What your blood sugars can and can’t tell you

What can your blood glucose level readings tell you about your diabetes management?

Your blood glucose meter is an important tool in your diabetes management and there are many options available in Canada. Your diabetes healthcare team can help guide you as to the most appropriate meter for you.

The main purpose for using a blood glucose meter is to record your blood sugar at a particular time – whether you’re in a fasting state (before a meal), after a meal, before, during or after exercise, or during the night. This number tells you if your blood sugar is high, low or in target range.

However, a single reading can’t tell you what caused the result, if anything interfered with the result (for example, food intake, exercise, medication, stress, etc.), or if your blood sugar levels are increasing or decreasing.

Interpreting your blood sugar readings – and taking action as needed – is up to you and your healthcare team.

What is pattern management and why should you consider using this?

Pattern management is a system for helping you figure out when and why you experience high or low blood sugar. Using the principles of pattern management allows you to take charge of your diabetes, can help you to achieve your blood glucose targets to prevent diabetes complications, and can also help you and your healthcare team make decisions about your diabetes management plan. There are five basic steps to pattern management.

1. Keep blood glucose records. Your healthcare team can help you determine when – and how often you should test your blood sugar. However, when you do check it, it’s important to review the results. Most blood glucose meters keep a log of the results that can be downloaded to a computer or smartphone. Alternatively, you can record the results in a logbook or diary. Reviewing an ongoing record, either from your meter or a written record, will help you spot patterns. Ask your diabetes healthcare team about which options might work best for you.
2. Review your records and see if a pattern appears. Review your blood sugar levels over a period of days or weeks. If you notice any out-of-target results (highs and lows), highlight them and think about whether there is a pattern to the highs or lows. This might include:

• Highs or lows at similar times during the day, for example, regular high levels before lunch
• Highs or lows throughout the day
• Highs or lows after particular events, for example, following exercise

3. Determine the reason for a pattern. A number of things can cause blood sugar levels to be out of target. Some examples include:

• Underestimating or overestimating food portion sizes, especially carbohydrates
• Taking part in exercise earlier in the day, or not getting enough exercise
• Over-correction of hypoglycemia events
• Illness

4. Making adjustments to eliminate a pattern. The changes you make to your diabetes management plan will depend on the cause of the pattern. However, some changes could include:

• Getting more exercise
• Incorporating more or less carbohydrate into a meal
• Ensuring meals aren’t skipped or delayed
• Increasing or decreasing medication or insulin doses

Your healthcare team is an important partner in making adjustments to your lifestyle and medication regimens, to eliminate highs and lows. That’s why it’s important to meet with them to review your blood glucose logbook and the patterns that you have identified.

5. Monitor your adjustments. The final step in pattern management is to monitor the effect that your adjustments have had. This is incredibly important, as it allows you to check whether your sugar levels have been able to return to normal and is also great for better understanding your diabetes management. If the changes you make don’t have the desired effect (e.g. returning your blood sugar to within normal ranges), then repeat the process again, consult with your healthcare team and make any further changes that are necessary.

Your blood glucose meter is an important tool, but it shouldn’t be used in isolation. By reviewing your blood glucose logbook on a regular basis, you can spot any patterns that emerge early and take action accordingly.