How blood sugar is measured

1 Why measure blood glucose?

• It has the potential to be used as a screening tool for type 2 diabetes (diabetes).
• It is an important tool in the evaluation of ill patients, particularly the young and the elderly.
• Extremes of blood glucose that are potentially life-threatening can be detected, allowing the patient, caregiver, or health worker to respond to high (hyperglycemia) and low (hypoglycemia) blood glucose levels by adjusting the diet or administering insulin as needed.

2 When to measure blood glucose?

• The blood glucose level should be checked whenever your diabetic patient is experiencing any symptoms of illness.
• The patient’s blood glucose level should be measured before surgery in order to ensure that the patient does not become ill during surgery and/or after general anesthesia. Measure blood glucose levels on a regular basis until the patient is eating and drinking normally and his or her blood glucose level is stable.
• Patients with newly diagnosed diabetes should have their blood glucose levels checked more frequently until their blood glucose levels are stable.

Patient safety and comfort

• Be aware of what constitutes “normal” blood glucose levels. Inquire with the patient and/or check their notes or file to determine what is considered ‘normal’ for that particular patient.
• When dealing with blood, it is important to follow all safety precautions.
• As the skin is being punctured, use aseptic techniques to keep the wound clean. While it is unlikely that an infection would occur, patients with diabetes tend to heal more slowly and may not be able to cope as well with an infection as healthy individuals.
• If the patient self-tests on a regular basis (and is familiar with the particular metre), ask them to perform the procedure; they may be more skilled at it than the health care provider. Take advantage of the opportunity to observe the patient’s technique.
• Take note if the patient provides you with suggestions for where to draw blood the most efficiently!

If you can’t get blood from the finger prick

• A minute or two of hanging with the hand below the waist can be requested of the patient.
• Instruct the patient to soak his or her hands in or under warm water and rub their hands together to relax.
• Gently squeeze the area to be pricked for 3 seconds after grabbing it with your hands.
• Place the finger on a table or other stable surface to prevent it from moving while being pricked.
• The dial-a-depth feature on the lancing device should be activated, and the setting should be increased by one level.

NOTE: Blood glucose monitoring is done to measure the concentration of glucose in the blood (glycaemia) over time, and is important in the care of patients with diabetes mellitus. Information about individual patterns of blood glucose changes, gathered through blood glucose monitoring, can be used to plan meals, activities, and at what time of day to take insulin. The better the patient’s blood glucose control, the less likely it is that diabetes will cause damage to the body and lead to complications such as loss of vision (due to diabetic retinopathy) and amputation.

3 What You will need

• A glucose monitor measures blood glucose levels.
• Strips for testing (check that they are in date and have not been exposed to the air)
• rubbing alcohol swab
• Safety lancets or a lancing device that is intended for single-use
• Gloves
• Fabric made of cotton wool or gauze
• A Sharps box is a type of container that is used to store sharps.
• Calibration solution with a control solution

When using the various types of electronic blood glucose meters that are currently available, keep these general principles in mind.

• To begin, ask the patient to take a seat and explain what you are about to do.
• Put gloves on your hands after washing them.
• Choose a site for the blood sample: it is usually taken from the side of a finger, but it can also be taken from the arm or thigh (change the site used if frequent measurements are needed).
• Remove any debris from the site with an alcohol swab and allow the alcohol to dry.
• Following the manufacturer’s instructions, insert the test strip into the monitor (Figure 1).

Figure 1

• To draw blood, use a single-use lancet or a lancing device (Figure 2) and dispose of it in a sharps container after you have finished.

Figure 2

• The blood should be applied to the testing strip (Figure 3) in the proper manner: some strips require the blood drop to be spread across the entire test pad, while others suck up blood directly from the site of the bleeding.

Figure 3

• Keep applying pressure to the site with the alcohol swab (be aware that it will sting) or a piece of gauze (Figure 4) until the bleeding stops, or allow the patient to apply pressure until the bleeding stops. Keep an eye out for excessive bleeding.

Figure 4

• Read the result and make a note of it, informing the supervisor and/or responding to abnormal readings.
• Inform the patient of the outcome, provide an explanation, and discuss treatment options.
• In accordance with hospital or health care policies, dispose of all used equipment in a safe manner.

4 Calibrating the blood glucose monitor

• Make sure to calibrate both the monitor and each new pack of test strips at the same time.
• Every week, make sure the monitor is calibrated.
• Place the control solution on a test strip and verify that the value displayed on the monitor corresponds to the value printed on the label of the bottle (or the pack of strips it accompanies). Make a note of the calibration results.
• If a check strip is provided, make use of it to ensure that the meter is in proper working order.

5 Final Words

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