Newly diagnosed diabetes patients have a lot to learn and manage. And it’s not always easy. Along with paying close attention to your diet and exercise, you must test and monitor your blood sugar (glucose) levels at home. But, how do you know which type of testing to use? Read our tips for newly diagnosed diabetes patients for helpful information that will help you decide which testing methods are right for you. Get started on the right path!
Quick intro for newly diagnosed diabetes patients.
If you or a loved one recently received a new diagnosis of diabetes, there is a lot of information to learn! The best place to start is with a quick introduction to diabetes.
Diabetes is a chronic (long-lasting) health condition that impacts how your body turns food into energy.
Your body breaks down most of the food you eat into sugar (glucose) and releases it into your bloodstream. When your blood sugar goes up, it signals your pancreas to release insulin. Insulin then lets the blood sugar into your body’s cells for use as energy.
When you have diabetes, your body doesn’t make enough insulin or can’t use it as well as it should. When this happens, too much blood sugar stays in your bloodstream. Over time, that can cause serious health problems, such as heart disease, vision loss, and kidney disease.
Note: the terms blood sugar and blood glucose are often used interchangeably.
Type 1 diabetes.
Experts believe an autoimmune reaction (when the body attacks itself by mistake) causes type 1 diabetes. This reaction stops your body from making insulin.
Symptoms of type 1 diabetes often develop quickly. It’s usually diagnosed in children, teens, and young adults. If you have type 1 diabetes, you must take insulin every day to survive.
Currently, there is no known way to prevent type 1 diabetes.
Type 2 diabetes.
With type 2 diabetes, your body doesn’t use insulin well and therefore can’t keep blood sugar at normal levels. It develops over many years and is usually diagnosed in adults (although children, teens, and young adults can also develop type 2).
You may not notice any symptoms, so get your blood sugar tested if you’re at risk.
Fortunately, you can prevent or delay type 2 diabetes with healthy lifestyle changes, such as:
- Losing weight.
- Eating healthy food.
- Being active.
Gestational diabetes, which develops in pregnant women with no history of diabetes, can increase your baby’s risk of health problems.
Fortunately, gestational diabetes usually goes away after your baby is born. But unfortunately, having gestational diabetes increases your risk for type 2 diabetes later in life.
Additionally, your baby is more likely to have obesity as a child or teen and develop type 2 diabetes later in life.
If your blood sugar levels are higher than normal, but not high enough for a type 2 diabetes diagnosis, then you may have prediabetes.
Prediabetes raises your risk for type 2 diabetes, heart disease, and stroke.
Fortunately, if you have prediabetes, a CDC-recognized lifestyle change program can help you take healthy steps to reverse it.
In your first appointment, you and your doctor will discuss changes you will need to make in your diet, as well as necessary lifestyle changes. Make sure you understand each topic – don’t be afraid to ask follow-up questions. And write down all key recommendations – it’s a lot to take in and it’s easy to forget and/or confuse details.
The importance of checking your blood sugar levels.
For newly diagnosed diabetes patients, one of the most important things to remember is the importance of monitoring your blood sugar (glucose) levels. Regular monitoring will help you keep your blood sugar levels in a healthy range.
If your glucose levels get too low, you can struggle to think and function normally. Conversely, if your levels get too high and remain high, you can suffer physical harm or complications over the course of many years.
Importantly, monitoring your blood sugar levels helps you make choices about diet and exercise and daily treatment goals.
Talk to your doctor about the best testing method, schedule, and frequency for your needs. For instance, some people with diabetes need to check their blood sugar levels several times a day, while others don’t even need to check it every day.
And ask your doctor what blood sugar levels would warrant an immediate phone call to the doctor or a trip to an emergency room.
What is a good blood sugar level?
Because blood sugar targets can differ for each patient, newly diagnosed diabetes patients must ask their doctor about target ranges. Your doctor will determine your blood sugar target based on many factor, including:
- Duration of your diabetes.
- Your age and life expectancy.
- Any other health conditions you have, including cardiovascular disease.
- History of diabetes complications.
- Your ability to recognize hypoglycemia.
How can you check your blood sugar levels?
There are 3 ways newly diagnosed diabetes patients can check blood sugar levels:
- Blood sugar (glucose) meters.
- A1c tests.
- Continuous glucose monitors (CGMs).
This post provides information on each of these methods, including the pros and cons and what to consider when buying a meter, test, or monitor.
What about urine checks for glucose?
If your blood sugar levels are high, or you are sick, your doctor may want to check your urine for ketones.
Keep track of your results.
Newly diagnosed diabetes patients need to add recordkeeping into their daily routine. It’s critical that you keep track of your test results and share them with your doctor. Your records will help you and your doctor identify trends and learn how your body is responding to your diabetes care plan.
Importantly, it’s not enough to just jot down your glucose level. Instead, every time you take a reading, make a note of the following factors:
- Time of day.
- Your blood glucose level.
- The amount of carbohydrates you ate.
- The type and dose of your diabetes medicine taken.
- Any exercise recently performed – including how long you exercised.
- Anything unusual, such as stress, eating different foods, or being sick.
To help you keep track of your levels, American Diabetes Association has a free printable blood glucose log. Additionally, many companies that sell blood sugar meters either include a logbook with the meter, or you can download a logbook from their website.
However, you can also keep track of your blood sugar levels, along with the above stated information, in a notebook or on your phone.
Additionally, if you use a continuous glucose monitor and/or an insulin delivery system, you (and your doctor) will automatically have access to your readings.
Importantly, always bring your records, blood sugar meter and/or your continuous glucose monitor, and A1c test results (if applicable) to doctor appointments.
At-home blood sugar meters.
You can easily check your blood sugar levels at home with a blood sugar meter (also referred to as a blood glucose monitor or glucometer).
Although these meters only provide information on what your glucose level is at the time of the reading, the information they provide can be invaluable.
For this test, you poke yourself with a lancing device to get a drop of blood. Although most meters recommend you poke your finger, other meters allow you to use your forearm, thigh, or the fleshy part of your hand. However, the finger is usually best when monitoring for rapid changes in blood sugar.
Place the test strip in the meter. After you draw a bit of blood, touch a test strip to your drop of blood. Your blood glucose level will appear on the meter’s display.
Since all meters vary slightly, make sure you read the user’s manual for specific instructions.
Importantly, before starting, make sure you carefully wash and dry your hands and the area of your body you will draw blood from!
Minimize the pain from daily blood draws.
To minimize any pain, the American Diabetes Association suggests the following:
- Use a meter that allows you to draw blood from other body parts.
- Use a spring-loaded lancing device that makes sticking yourself less painful.
- If you use your fingertip, draw blood from the side of your fingertip by your fingernail. This avoids sore spots on the part of your fingers you frequently use.
Can you trust at-home blood sugar meters?
Importantly, the Mayo Clinic outlines the following factors that can impact accuracy, and solutions:
Given all the issues that can arise, if your blood glucose value is unexpectedly high or low, measure again with a new strip.
What to look for when buying a blood sugar meter.
To perform these tests, you will need a blood sugar (glucose) monitor, testing strips, and a lancet to draw your blood. Some testing kits come with all 3 components, while others require you to buy each part separately.
You can ask your doctor for suggestions and/or do your own research.
When shopping for a meter, consider these factors:
- Ease of use.
- Cost of the meter.
- Cost of the test strips (note you will likely use many strips so don’t ignore this cost).
- Insurance coverage.
- Ability to download testing data from the meter to your computer or smart phone.
- Ability to use blood samples from places other than your fingertips.
Also, look for brands that:
- Have a trustworthy reputation.
- Provide data showing the accuracy of their meter.
- Have clear and complete instructions.
A1c tests have long been the standard method to measure the amount of glucose in blood.
An A1c test measures the amount of sugar bound to hemoglobin (Hb), a protein in red blood cells that transports oxygen through the body. Importantly, A1c tests provide an estimate of the average amount of glucose in the blood over the past 2 – 3 months.
How can you check your A1c levels?
There are several ways you can test your A1c levels:
- Office capillary tests. With these tests, blood is taken from a finger prick and analyzed with equipment in the doctor’s or clinic’s office, providing results rather quickly, often during your visit.
- Venous blood laboratory tests. For these tests, a blood sample is drawn from a vein and sent to a laboratory for a more sensitive and accurate analysis.
- At-home rapid tests. With these tests, you prick your finger at home and add your blood sample to the test tray. Then you insert the tray into the reader which provides results in just a few minutes.
- At-home, mail-in tests. For these tests, you take a finger stick blood sample and mail it to a laboratory. You’ll usually get your results within days or weeks.
Experts believe that venous blood lab tests provide the best results, with in-office capillary tests the second best choice. Generally speaking, testing A1c levels at a medical office will provide more accurate results than at-home tests. However, experts also believe that at-home A1c tests provide worthwhile information, particularly for patients without access to doctors or clinics.
Importantly, the CDC states that although testing A1c is an important tool for managing diabetes, it should not replace regular blood sugar testing at home. Why? Because blood sugar can vary throughout the day, and an A1c test cannot capture this type of important information.
At-home A1c tests.
Several companies sell at-home A1c tests that allow you to test your A1c levels at home, without time consuming trips to the doctor’s office. Importantly, at-home tests make routine testing possible if you live in a rural area with limited access to healthcare providers.
Can you trust at-home glucose A1c tests?
Maybe not as much as you’d expect, given their certifications, approvals, and advertisements.
Importantly, a study published in October, 2022 in Diabetes Technology and Therapeutics, shows that at-home A1c tests don’t always deliver the same accuracy as laboratory A1c tests.
In their study of 219 people with type 1 or type 2 diabetes, researchers compared the readings from 3 brands of at-home A1c tests to the results provided by laboratories. Unfortunately, they found large discrepancies in the results of all three at-home tests.
Interestingly, the Home Access tests performed substantially better than tests sold by CoreMedica, and A1cNow+.
Although these results are disappointing, at-home A1C tests can still help doctors and people with diabetes, particularly for people who otherwise cannot get their A1c checked.
Pros and cons of at-home A1c tests.
Here is a summary of the pros and cons of at-home A1c tests:
- Early detection is possible before symptoms arise.
- Can help motivate you to better manage your health.
- Can be less expensive than lab testing if you have limited or no insurance.
- Provides an option if you cannot get to a clinic.
- Risk of making a mistake using the device, thereby providing inaccurate results.
- Lower accuracy in results.
- Risk of misinterpreting results.
- May not be covered by insurance.
- You may rely on a home test instead of seeing a doctor.
What to look for when buying at-home A1c tests.
You can ask your doctor for suggestions and/or do your own research. Before purchasing a test, consider these factors:
To ensure your sample will undergo testing in a high quality lab, look for companies that run their tests in labs that have received CAP-accredited and CLIA-certification.
Look for brands with a trustworthy reputation for producing and handling at-home medical tests. Read customer reviews and check Trustpilot and BBB.
Accuracy of results.
Choose a brand that provides data showing the accuracy of the test. Additionally, look for a company that uses board certified doctors to review and approve test results.
Clarity of information and instructions.
Use tests that have clear and complete instructions that will reduce the risk of errors and specimen mishandling.
Since you will likely perform an at-home test by yourself, look for a company that offers assistance during the testing process. Ideally, the company should offer online and/or phone support 24/7.
Some at-home testing companies provide a free consultation with a medical professional to discuss your test results and help you plan your next steps.
Look for companies that are HIPAA compliant to ensure no one shares your health information.
Continuous glucose monitors.
Experts believe continuous glucose monitors (CGMs) are the new gold standard in diabetes management. Why? These devices are easy to use and provide a wealth of valuable data.
CGMs take readings every few minutes, providing immediate data that you can use to control your blood sugar levels, while also showing trends in your glucose fluctuations.
Moreover, CGMs provide data that shows the percentage of time a person’s blood glucose levels stay within their target range (referred to as TIR – time in range), information an A1c test cannot provide.
How do they work?
The standard CGM requires you to attach a sensor, which can last 1-2 weeks, to your skin. Some devices show your blood sugar reading at all times on a receiver, smartphone or smartwatch, and an alarm goes off if your blood sugar is going up or down too quickly. Other devices require you to periodically run the receiver over your sensor to check your blood sugar.
Interestingly, the newest type of CGM uses an implanted sensor that can detect blood sugar levels for up to three months. A transmitter worn on your body sends blood sugar information wirelessly from the sensor to a smartphone app.
Insulin delivery systems and CGMs.
If you choose a CGM, you may be able to use a CGM that “talks” to your insulin delivery system. In this scenario, your blood sugar reading is sent to a separate insulin delivery system that administers the right amount of insulin, depending on the CGM reading.
Importantly, you will still have to manually input the carbs you plan to eat (about 20 minutes before eating) into your insulin delivery system for your mealtime (bolus) insulin delivery.
However, you may have two separate systems that require you to manually input your CGM readings into your insulin delivery system. Or you may use just a CGM or just an insulin delivery system.
Also, if you plan on using a CGM and/or an automated insulin delivery system, make sure your cell phone is compatible with the systems!
Can you trust at-home CGMs?
In general, yes. But there are several factors that can cause inaccurate readings, including certain medications and some health conditions.
According to the Mayo Clinic, the following medications might interfere with the accuracy of some GCM readings, particularly on older models:
- Acetaminophen (Tylenol, others)
- Albuterol (Proair HFA, Ventolin HFA, others)
- Lisinopril (Prinivil, Zestril, Qbrelis)
Fortunately, newer CGMs don’t seem to be affected by standard doses of acetaminophen (up to 1,000 milligrams for an adult).
Certainly, if you take any of the above medications, talk to your doctor.
Additionally, if you’re pregnant, on dialysis, or critically ill, talk to your doctor about using a CGM, since these conditions may affect a CGM’s blood sugar readings.
Calibration is key.
To ensure accurate readings, you will likely have to do finger-stick checks to calibrate your CGM. Check your device’s user’s guide to learn if you need to check, and if so, how often you should check it.
What to consider when selecting a CGM.
Unfortunately, not everyone with diabetes has access to a CGM because they are expensive and not covered by all insurance plans.
Before you decide about using a CGM, ask your doctor which monitor(s) suits your needs. And, importantly, check with your insurance company since they may only cover one type of CGM.
Furthermore, if your insurance company refuses to pay for a CGM, you can appeal the decision. Under these circumstances, involving your doctor may give you the best chance of approval.
Newly diagnosed diabetes patients have a lot to learn and manage. Therefore, I suggest you read these posts for helpful tips:
- 10 Tips for a Better Medical Appointment
- The Importance of Shared Decision Making.
- Understanding Medical Information Is Harder Than Most Realize.
- Why Take Detailed Notes at Doctor Appointments?
- Should You Record Medical Appointments?
- 10 Tips to Communicate Better with Doctors.
- What is the Best Time of Day for Medical Care?
- How Can You Get the Best Healthcare? Actively Participate!