5 Factors That Affect How Often To Check Your Blood Sugar

The decision is ultimately up to you and your healthcare provider—but consider your medical history, changes, and medications.

If you have diabetes, you may need to test your blood sugar at home, but how often is enough? Well, it depends—mostly on your medication, you, and your healthcare provider.

The American Diabetes Association (ADA) recommended testing your blood sugar at least three times a day if you need multiple daily insulin injections. But for the rest of those with type 2 diabetes, testing frequency should be "dictated by the particular needs and goals of the patients," the ADA said.

That means that frequent testing is clearly necessary for some people with type 2 diabetes, but there is a little wiggle room for others. (All type 1 diabetics take multiple daily insulin injections and need to monitor blood sugar frequently.)

Some studies have suggested that frequent monitoring is not always helpful for people with type 2 diabetes, specifically to those who do not take insulin, according to the American Diabetes Association in May 2022. Your healthcare provider or diabetes educator can help you determine how often and when you should be testing.

How often you test depends on the following factors.

  • Medication: Some classes of oral drugs can cause hypoglycemia (low blood sugar), so you may need to test more often. "Generally, anyone who takes insulin should test several times a day, as well as individuals who take sulfonylureas or meglitinides," said Nadine Uplinger, a spokesperson for the American Association of Diabetes Educators and director of the Gutman Diabetes Institute at the Albert Einstein Healthcare Network in Philadelphia. Both sulfonylureas and meglitinides are types of medications used to lower blood glucose, according to the American Diabetes Association.
  • Changes: If you've just been diagnosed with diabetes, started on a new medication, added a new type of food, or recently changed some other factor (for example, you have gained or lost weight, or are exercising more or less often), then you should test more frequently. "Individuals who are changing their treatment regimen should test several times a day," Uplinger said.
  • Blood sugar at diagnosis: People who have high blood sugar levels when they're diagnosed will need to test more often as well. According to the American Diabetes Association, your blood sugar level before a meal should be in the range of 80 mg/dL to 130 mg/dL, and after a meal, it should be less than 180 mg/dL. A person whose sugars are in the 500s when they're first diagnosed will have to test more often than someone whose sugars were 180, said Diana Berger, MD, a diabetes medical specialist at the Diabetes Prevention and Control Program at the New York City Department of Health and Mental Hygiene.
  • History of blood-sugar control: The American Diabetes Association recommended that patients who are meeting treatment goals get hemoglobin A1C tests at least twice a year at their healthcare provider's office. For patients whose therapy has changed or who are not meeting treatment goals, the ADA recommended hemoglobin A1C testing more often. If the hemoglobin A1C test result is less than 7%, suggesting relatively good long-term blood-sugar control, you may be able to test your blood sugar less often (if you're not on insulin). Many healthcare providers recommend testing twice a day at varying times, such as before and after breakfast, lunch, and dinner, or at bedtime. "Two tests a day over the course of a month can really characterize the glucose profile of a patient," said Stuart Weiss, MD, an endocrinologist at New York University School of Medicine.
  • What you can afford: You can usually get a blood glucose monitor for free or insurance may cover it. It's the strips that can be expensive, even when covered by insurance. Don't hesitate to tell your healthcare provider if you can't afford frequent testing. If you're not on insulin or other medication, you may be able to use "block testing," in which you test blood sugar four or more times a day, one day each week (or some other pattern to get a "snapshot" of daily blood sugar), and then discuss the results with your healthcare provider. Just be careful not to "game" the results by changing what you do on those days or times when you are testing. Don't deceive yourself by taking more care with exercise, diet, and medication on the day you're going to do all the monitoring. For example, if you go out to dinner for your anniversary and have a piece of cake, that's a great day to check your blood sugar to see how much you can get away with.
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