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Controlled Diabetics Can Slack Off Their Blood Sugar Testing (a Little)

by — Last updated: 2017-08-08 in Lymphatic & Endocrine system

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Most diabetics don't control their high blood sugar levels well enough to avoid long-term diabetic complications. But is the answer really to test, test, and test some more?

Once a diabetic has met goals for at least long enough to bring HbA1C levels down to goals, which usually takes 90 days or so, then it is OK to consider testing less. Unless a patient is instructed otherwise by their physician, here are the guidelines that work to keep blood sugar numbers in control.

A type 2 diabetic who really controls blood sugar levels with diet, exercise, and maybe a single medication like metformin might test blood sugar levels just twice a week, once in the morning while still fasting, and once after a meal. If both numbers are within the doctor's guidelines, then it's OK to continue testing just twice a week, one fasting test, and one post-prandial test. Doctors usually look for fasting numbers below 120 mg/dl and post-prandial numbers below 170 mg/dl.

If those tests run high, however, the same diabetic will need to start testing twice a day until numbers get back to normal. That means one test in the morning for a fasting blood sugar level and one test 90 minutes after an hour to see how well the pancreas is responding to the diabetic diet, or the diabetic is following the diet. When numbers come out within acceptable ranges three days in a row, then it's OK to go back to testing once a week.

A type 2 diabetic who is has more than one medication, or who hasn't achieved HbA1C goal, probably needs to test twice a day, once while fasting and once after a meal. These numbers are a good indicator of any need for fine tuning of the diet plan or medication. It's absolutely essential to test after at least one meal to know blood sugar levels aren't ever going over about 170 mg/dl, the level at which insulin resistance, and the severity of the disease, increase. 

Type 2 diabetics who take insulin can get away with not testing five times a day if an only if they carefully follow their diabetic diets and get predictable amounts of exercise every day. For them, it may be OK to test just two or three times a day. However, it's essential to test:

  • At least one fasting blood sugar level, shortly after rising to start the day.
  • At least one post-prandial blood sugar level, after the largest meal of the day.
  • Whenever you do a hard work out or you spend an extended time in physical activity.

It's every bit as important to avoid lows as highs.

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Type 1 diabetics, unfortunately, really need to test five times a day.

In the era when glucometers were new and test strips were exorbitantly expensive, doctors might tell type 1 diabetics to test until they knew how their bodies reacted to specific types and amounts of food and specific types and lengths of exercise. Even so, stress and infection could run up numbers and hitting a vein with an insulin injection could run them down. In the "old days," nearly all type 1 diabetics developed complications early in life and life-threatening complications were common. Even now, when test strips are covered by insurance, it's simply better to catch mistakes early on by testing frequently.

And that's true for any case of diabetes. The more often you test, the less likely you are to make catastrophic mistakes. If you have to save on test strip expense, and you have type 2, test less often. But if you have type 1 diabetes, seek sources of test strips that match your budget. Small mistakes are always easier to correct.