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January 20, 2002

Blood Tests and Insulin Injections

Question from Stafford, Virginia, USA:

I am a 43 year old female who was diagnosed recently with type 2 diabetes. When is the best time to prick my finger and check my blood sugar levels, before or after I eat or both? Do I need to do it daily?


The answer depends, in part, with the preferences of your diabetes team, your meal planning, activity, and medications. In very general terms, for a person with non-complicated type 2, on an oral hypoglycemic agent, I usually ask my patients initially to assess blood sugar before meals and at bedtime. After this skill is refined, and if the glucose levels are stable, then I will allow some greater flexibility by having patients check twice daily but at different times over the course of any one week. For example, before breakfast and lunch one day, before breakfast and bed another day, before lunch and bed one day, before breakfast and dinner another, etc, etc. You get the idea. This way, there are sugar checks from the various times.

This easy start would change if insulin were given, during sick days/illnesses, other medications, activities, etc.

Additional comments from Dr. Philip Ledereich:

I would consider testing in the morning, then on different days, also test once two hours after breakfast, then the next day before lunch, then two hours after lunch, then before supper, then two hours after supper, so you could get a full range of how you are doing both before and after eating. You do not need to do this all the time, once you understand how food/timing/exercise affects you, but I would monitor closely, depending how your numbers are. You should follow your own physician’s recommendations as well, and review it with him/her.