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To control your diabetes, you need to get a good balance among the treatments you take (insulin, tablets or both), the food you eat and your physical activity.

Your doctor may suggest you check your blood glucose regularly, to see if it’s in the right range. Regular checks will also tell you if your blood glucose is dropping too low (hypoglycaemia or hypo) or climbing too high (hyperglycaemia). Both of these can be dangerous.

For example, if you’re about to do some exercise and you find that your blood glucose level is quite low, you need to eat something before you exercise. If you don’t eat anything, exercising could lower your blood glucose level even more. You could have a hypo.

Testing your blood glucose is most important if you use insulin. People with type 2 diabetes who use insulin need to be sure that they don’t have a dangerous hypo. But we don’t know whether testing your blood glucose yourself is helpful if you have type 2 diabetes but don’t use insulin.

Testing kits

There are kits to help you test your blood glucose. The kits make testing simple. Here’s what you do.

• First, take some of your blood, usually one or two drops from your finger or your forearm. To get blood for the test, most people use a special needle that springs out when they press a button. You put this needle on your finger. When you press the button, the needle makes a prick that gives you exactly the right amount of blood.
• When you have a drop of blood on your finger, you touch the drop to a test strip. The test strip is usually held in place on a meter.
• There are many types of meters. But they all do the same thing. The meter analyses your blood. Then it tells you how much glucose is in it. The number usually shows on a little screen on the meter.

Your doctor will help you decide how often to test your blood. You also need to decide when you will do the test. Some people need just one test a day. Others need to do it before they take their insulin therapy (three or four times a day).

You also need to get used to adjusting your insulin dose or your activities based on what you find in your test. You will get used to this over time. But if you’re not sure what to do, ask your diabetes nurse or your doctor for advice.

If you are having a treatment called peritoneal dialysis because your kidneys aren’t working or if you are getting injections called immune globulin to boost your immune system, check with your doctor. Some blood glucose meters might not give you a reliable reading. Your blood glucose might read high when it isn’t. It is very important to have a reliable reading to avoid getting low blood glucose.[2]

It’s a good idea to keep track of your blood glucose level over a period of time. This will help your doctor see how you’re controlling your diabetes. You can carry a notebook with you to write this down. Or you can plot your blood glucose levels right onto a graph. This will help you see how your levels change.

Also, most modern meters have an internal memory. This means that you don’t have to keep a record yourself. You can simply show the meter to your doctor.

Keeping a record of your blood glucose level helps your doctor decide if you need to change your treatment, change to a different kind of insulin or change when you give yourself insulin (this is called your dosing schedule). For example, when you go to bed, you might find that your blood glucose is always a little bit higher than it should be. If this happens, your doctor may advise you to take more insulin before your evening meal.[1]

Haemoglobin A1c test

Another test you’ll get used to is the test for haemoglobin A1c (HbA1c for short). Haemoglobin A1c is a chemical found in your blood. You might hear it called glycated haemoglobin, glycosylated haemoglobin or glycohaemoglobin.

Your haemoglobin A1c level gives your doctor an idea of what your glucose level has been over time. It is kind of an average of your blood glucose level over the previous weeks. If your blood glucose level is often higher than normal, you will also have a high haemoglobin A1c level. So this test is useful for seeing how well you’re keeping your diabetes under control. Most people with diabetes should have their haemoglobin A1c checked every three months to six months.

The result of this test is given as a percentage. A good result is 7 percent. Your ideal result depends on your own situation, but it should usually be between 6.5 percent and 7.5 percent.[3] The higher the number, the greater your chance of getting complications from your diabetes. But most likely it would have to stay high for many years before you got problems.

Driving

If you take insulin, you must inform the Driver and Vehicle Licensing Agency (DVLA) about your diabetes. You must also tell the DVLA if you control your diabetes with tablets or diet and you have a complication that could affect your driving, such as a problem with your eyes.

You need to be especially careful about checking your blood glucose level when you’re driving. If it drops too low when you’re at the wheel, you could have a hypo and black out. To reduce your chances of getting hypo while driving, check your blood glucose level just before you get into the car.[4] If it is low, have a snack and check again before you set off. Try to always have some sugary drinks or sweets in the car. If you feel you’re going into a hypo, you can stop and have a drink or sweet, to boost your blood glucose.

If you feel you’re going into a hypo while you’re driving:[4]

• Stop the vehicle in a safe place
• Switch off the engine
• Have a sweet drink or snack, such as a sweet or glucose tablet. Wait until you feel better before setting off. This can take 15 minutes
• It’s a good idea to check your blood again before driving.

© BMJ Publishing Group Limited (“BMJ Group”) 2010

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