Monitoring Diabetes

Basal Bolus Safety Skills Training

Learn tips on how to monitor diabetes. 

Blood sugar testing

Why is it important to check blood sugars?

• It helps you make decisions about insulin, food and activity.
• It helps you keep the blood sugars in range.

What is the ideal range for my child’s blood sugar before meals?

• The diabetes team will help you set a range that works best for your child.
  • Younger than 6 years: 80 to 180
  • 6 to 12 years: 70 to 165
  • 13 years and older: 70 to 150

How do I check my child’s blood sugar?

• Follow the instructions for your lancing device and glucose meter.
• The nurse will teach you how to use them.
  • Make sure fingertips are clean and dry.
  • Use one drop of blood.
  • Hold fingertips lower than the heart.
  • Use a new, sterile lancet. Lancets are for one use only.
  • Keep your lancing device and glucose meter clean.
  • Never share a lancet or a lancing device with anyone.

When should I check my child’s blood sugar?

• Test before all meals and snacks. You need to know the pre-meal blood sugar to decide on an insulin dose.
• Test blood sugar at least 3 hours after last insulin injection.
• Testing sooner may lead to a false high blood sugar.
• Checking blood sugar 3 hours after a meal tells you if the amount of insulin your child took for that meal is working.

Other times you will need to test your child’s blood sugar:

• When you think your child is having a low blood sugar
• After exercising for 30 minutes
• After treating a low blood sugar
• When your child is sick
• When you need more information
• If your child has a very active day
• Before your teen drives a motor vehicle
• When you change your child’s insulin dose

Will I always have to test blood sugar this often?

• Yes. Frequent blood sugar testing is necessary for good diabetes control.

How do I know if the number on the glucose meter is correct?

• If a number on the meter does not make sense, always recheck it.
• The most common mistake is not putting enough blood on the strip. This gives a false low reading.
• Wet fingers can dilute the drop of blood and also give a false low reading. Wash and dry hands well.
• Food on the hands may give a false high reading.

What is Alternate Site Testing (AST)?

• Some meters allow you to test blood sugar on palms and forearms.
• Some children find this less painful.
• In the beginning we will teach you to use your child’s fingertips.
• Discuss AST with your diabetes provider before using.

Are there times I should not use AST?

• Do not use AST when your child’s blood sugar could be rising or dropping.
• Do not use AST when your child is:
  • Exercising
  • Sick
  • Testing a blood sugar before driving a car
  • Unable to feel a low blood sugar (hypoglycemia unawareness)
• At these times, check blood sugar on fingertips to make your decisions.
• Repeat any high or low blood sugar reading using the fingertips.

What do I do if my meter breaks?

• Call the number on the back of your meter.
  • They can often talk you through the problem on the phone.
  • If not, they will arrange to send you a new meter.

Ketone testing

What are ketones?

• Ketones are strong acids that come from fat breakdown.
• Fat breaks down when there is not enough insulin.
• Ketones are found in the urine and blood.
• Ketones make the body sick.

When should I test my child’s urine for ketones?

• When blood sugar is over 240
• When your child is sick or beginning to get sick

How do I test the urine for ketones?

• Dip a ketone dipstick into a fresh urine sample or have your child urinate on the end of the strip.
• Ketones will turn the dipstick a pink or purple color.
• Refer to the package insert for color codes for your brand of ketone test strips.
• Wait the amount of time stated in the directions.
• Note if urine ketones are negative, trace, small, moderate or large.

What else do I need to know about ketone strips?

• Some strips test the urine for more than just ketones. Look for pink-purple ketone color.
• Ketone strips will not work correctly if they have expired.
• Make a note of the date you open the box. Write it on the box. Ketone strips expire in 6 months after opening, or on the expiration date listed on the box (whichever is first).
• Protect your ketone strips from moisture and light.
• Keep the bottle tightly closed when not in use.