To test or not to test?

“How often should I test my blood sugar?”  This is very common questions I get and my answer always is…”it depends!”


Self monitoring of blood sugar (or SMBG as medical people call it) is not a one size fits all approach.  Previously as diabetes educators, we were trained to tell patients to do routine testing but the benefits of that approach have come into question due marginal benefits and significant costs. There has also been studies to show routine testing may be associated with depression and reduced quality of life.

The thinking now is that the frequency of  SMBG should be based on your current diabetes management. This can be broken down into 3 categories;

1. For most patients on insulin +/- other diabetes medications – SMBG should be tailored to fine tune insulin therapy to acheive optimal blood glucose control. If on once daily long acting insulin (i.e. basal insulin) you should be doing no more than 14 tests for the week on average. If on 2+ insulin injections per day, more testing may be required but speak to your diabetes educator to determine an meaningful and realistic schedule.

2. For most patients on diabetes medications (other than insulin) – routine SMBG is not recommended. Periodic testing can be done in certain situations but only if it helps determine a specific course of action. Examples of situations include: changes to medications, having an illness,  diet and/or exercise changes and to confirm a low blood sugar.

3. For most patients who control their diabetes through diet and exercise – routine testing is not required unless you are trying to reinforce diet/lifestyle changes.

Bottom line is test meaningfully…if testing does not change a specific course of action then don’t bother!




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