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Diabetes and Self
Monitoring
What is Diabetes?
Diabetes is a condition in which there is too much sugar
(glucose) in the blood. Although sugar is needed to provide
energy for the body, when in excess, it causes problem.

Persons with diabetes have excess sugar because they lack or
have deficient supply of insulin.

Diabetes
Mild Disease
Serious consequences

Diabetes Mellitus
A Serious Disease
Leading cause of new
cases of blindness
25 times more prone to
eye problems
6 times higher risk for
Paralysis (stroke)

5 times more prone to
Kidney failure
20 times more prone to
lower limb amputation
Nerve damage causes
loss of sensation
2-3 times higher risk for
heart attack
What Are Common Symptoms
of Diabetes ?
Frequent Urination
Hunger
Weight loss
Excessive thirst
Other Symptoms like:
Fatigue
Unusual Infections
Blurred vision
Dry and itchy skin etc
How do you Manage Your Diabetes?
Follow a Healthy
Meal Plan
Take your
Medication
Regular Exercise

Test blood sugar
Regularly
Diabetes Self-management
Understanding diabetes, its management and the
problems
associated with it

Participation in decision making and taking an active part
in day
to day management

Monitoring and keeping track of your blood sugar
It requires determination, effort and time
It requires willingness for self-care
It requires close co-ordination with your doctor and the diabetes care
team
Benefits of Normal Blood Sugar
Normal blood sugar
Improves your sense of well being
Restores energy
Makes you symptom free
Helps prevent long term complications of diabetes
Self Management
What Is Required?
Test and record blood and /or urine sugar regularly as advised

Record your medication, food and activity pattern

Identify blood sugar pattern in relation to the above and learn
how your blood sugar reacts to changes

Use the learning and your blood sugar results to adjust your
food, activity and medication
Learn to recognize and manage hypoglycemia and sick day
problems

Visit your doctor and diabetes care team regularly and carry out
other tests and examinations as advised

Make all efforts to control your diabetes with help of your
diabetes care team to prevent long term complications
Self Management
What is Required?
Methods of Self-monitoring
Home monitoring and recording of
blood sugar using glucose meters, or color strips
urine sugar and ketones using strips or reagents
Self Monitoring of Blood Sugar
Your Tool to Good Control !
It allows you to determine pattern of blood sugar level and
make necessary changes in your food and activity program or
insulin / OHA dose

Allows you to respond quickly to a rise or fall in blood sugar

Useful in preventing long term complications
Home Monitoring of Blood Sugar
Check when and how often to monitor - suggested times
include
Fasting, before lunch and dinner
2 hrs after breakfast, lunch and dinner
3 AM

Test more often
When not well
Suspect hypoglycemia
During pregnancy
When changing treatment or not in control
What is needed
Lancet
Test strips
Cotton swab
Glucose meter or color chart

Steps
Clean and dry hands
Puncture skin of finger (side), squeeze out large drop of blood
Apply blood to test strip, and do as per instructions
Apply cotton swab to puncture
Note and record result
Home Monitoring of Blood Sugar
Urine Testing
Positive only when blood sugar is high > 180 mg/dl.
Messy, not accurate but non invasive and less expensive
Not useful to detect and document hypoglycemia
Very useful in testing for ketones

What is needed
Test tube to collect urine
Test strips

Steps
Collect urine in test tube (second void preferable for urine sugar)
Dip test strip in urine and do as per instructions
Note and record result
Home Monitoring of Urine Sugar
and Ketones
Why Test for Ketones in the Urine?
Ketones are acid waste products formed when the liver burns
fat for energy
Produced when level of insulin is very low and blood sugar is rising
Accumulate in the bloodstream and spill into the urine
Can be detected by special test strips
Provide warning that blood sugar is out of control
High levels can lead to life threatening Ketoacidosis requiring prompt
treatment and frequent monitoring
When to Test for Ketones?

Sick, high fever or a stressful medical, physical or emotional
condition
Blood sugar >250 mg/dl
Nausea, vomiting, or abdominal pain accompanied by severe
thirst and confusion
Peculiar fruity smell in breath
What Is Glycosylated Hemoglobin ?
HbA
1
c is a test that reflects the average of your blood sugar
levels over the past 2-3 months

Optimal value of the HbA
1
c is 7%

Higher value means, you had higher blood sugar levels for last
2 3 months

HbA
1
c maybe high despite one or two near normal blood sugar
values in between
Your Daily Diabetes Diary!
An important tool to learn and manage your diabetes

Helps keep record of
Food, activity and medications
Blood sugar and other tests
Weight changes
Hypos

It will help you to understand how your body responds to
different foods, to different situations, and to your medications

Your Daily Diabetes Diary!

It will also help your diabetes care team to discuss and
plan your treatment effectively
Set Your Goals and
Achieve Them
Goal must be realistic and based on your need, lifestyle, health
and age
You and your diabetes care team must be equally involved in
setting the goal
Once set, you and your diabetes care team must make all efforts
to achieve it by appropriate monitoring and adjustments to your
food, activity and medication
Blood Sugar
mg/dl
Good Borderline Poor
Fasting 80-110 111-140 > 140
Post Prandial 80-144 145-180 > 180
Keep your blood sugar as close to good as possible to
prevent long term complications. Take insulin, if advised.
Set Your Goals and
Achieve Them
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