My 23 year old boyfriend has type 1 diabetes and is very out of control right now so I am concerned. His blood sugars are anywhere from 73 to 579 mg/dl [4.1 to 32.2 mmol/L]. How often should he check his blood glucose? What times are best? How can he get his diabetes more regulated?

It is great that you are concerned, but it is a bad sign that you are the one inquiring and not your boyfriend. First, the extreme blood sugars should be addressed. This can be done with adjustments in insulin therapy and lifestyle (schedule, meal content, etc.). Your boyfriend needs to discuss his blood sugar goals with his physician. Most individuals on a intensive regimen monitor four times per day. Frequently, the four times per day include pre-meal and bedtime sugars. It is also helpful to monitor sugars after meals to evaluate the adequacy of the rapid-acting insulin given before meals. Finally, a hemoglobin A1c test needs to be performed every three months to evaluate the average daily blood sugar over that time. This number has been correlated with risk of developing microvascular complications of diabetes.

I would encourage him to get more involved in his care, in order to improve his control. If there is a diabetes education team nearby, this would be a good place to start.

JTL