Type 2 diabetes is a major public health priority in the UK, with the disease affecting more than 4 million people and these numbers only rising.[1] Those diagnosed with type 2 diabetes may wonder whether self-monitoring of blood sugar should be part of their daily routine—but as with most things in healthcare, it really depends on the person and their treatment plan (including disease history, medications, and practical considerations).

For type 2 diabetics on insulin therapy or some anti-diabetic medications, self-monitoring of blood sugar levels is typically necessary to avoid hypoglycaemic episodes (which can be incredibly dangerous). For those not on these medications, self-monitoring can be an effective tool for helping to keep levels within a more tightly controlled range—but monitoring alone is not a silver bullet and the recommendations differ across geographies and depending on your care provider.[2,3]

This article will explore everything you need to know about self monitoring of blood sugar.

Blood sugar monitoring & type 2 diabetes management

If you or a relative are diagnosed with diabetes, blood sugar monitoring can play a key role in helping you to avoid hyperglycaemic episodes and being healthier in the long term. In fact, some health organisations say that the most important thing you can do to manage type 2 diabetes is to regularly monitor blood sugar levels.[4] While it’s not usually mission-critical to measure blood sugar regularly if you’re not on insulin or other blood sugar lowering medications, doing so can help to keep your levels in range, as well as help you understand how different behaviours impact your blood sugar.

Should people with type 2 diabetes monitor blood sugar?

The management of type 2 diabetes is all about keeping blood sugar levels in normal ranges in order to reduce the risk of complications resulting from the disease. Sugar levels can provide more information about:

• Whether blood sugar medications you’ve been prescribed are working properly
• Whether the treatment goals set by your doctor for your diabetes management have been achieved or not. 
• The impact of diet and physical activity on your blood sugar levels
• Other factors, such as stress or illness, that may affect your blood sugar levels

In the UK, not all patients with type 2 diabetes will receive a prescription for a monitor and test strips, but this will be determined by your doctor. If you don’t receive a prescription, it’s still possible to purchase a monitor and strips on your own, but of course not everybody can afford these tools. If you feel self-monitoring of blood sugar would benefit you, chat to your GP to see if it’s something they might be able to prescribe.

Benefits of blood sugar monitoring

Monitoring blood sugar levels, while not absolutely essential in many cases, can be a helpful tool for managing diabetes. In the long term, keeping blood sugar levels in range can decrease HbA1c, and therefore reduce the risk of complications. In addition, regular monitoring of blood glucose can help you to learn about when your levels go up or down drastically in response to different activities such as food intake, different medicines, or physical activities.

In the long term, keeping blood sugar levels in range can decrease HbA1c, and therefore reduce the risk of complications.

These numbers can in turn help your doctor to make informed decisions in order to devise a diabetic care plan for you. Many diabetic complications such as stroke, heart attack, or kidney disease can be prevented or delayed with the help of these informed decisions.[5]

How to monitor blood sugar levels?

Finger prick blood sugar testing can be carried out fairly easily (as long as you’re not scared of blood!), as it only requires a small blood glucose meter, a lancet, and test strips.

Studies have found that testing blood sugar gives maximum benefit when it is carried out in a systematic and structured way, rather than randomly, as doing so provides you with more actionable information based on your finger prick results.

If carried out too frequently or at random, you may experience soreness of your fingers from the prick, not to mention being overwhelmed by the data. It is very typical for blood glucose to vary across the day based on food intake, activity, sleep, and many other factors, so taking random finger prick tests typically doesn’t provide very useful information.

If you are considering regular blood sugar self-monitoring, consult with your GP in order to determine the ideal system in terms of timing, frequency, and logging of your blood tests.

Another newer option is to use a continuous glucose monitor (or CGM), which gives you a continuous view of your blood sugar levels. There is evidence that using a CGM can help to keep blood sugar levels in a healthy range, however at present CGM devices are quite expensive and not available on the NHS.

Recommended target range for blood sugar levels

The target blood sugar range for people with type 2 diabetes is between 4 to 7 mmol/l before meals, and less than 8.5 mmol/l two hours after eating.[7] That said, standard ranges are just the average recommendation, and you should talk to your doctor to identify your ideal blood sugar range based on your gender, age, type of diabetes treatment, and other illnesses. If you also suffer from other health problems, then your target blood sugar range may differ.

How frequently should you take blood sugar readings?

Blood sugar levels are typically checked before or after meals, before bedtime, and before and after physical activity or exercise. However, several factors play an essential role in determining the frequency of testing blood sugar levels, and your doctor is the best person to answer this question based on your health status and diabetic care plan.

1. Newly diagnosed diabetes: Self-monitoring of blood sugar levels when you are newly diagnosed with type 2 diabetes may help you to develop an understanding about how different factors impact your blood sugar levels.[8]
2. When you are taking insulin or medicines that can lower blood sugar levels: Your doctor will likely recommend that you check your blood sugar levels three or more times during the day because insulin and certain other antidiabetic medicines can lower blood sugar levels to an alarming point.
3. Changes: If your treatment has been changed, you have added something new to your diet, you have started to be more active, or you have experienced weight gain or loss, you need to check your blood sugar levels several times a day.[9]
4. Presence of any safety concern: If you are going to drive or operate any heavy machinery and you have type 2 diabetes, then your doctor may recommend that you check your blood sugar more frequently in order to keep yourself and others safe

The takeaway

One tool for keeping type 2 diabetes in check is regular self-monitoring of blood sugar, however whether it’s right for you will depend on your health history, whether your doctor will prescribe it (and, if not, whether you have budget for it), and your treatment goals.