Monitoring Tests

Tests for Blood Glucose Levels. Both hypoglycemia and hyperglycemia are of concern for patients who are receiving insulin. It is important, therefore, to monitor blood glucose levels carefully. In general, patients with type 1 diabetes need to take readings four or more times a day. Patients should aim for premeal glucose levels of between 80 and 120 and bedtime levels of between 100 and 140. Different goals may be required for specific individuals, including pregnant women, very old and very young people and those with accompanying serious medical conditions. Usually, a drop of blood obtained by pricking the finger is applied to a chemically treated strip.

A laser finger-prick device is now available that may be particularly beneficial for children. The glucose level is read on a standard meter or a small, portable digital display device. Home monitors are about 10% to 15% less accurate than laboratory monitors and many do not meet the standards of the American Diabetes Association. One, called SureStep, has recently been recalled because it did not specifically warn patients of dangerously high glucose levels. Many experts believe, however, that most are accurate enough to indicate when blood sugar is too low. Some simple procedures may improve accuracy: testing the meter once a month; recalibrating it whenever a new packet of strips is used; using fresh strips; keeping the meter clean; and periodically comparing the meter results with the results from a laboratory.

Monitoring is expensive, costing 50 cents for each strip. Researchers are testing various noninvasive monitors, such as skin patches and infrared devices. A monitoring device implanted under the skin in the abdomen is also being tested.

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