If you are going to self-test then it is important that you have a strategy. Testing can tell you various different useful things - but only if you time it and interpret the results correctly. So, here are various testing strategies you might like to consider. Not all will be relevant for you, some are likely to be ongoing and some part of a learning process.
1. Monitor your condition
This is probably the most important for T2s. You need to know how good your control is, and how things are changing. The best test for this is a fasting test. This is taken first thing in the morning
before you eat or drink anything. This gives you a very rough guide as to how good your control was the day before. If the diabetes is under good control, then this should be below 6mmol/l. Ideally it should be closer to 5, and some people manage to get it slightly under 5. If it is regularly over 7 then the diabetes is not yet under control, and you need to do something about that. Don't worry if you get the occasional glitch (they happen) - the important thing is to look for long term trends (you should keep records - either in your meter, on a computer or just keep a notebook).
Another way of monitoring your condition is to test several times during the day - generally two hours after eating. This will give you an idea of how high it goes during the day. Don't test within an hour of eating. That might well be very high, and that doesn't matter. Even non-diabetics can get a fair size BG spike after eating - the important thing is how quickly it comes down again. Ideally you want most 2 hour readings to be under 7. Again, don't worry about the occasional glitch but if you often get figures higher than that then that suggests that the diabetes isn't under as good control as it might be.
You probably do need to monitor your condition as a permanent routine. However, once you are confident that the diabetes is under good control, you don't need to do this that much. I would suggest that a single fasting test two or three times a week is enough to keep an eye on things. If the figures start creeping up then you need to test more to find out what is happening (maybe your diet has changed, or maybe the diabetes is deteriorating and you need different medication). This sort of occasional monitoring is very economic in strips.
2. Preventing hypos
This is something that may well not be relevant for you. Although anyone (even non-diabetics) can get a hypo, they are uncommon unless you are on insulin or certain drugs. If you are at risk of hypos, then you should test before you drive or do anything else potentially dangerous. Symptoms occur at different BG levels in different people, but usually they don't become noticeable until it is well under 4mmol/l. However, the rule of thumb is that you shouldn't drive if you get a reading less than 5mmol/l - if that is the case then eat something first.
If you have never had a hypo, then don't worry about this.
3. Learning how your body works
In order to control diabetes - especially if you hope to control T2 by diet, then you need to learn how your body works - how your BG fluctuates during the day in response to food and exercise. To do this I suggest that for several days you monitor intensely, and keep detailed records of everything that you eat and all exercise you do. You should then test:
- First thing in the morning (before breakfast)
- Immediately before each meal
- One hour after each meal
- Two hours after each meal
- Last thing at night
This will use a lot of strips, but you only need to do it for a few days (maybe a week or so) to get a pretty good idea of what is going on. Remember, you are aiming to keep your average BG well below 7, and when it spikes after meals to get it down again as quickly as possible.
If you want to get a really detailed view of how your BG changes, then - for one day only - you could test every 30 minutes throughout the day. If you do this then choose a "typical" day (usual patterns of eating and exercise) and keep an absolutely scrupulous record of everything that passes your lips and everything that you do. This uses an awful lot of strips, but I have found it to be really interesting and it does help give you a good idea of exactly what is going on inside your body.
4. Learning the effects of specific foods
Once you have the diabetes pretty much under control, you will probably want to fine tune your diet. Everyone responds differently to various foods - so it is useful to know exactly what effects specific foods and combinations of foods have on you. You can find this out by conducting simple experiments. Measure your BG immediately before eating a "test" meal, and then measure it again every 30 minutes while it is still rising and once it peaks every hour until it gets back to where it started. If you plot this curve on a graph, then the area under the curve will represent your own personal glycaemic index for that meal. You can then use this information to help plan your diet. Meals with a low personal GI are better than meals with a high one. You should be careful about meals that take a long time for your BG to come back down again - you should avoid these sort of meals knocking in to each other. If you have several of these sort of slow effect meals during a day then the overall effect can be for your BG to rise throughout the day - and this is a bad thing!
