7 key strategies for monitoring your blood sugar

The more often you test your blood sugar, the better you can hone in on the perfect combination of strategies related to medicine, diet and exercise for keeping it within reasonable targets.

Your doctor or someone in his office should demonstrate how to do a self-test.

• You'll start by sticking your finger with a small needle, called a lancet. Some meters have a built in lancet that takes blood from your forearm or thigh. There are also spring-loaded lancing devices that resemble a pen, which make sticking yourself less painful.
• If you use your fingertip, stick the side of your fingertip by your fingernail to avoid having sore spots on your finger pads.
• Apply the drop of blood to a testing strip. Your meter will provide results in about five to 30 seconds, and you'll record the numbers in a log book; some meters record and store the results.

Everyone's schedule will be different, so you should get specific directions from your doctor about what times of day are best to check.

After discussing meter options with your doctor, call your insurance company before making a purchase.

• Many cover some or all of the cost of meters and other supplies.
• You can also ask for a referral to a diabetes educator, who might have samples of meters available for you to see and touch.

If you get a result of 70 mg/dl or under, your blood sugar is too low and you should consume 15 grams of carbohydrate.

Even if you feel okay, don't wait for the symptoms of hypoglycemia to kick in.

• Take three to four glucose tablets, 125 millilitres (1⁄2 cup) of orange juice, 15 millilitres (one tablespoon) of honey, six candies, 175 millilitres (3⁄4 cup) regular soda or 15 millilitres (one tablespoon) of sugar dissolved in water. (A candy bar isn't ideal because the fat it contains can delay the glucose-raising effect.)
• Wait about 15 minutes, then check your blood sugar again.

Clarify with your doctor what level is too high for you.

It could be 250 mg/dl, or it could be higher.

• Whatever the cut-off point, you'll need to call your doctor if you hit it.
• You'll also need to alert your doctor's office if you have elevated readings (higher than your designated goals) for more than three days in a row. Often, illness, stress, missing a dose of medication or eating too much can cause spikes in your blood sugar.

During the wee hours of the morning, the body secretes hormones that inhibit insulin so that more glucose is available to the body at the start of the day — not what you need if you have diabetes.

A related phenomenon can happen if your blood sugar drops too low in the middle of the night, causing your body to react — actually, to overreact — by releasing hormones that raise blood sugar.

• If you notice a pattern of high morning blood sugar, talk to your doctor.
• You may need to change the type or dosage of medication or insulin you take or when you take it, or tweak your evening eating habits.
• Your blood glucose will be easier to manage throughout the day if you can start the day off with normal readings.

You'll want to do extra checks when you're sick or under significant stress. Your doctor may also request that you do extra checks when you make a change to your treatment plan.