Glucometer is a little machine, which can measure blood glucose level.
It's made for outpatient glucose self monitoring.
The self monitoring of glucose is the one of the main parts of diabetes management.
And the most popular method for this is to use glucometer.
WHY IS GLUCOSE SELF MONITORING IMPORTANT
Despite physical activity level and eating pattern the blood glucose level is regulated properly in healthy individuals.
But when diabetes occur this mechanism is disrupted and blood glucose regulation is out of body's control.
The self monitoring of blood glucose levels is the only way to discover how different factors such as eating, physical activity, medications affect glycemia.
This information of course may help to improve diabetes management.
HOW TO USE A GLUCOMETER
The glucometer equipment also includes:
Lancing device - to make finger prick for blood sample.
Lancets - for single use.
Tests strips - to put a blood sample on it and then it's connected to glucometer device.
Every glucometer needs its own strips to work.
Blood glucose checking needs to make several steps:
- First step is to wash hands with warm water and to dry them well.
- Test strip must be inserted in glucometer device.
- Lancet must be inserted in lancing device.
- On lancing device blood collection depth is chosen (average is 2 or 3 points).
- Blood sample must be put on test strip's special area.
- Blood glucose measurement will be written on glucometer screen in a few seconds.
Glucose measurement is performed in two different units, such as: mmol/l or mg/dl.
Converting is possible with the formulation:
mg/dl = mmol/l x 18
mmol/l = mg/dl / 18
HOW TO INTERPRET BLOOD GLUCOSE LEVELS
Is the blood glucose sampling with glucometer same as it's done in laboratories? What is the difference between this two methods?
Capillary blood sample is used when measuring with glucometer and the blood is with full composition, without filtration. In contrary venous sample is done in laboratories and blood glucose measurement is done in plasma.
Of course testing in laboratory is more accurate, but it doesn't underestimates the importance of glucometer. This device does its work perfectly - it helps diabetes patients to make decisions about eating, physical activity and medications using in everyday pattern.
The difference between glucometer measurement and venous blood sampling can be approximately 15-20% and it still is considered as accurate.
This is one of the ISO's criteria for assessing the quality and accuracy of glucometers.
For example, if the test result is 100 mg/dl in laboratory, it will be normal for glucometer result to be 85 mg/dl or 115 mg/dl.
HOW OFTER TO USE GLUCOMETER MONITORING
Frequency of glycemia monitoring is individual and everyone should ask a doctor for individual recomendations.
One must take into account diabetes type, medications in use and other factors.
The monitoring of blood glucose level can be necessary every second day, once a day or few times a day.
The average times for glucose monitoring are before meals and 2 hours after eating. Sometimes it routinely must be done before sleeping too.
Other situations when glucose monitoring is needed especially for persons who are insulin dependent, are:
- Before or in time of physical activity
- When hypoglycemia is suggested
- After treatment of hypoglycemia before normal glucose levels restore
- Before or in time of actions such as driving for example.
It's recommended to have a dairy and to put on it any results and situations and then to discuss these cases with the doctor for better management of disease.
BLOOD GLUCOSE LEVEL RANGES FOR GLUCOMETERS
Most of the glucometers can detect blood glucose levels as low as 20 mg/dl and as high as 600 mg/dl.
If the blood glucose level is below 20 mg/dl, the symbol ''LO'' is appeared on glucometer's monitor. When the blood glucose level is more than 600 mg/dl, the indicator is symbol '' HI''. LO (ინგლისური სიტყვიდან low – დაბალი). ხოლო როცა მაჩვენებელი მაღალია 600 მგ/დლ-ზე, გლუკომეტრზე ჩნდება სიმბოლო HI. (ინგლისური სიტყვიდან high – მაღალი).
Both of these symbols mean that there is critical situation and urgent help is needed.
RECOMMENDATIONS FOR EFFECTIVE USE OF GLUCOMETERS
Here are some recommendation how to lower the pain and discomfort during glucometer use, also to increase measurement accuracy to its maximum.
Wash your hand with soap and worm water prior using the glucometer.
Worm water makes blood to flow freely toward the fingers. For this purpose you can also exercise your hand and finger before measurement.
Washing hands also helps to avoid false high results which can be provoked by food remnants on the finger.
If there is not a possibility to wash hands, its better to use second drop of the blood. Otherwise usage of first drop is possible.
Some of instructions include cleaning the finger with alcohol pad, but as the alcohol may cause skin dryness and increase thickness, the process may become more painful, so this step can be missed.
While measuring finger must be completely dry.
To minimise pain the lancing device should touch the skin very tightly.
The pen button should be pressed as quickly as possible, without hesitation or slowing down, because the slower the needle enters the skin, the more painful the process can be.
The depth of the needle must be chosen correctly. If the prick is constantly painful, the depth setting on the pen may need to be reduced. It must be chosen as to break the integrity of the skin so that the required amount of blood drops comes out, but at the same time it must be minimally deep.
It's very important to use the lancets just ones, because used needle can be more painful.
To lower the pain use the side parts of the fingers to prick, because of less innervation of this area.
Change fingers constantly to give it time for repair.
Using an expired or damaged test strip usually gives incorrect results. So it's important to know and adhere test stripe's storage rules.
Continue reading: NORMAL RANGES OF BLOOD GLUCOSE LEVELS AND DIAGNOSTIC TESTS
Author: Elga Giorgadze (MD of Endocrinology)
