Still, for such a simple concept, it raises many questions. How often should you test? What time of the day should you do it? You and your doctors will work closely together to find the answers that will keep you healthy.
You’re shooting for an A1c level of 7% or less, which equals an average glucose (or eAG) of 154 mg/dL. Your doctor will give you an A1c test every 3-6 months.
When you should test and what goals you’re aiming for depend on:
- Your personal preferences
- How long you’ve had diabetes
- If you’re pregnant
- Your age
- Other health problems you may have
- Medicines you’re taking
- If you have complications like retinopathy or neuropathy
- If you have low blood sugar (your doctor may call this hypoglycemia) without warning signs
But what about other times? Testing 1 to 2 hours after breakfast or before lunch gives a more complete picture of what’s going on, says Pamela Allweiss, MD, of the CDC.
“Monitoring is really important, particularly if you take insulin or medicine that can cause hypoglycemia,” says David Goldstein MD, professor at the University of Missouri School of Medicine. And measuring both before and after meals is important in understanding what your blood-sugar patterns are and what to do about them.
This switch is part of a move away from a kind of one-size-fits-all thinking and toward more individualized care.
Why? The old mantra was that better control led to fewer complications, Allweiss says. And that works OK for people who are healthy despite the diabetes. But then doctors figured out that tight control of the disease might not be safe for people with other conditions like heart disease.
All this testing means nothing if you don’t keep track of the results. Many glucose meters now do that for you. You can also keep a log. A full lifestyle diary that includes your eating and exercise habits, and how you feel at different times of the day, can also be a big help.
There’s lots to monitor and lots to learn. Your self-testing is a big part of it. One number doesn’t tell the story.
A number by itself is just a number, Allweiss says. “We want to look at a pattern.”
The steps to take after testing, of course, are simple enough: Talk to your doctors, learn what all those numbers mean, and figure out how you can meet your blood-sugar goals.
“Diabetes requires a lot of education. It isn’t like taking a pill and seeing a doctor twice a year. You have to be engaged,” Goldstein says. “We have great tools now, and we need to teach people how to use them. People have to know what to do -- and then they have to do it.”