What are the guidelines for blood glucose monitoring?


February 4th, 2022

What are the guidelines for blood glucose monitoring?

1. Tools that you need to monitor blood glucose levels.

Blood glucose meter
This is a portable electronic device that’s used to measure how much glucose is in the blood. It only needs a small drop of blood from the finger.
The blood glucose meter should be maintained according to the manufacturer’s advice and calibrated regularly. Procedures may vary from one device to another. Check the user’s guide or ask your doctor/nurse how to use and store the blood glucose meter.

Blood glucose test strips
Use only test strips designed for the meter. You can only use a test strip once. That means you have to take out a new one every time you want to check blood glucose levels. Do not use expired test strips. Store test strips as directed. Do not place test strips in the refrigerator.

Finger prickers and lancets
A lancet is a fine, sharply pointed needle used to prick the skin. Those with diabetes will need a finger pricker, with a lancet attached, to obtain the drop of blood needed for the blood glucose test. A doctor or nurse will advise on the best device for the person with Type 1 Diabetes, depending on their age and preference.

2. When and how often to check blood glucose?

You should help those with diabetes test their blood glucose levels at least 4 times per day but aim for 6 times if there are enough test strips available and keep a record of the result.

Blood glucose is best measured:
1. When those with diabetes wake up, before breakfast
2. In the late morning before lunch
3. In the evening before dinner
4. Before bedtime

When it’s possible and if you have enough test strips, some extra tests can be added:
5. 2.5 hours after eating breakfast
6. 2.5 hours after eating lunch

It’s important to test more often when they are doing vigorous exercise (before, during, and several hours after), sometimes during the night to detect nocturnal low or high blood glucose level, or when they are sick to prevent hyperglycaemic crises. It’s also important to test to confirm hypoglycaemia (low blood glucose level) and to monitor recovery.

Out-of-control blood glucose levels not only lead to short-term problems like hypoglycaemia but also life-threatening events like diabetic ketoacidosis (DKA) and diabetic coma.

3. When and how often to check blood glucose?

Successful diabetes management requires self-monitoring of blood glucose as much as possible. You can aim for 6 times per day if you have enough test strips available. The results should be regularly reviewed with a doctor to identify some glucose fluctuation patterns. With this knowledge, doctors will be able to adjust the diabetes treatment plan.

Of course, it’s not always easy to have 6 test strips available everyday. If you have less, try at least to support 4 tests per day before meals and before bedtime and you can always discuss this with a doctor.

4. How to Check Blood Glucose Levels?

1. Wash and dry the hands
2. Insert the test strip in the blood glucose meter
3. Prick the dried finger with the lancet
4. Apply the drop of blood to the test strip until it has absorbed enough blood to begin the test
5. Within seconds, the blood glucose meter will give you a result
6. Record the result in the blood glucose logbook or diary
7. Discard the used test strip and lancet in a proper container (like a plastic bottle).
Tips: Don’t check from the same finger all the time. Using the side of the fingertip may be less painful than the pads.

5. How to read the results?

In general, a good blood glucose level is between 4 – 10 mmol/l (72 – 180 mg/dL).
– When waking up and before meals, blood glucose level should be between 4 – 7 mmol/L (72 – 126mg/dL)
– After meal and at bedtime, blood glucose level should be between 5 – 10 mmol/L (90 – 180 mg/dL)
The target level will be individual to each person. Please discuss with a doctor to know the specific range.

If the reading is below 4.0 mmol/L (72 mg/dL), treat it as a HYPO (low blood glucose level). Refer to the hypoglycaemia fact sheet for details.
Sometimes hypoglycaemia symptoms can be experienced at a level over or around 5.0 mmol/L (90 mg/dL) – this should still be treated as a HYPO.
– If pre-meal blood glucose is always high, the preceding dose of insulin may have been too low.
– If pre-meal blood glucose is always low, the preceding dose of insulin may have been too high.
– If pre-meal blood glucose is sometimes high and sometimes low, there could be lots of reasons like insulin dose, food that was eaten and exercise.

This should be discussed with a doctor.

6. What is HbA1c?

Every 3 months, doctor will do a HbA1c test. The result of this test reflects the average blood glucose level for the past two to three months. The higher the HbA1c level is, the poorer the blood glucose control and the higher the risk of diabetes complications.
With a good blood glucose self-monitoring habit, doctor will target a HbA1c result below 7%.
If the current level is above 7.5% it’s important to understand that any reduction in HbA1c level reduces the risk of long‑term complications. It can be done with a more regular blood glucose testing habit.


HelloType1 content is based on published, internationally recognised guidelines and then reviewed by local experts to ensure it fits local context. The translation is based on simplified English language to ensure it conveys the safest and clearest possible message in regional languages. Basic insulin and blood glucose testing access is still an issue in the South-East Asia region and our chief aim is to address this. HelloType1 content is not intended to replace the advice of individual healthcare professionals but as a collaborative tool to help them improve the outcomes of disadvantaged people with Type 1 Diabetes in the region.

HelloType1 content is curated for the topics using information only taken from accredited sources such as the International Diabetes Foundation (IDF) and the International Society for Paediatric and Adolescent Diabetes (ISPAD).

This content is then reviewed and adapted by a panel consisting of healthcare experts (e.g. endocrinologist, nutritionist, diabetes nurse, psychologist) and members of the South-East Asia T1D communities, helping ensure the information is appropriate in a local context.

Writers of HelloType1 content:
Anne-Charlotte Ficheroulle, Pharmacist, Digital Innovation Manager at A4D
Charlotte O’Brian Gore, Research assistant ImmunoEngineering, King’s College. UK

Content Reviewers – healthcare professionals:
Dr. May Ng, Paediatric Endocrinologist, Chief Medical Advisor A4D, UK
Dr. Yeow Toh Peng, Endocrinologist, Malaysia
Dr Jaturat Petchkul, Paediatric Endocrinologist, Thailand
Dianna Culbertson, Physician Assistant T1D care, US
Prof Dr Malene Iv, Endocrinologist, Kantha Bopha Hospital, Cambodia
Steffen Tange, Consultant Psychology, Denmark
Soe Nyi Nyi, Nutritionist, Myanmar
Lucas Lim, Dietician, Malaysia

Content Reviewers – people with Type 1 Diabetes:
Jerry Gore, Co-Founder A4D, Mountaineer, UK
Diana Maynard, T1D advocate, UK
Emelyne Carmen Ho, College Student, Malaysia
Molly Seal, College Student, UK

Content Reviewers – parents with T1D child:
Samantha Seal, Teacher, Thailand
Kim Than, Deputy Country Director – Plan International, Cambodia




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