Blood monitoring and Carbohydrate diary – for patients on insulin

Blood monitoring and Carbohydrate diary – for patients on insulin

BLOOD GLUCOSE MONITORING

Why should I monitor my blood glucose (BG)?
Monitoring your blood glucose can help you to see if your insulin doses are correct or need adjusting and also see how your carbohydrate intake and activity levels affect your blood glucose.

Blood glucose monitoring is useful to look at trends– not one off results. Only make changes to your insulin doses if advised to by your diabetes team.

How often should I monitor my blood glucose?
The results of your blood glucose monitoring should be useful to you. Frequency of testing depends on your insulin regimen and  various other factors. The guidelines in this leaflet are a guide only.

Targeting your testing
Monitoring at specific times can give you an indication of what is happening and can guide adjustment of specific insulin doses.

For example: Testing before bed and pre breakfast helps inform dose adjustment of once daily or background insulin doses.

MONITORING ON A MULTIPLE INSULIN INJECTIONS AND INSULIN PUMP:
It is useful to test 4-6 times per day, aiming at least 4 tests per day before main meals and before bed:

• Before breakfast
• Before lunch
• Before evening meal
• Before bedtime

Remember your blood glucose levels before lunch and evening meal tell you how well your morning and lunchtime insulin is working and the effect of carbohydrate consumed at breakfast and lunch.  Your blood glucose level before bed is important, as it tells you how well your teatime insulin is working and the effect of your evening meal. The morning blood glucose in the morning will indicate if the level of your long acting insulin is well adjusted.

Testing at other times can be helpful/ advisable for example when driving, feeling unwell or hypo.

Background Insulin

• If blood glucose pre breakfast is similar to the level it was at bedtime your background insulin doses are correct overnight.
• If your blood glucose falls overnight or you need to snack before bed you need to reduce your background insulin dose.
• If your blood glucose raises overnight and you frequently need a correction of rapid acting insulin, your background insulin may need to be increased.

Mealtime Insulin

• If blood glucose pre lunch is similar to what it was pre breakfast then you gave the correct insulin for breakfast.
• If blood glucose pre evening meal is similar to what it was pre lunch then you gave the correct insulin for lunch.
• If blood glucose pre bed is similar to what it was pre evening meal then you gave the correct insulin for evening meal.

Correction doses

• Your blood glucose results can also guide you whether to give additional insulin at mealtimes to correct for high blood glucose results if you have been advised by your diabetes team to do this.

SNACKS AND EXERCISE/ACTIVITY
Remember to make a note of snacks eaten and any activity as this will affect your BG results.

If your symptoms or condition worsens, or if you are concerned about anything, please call your GP, 111, or 999.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you. 

Feedback
Feedback is really important and useful to us – it can tell us where we are working well and where improvements can be made. There are lots of ways you can share your experience with us including completing our Friends and Family Test – cards are available and can be posted on all wards, departments and clinics at our hospitals. We value your comments and feedback and thank you for taking the time to share this with us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: wah-tr.PET@nhs.net

Opening times:
The PALS telephone lines are open Monday to Thursday from  8.30am to 4.30pm and Friday: 8.30am to 4.00pm. Please be aware that a voicemail service is in use at busy times, but messages will be returned as quickly as possible.

If you are unable to understand this leaflet, please communicate with a member of staff.

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