When you have T2DM there are a variety of ways which people can monitor their glucose levels. When you are initially diagnosed, we normally monitor your blood glucose levels with a blood test, this is called a HbA1c.
HbA1c
Is a venous blood sample which is taken and gives an average of your glucose levels for 3 months. This is because it measures glucose sticking to your red blood cells and the average life span of a red blood cell is 3 months hence why it gives an average over 3 months.
When you are diagnosed with T2DM your HbA1c is above 48mmol
The national guidance is that all people with diabetes should aim to have their HbA1c below 58mmol. This target changes and is individualised when you discuss your health goals with the health care professional that supports you.
To put your T2DM into remission with diet and lifestyle changes you should aim to have a HbA1c of less than 42mmol.
Home blood glucose monitoring
Blood glucose monitoring at home is not recommended routinely if you have T2DM unless you are on medication which can result in hypoglycaemia. If you are taking above 80mg gliclazide twice daily or insulin, then blood glucose monitoring is recommended.
If you are on 80mg twice daily of gliclazide it is recommended that you monitor your glucose levels twice per day. For example, before breakfast and before dinner. If you feel unwell you should monitor your glucose levels and increase your glucose monitoring.
If you are on insulin, you should monitor your glucose levels whilst the insulin you are on is ‘active’ in your body. When you commence on insulin you will learn how long that insulin lasts for.
If you are on insulin that lasts for 12 hours you should monitor your glucose levels before you take insulin, 6 hours later and at the end of the 12 hours. These readings will help you to decide if you are taking the correct amount of insulin.
It is also recommended that in periods of illness you should monitor your glucose levels more regularly and if you suspect you are hypo you need to test your glucose level as soon as possible.
Below there is a video of blood glucose monitoring.
Continuous glucose monitors
You may have seen or heard about sensors that monitor glucose levels, these are available on the NHS. There is criteria which is set nationally to provide equity of care, the main current criteria references people on multiple daily injections of insulin, however there are other specialist criteria included alongside this. Please see the current national guidance.
In NHS FV we use both Freestyle libre and Dexcom one for those who meet the criteria for continuous glucose monitoring.