Mistakes made when checking blood sugar levels can mean inaccurate test readings for people with diabetes.

This can lead to further health problems because the diabetes is not being controlled properly.

“There are many things to remember when carrying out blood glucose testing,” says Clair Naughton, a diabetes nurse specialist and Diabetes Ireland regional development officer for the north west.

“Keeping control of your diabetes properly is very important,” she says, “and correct testing is a big part of that.

“If it’s not done accurately, your diabetes may not be managed well. If diabetes is well controlled, you’ll feel at your best, with normal energy levels.”

Diabetes is a long-term condition characterised by a raised level of glucose (sugar) in the blood. The amount of glucose in blood is controlled by a hormone called insulin. When a person has type one diabetes, they make no insulin. Their diabetes is treated with diet, exercise and insulin injections. When a person had type two diabetes, they either don’t have enough insulin or the insulin doesn’t work properly.

This type of diabetes is treated with diet, exercise and sometimes insulin injections.

So what kind of things can go wrong?

A lot seems to revolve around knowing how to use your blood glucose meter properly.

It’s the gadget that you may have been given when you were first diagnosed with diabetes. A diabetes nurse or GP practice nurse will have instructed you on how to use it at the time.

The whole process of testing can get a bit tedious after a while and anyone can forget instructions. However, because doing the testing properly is so crucial, it is important to remind yourself every so often of the correct procedure.

Clair, a diabetes nurse for nine years, has this advice about the testing process:

1. Ensure your blood glucose meter is less than two years old. If it is older than this, it can be replaced free of charge by phoning the company that makes the meter. Helpline numbers are supplied with the literature that comes with the meter.

2. Avoid having several meters from different companies. If more than one meter is required (to keep in the car/at work) it is best if they are all the same.

3. You should be instructed on how to use the meter by a trained healthcare professional.

4. Check if your meter needs to be coded (calibrated) or if and when you are to use quality control testing. Follow the instructions carefully. If you are unsure, telephone the manufacturers’ helpline number.

5. Strips should be stored in the container they come in. Close the container after each use (to avoid moisture affecting them).

6. Wash your hands before performing a blood test. Use warm water and soap, rinse, and dry with a clean towel. Having traces of food on your hands may give a false high reading. Having wet hands could dilute the blood sample. Alcohol wipes can be used away from home to clean the test site if hand-washing facilities are not available.

7. Keep meters at room temperature. Some won’t work if left in a hot or cold environment.

8. Change the needle in the lancet device regularly. If it becomes blunt it is more painful to use. Use the sides of finger tips to obtain a drop of blood.

9. Record results in a diary and bring this to your appointments for review by your doctor/nurse. Your medications may be altered depending on the results.

In Clair Naughton’s experience as a diabetes nurse, the main errors associated with blood glucose testing are:

  • Insufficient blood on the strips or blood not being applied correctly

  • Strips being out of date or not compatible with the meter

  • Meter batteries needing to be replaced

    • How often you test depends on the type of diabetes you have and on your prescribed treatment.

    You should follow the guidelines given to you by your nurse/doctor, she says.

    You will also have been told the most appropriate time for you to test your blood glucose level and what is an acceptable range for you.

    Costly strips

    The strips used to test blood glucose levels are expensive, she adds.

    “People don’t realise the costs. While the meters are free, each test strip costs the HSE approximately €1. Therefore, it is important that you only get strips from the pharmacy when you need them and avoid your supply of strips being built up at home.

    “It’s also a good reason for using the same type of meters if you use several, so that you only have to get one type of test strip.”

    ,ch>Avoid complacency

    “At times in life, diabetes management may take a back seat and complacency sets in,” she states.

    “It’s important to remember however that your body will not always warn you if your blood glucose levels are out of control. Correct testing is also important because it lets you see how certain foods and daily activities, such as exercise, impact on your diabetes.

    “This can lead to you making more informed choices on a day-to-day basis. It can also give you confidence in managing your diabetes, which leads to a better quality of life.”

    Reasons to control your diabetes

    Here are three great reasons why correctly managing your diabetes can be to your advantage.

    1. You’ll feel well: If blood glucose levels are high, it can cause symptoms such as excessive tiredness, thirst, passing urine more often than normal, blurred vision, thrush or other repeated infections.

    2. You’ll stay safe: If a person is on insulin or medications that can cause low blood glucose levels (hypos) it is essential that their diabetes is managed to ensure that hypos don’t occur regularly. Hypos can cause symptoms such as weakness, shaking, sweating, inability to concentrate and drowsiness. They are, therefore, dangerous if they occur at a time when operating machinery or driving. Blood glucose levels should be checked prior to driving or operating machinery to ensure it is greater than 5mmol/mls. If it is less than 5mmols/mls, you should eat something and recheck it before driving or operating machinery. Also, during times of increased physical activity, levels should be checked more frequently.

    3. You’ll prevent chronic complications developing: Keeping blood glucose levels under control can help to prevent or slow down the progression of chronic diabetes complications such as eye disease, kidney disease, heart disease and foot disease.

    “You should control your diabetes rather than letting it control you. Almost 100% of the care necessary for the management of diabetes is provided by the person with diabetes and their carers. Learning how to self-manage your diabetes means that you can live life to the full.”

    Free refresher course on managing your diabetes

    Diabetes Ireland runs an education programme called CODE in a local community group setting for people with type two diabetes.

    The programme is free and is facilitated by a diabetes nurse or dietician. You can ask your GP to refer you or ring Diabetes Ireland on 1850-909-909 for more details.

    Diabetes Ireland is the national charity dedicated to providing support, education and motivation to all people affected by diabetes.

    See www.diabetes.ie for more information

    Causes of high blood sugars (Hyperglycaemia)

  • Eating large portions or eating sugar-rich foods.

  • Reducing your level of regular physical activity.

  • Your medication may need to be increased.

  • Illness, infection or injury.

  • Stress or emotional upset.

  • Some medications, e.g. steroids.

    • Symptoms

  • Thirst.

  • Passing urine more frequently.

  • Tiredness.

  • Weight loss.

  • Blurred vision.

  • Repeated infections.

    • Causes of low blood sugars (Hypoglycaemia)

  • Too many tablets (diabetes tablets) or insulin.

  • Missed or late meal or snack.

  • Too little starchy food at meal or snack.

  • More exercise than usual.

  • Alcohol can cause hypos often the morning after. The advice is drink in moderation and eat something before you go to bed to avoid this.

    • Symptoms

  • Sweating

  • Headache.

  • Hunger.

  • Shakiness or dizziness.

  • Being pale.

  • Lack of co-ordination.

  • Confusion.

  • Anxiety or irritability.

    • How to treat low blood sugar levels

    Step one - consume a quick-acting carbohydrate such as:

  • Five glucose sweets.

  • Half a glass of Lucozade.

  • Tea or water with two teaspoons of sugar in it.

    • Step two - follow up step one with a low-acting carbohydrate such as:

  • Two plain biscuits.

  • A sandwich.

  • A glass of milk.

  • Your usual meal, if it is due.