talk about strategies for checking blood sugar, you need to know how to use a glucometer. I won’t go into too much detail here, but if you need further help, be sure to check out my Using a Glucometer handout for step-by-step instructions and trouble shooting tips.

These are the main things you need to know:

  1. Always wash your hands or use an alcohol swab before poking your finger. This reduces the risk of infection and improves the accuracy of your reading. 
  2. Most devices will come with a lancing device that needs a lancet, or needle, to be inserted before it can be used. You will need to insert a new needle each time you check your sugar. The device often need to be “triggered” before you can press the button to poke your finger.
  3. A strip needs to be inserted into the meter to collect your blood sample. Make sure that your strips are the same brand as your meter, as they do need to be compatible.

It is also helpful to know that meters are not going to be 100% accurate. Even if you purchase the most expensive meter you can find, the industry allows 15-20% variance in the results. This means that you could check your sugar once and it is 200, then you could check again immediately, and it is 240. This is an acceptable variance. Try not to get too caught up in the accuracy. Generally, your result will be accurate enough to provide you guidance on what to do next. It’s either low, normal, or high. Just take the first number you get and make a decision from there.

Now, let’s move on to some strategies for getting the most information from your checks, such as checking in pairs.

Checking in Pairs

Checking in pairs is a great way to get specific information on the adjustments you may need to make in order to better manage your blood sugar. Basically, this means checking before and after a certain event, like a meal or an exercise routine. By checking both before AND after, you can see the direct impact that the activity had on your blood sugar. Let’s look at an example:

John checked his sugar before eating and it was 95mg/dL. He then ate a personal pizza and two glasses of wine. When he checked his blood sugar two hours after the meal, it was 190mg/dL.

What information can we gather from this example?

  1. John was at a good blood sugar level before eating (the goal for fasting blood sugar is 80-130).
  2. After the meal, John was higher than the recommended level (the goal 2 hours after a meal is <180).
  3. John’s blood sugar jumped up by 95 points due to his meal.

Although John was on target before he ate, his blood sugar increased quite a bit after eating his meal. As a rule of thumb, we don’t want blood sugar to increase by more than about 50 points with a meal. A common reason for this kind of jump in blood sugar is that the meal had either two many carbs or the meal did not have enough balance between carbs and non-carbs.

What adjustments could John make?

  1. Eat half of the pizza and have a side salad to balance out the meal.
  2. Drink only 1 glass of wine instead of 2.
  3. Choose a thin crust pizza or a cauliflower crust to reduce the carbs.
  4. Anything else you can think of?

Checking before and after a meal is one of the obvious was that you could check in pairs, but this strategy could be used around any event or activity. For example, you could test before and after exercise (maybe try different types of exercise to see how your body reacts). You could test before bed and in the morning. You could test before and after a relaxing activity. I am sure that you could think of many other ways that you could use this strategy. Below are some examples of what this could look like.

Checking in Pairs Examples

Put it into Practice

The overall goal of checking your blood sugar is to identify trends or patterns. There is no point in checking 5 times a day if you aren’t analyzing the information and trying to find room for improvement.

Here’s what I suggest: Pick a meal and test before and 2 hours after that meal for a whole week. Write down your numbers or track them in an app. At the end of the week, look for any patterns. If you picked breakfast, were you usually high before breakfast? Maybe you were normal before breakfast, but your blood sugar increased too much. Or maybe all of your numbers were great! If that’s the case, move on to another meal; try testing before and after lunch the next week. And so on.

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