Monitor closely to live longer...

I love new toys! Having diabetes means I have an excuse to buy some new ones that I hadn't even considered before. This page documents the blood glucose meters and software that I've used and my excuses for trying new stuff.

I record my blood glucose level immediately before and 2 hours after every meal using a LifeScan Ultra meter. For meter reviews, see http://www.mendosa.com/meters.htm, http://www.childrenwithdiabetes.com/d_0i_000.htm, and the October 2001 issue of Consumer Reports. Also see the FDA site on Glucose Meters & Diabetes Management.

Before buying a meter, check with your insurance company to see which test strips they will pay for; contact the meter manufacturer and ask about the possibility of receiving a free meter from them; ask your local pharmacist if they will provide a free meter if you buy the test strips from them; try buying a less-expensive meter and exchange it for a more expensive one; also check with your local diabetes association, they may have coupons for a free meter. Manufacturers make money from test strips not from meters! I can't help wondering if that's why noninvasive meters aren't generally available yet! For promising steps in the right direction, see GlucoWatch; the SensElly sensor being developed by SINTEF; ear heat emissions device; and optical measurement of blood glucose levels.

Should lancets be reused? No! Why? See http://www.bddiabetes.com/ca/english/managingdiabetes/dangers.asp

Index
My first meters: Roche AccuSoft Advantage and LifeScan FastTake
My current and preferred meter: LifeScan Ultra
My newest meters: Accu-Chek Compact, Precision QID, MediSense Precision Xtra; and TheraSense FreeStyle
Diabetes tracking software: LifeScan InTouch, Diabetes Diary, BalancePC, and Palm-based
Using your meter: to determine when to eat

My first meters

Within two weeks of being diagnosed, in November 2000, I purchased a Roche AccuSoft Advantage blood glucose meter and starting monitoring my blood 2 to 4 times per day during November and December 2000. Although I liked the Advantage meter and found it very easy to use, I subsequently changed to a LifeScan FastTake meter in January 2001. Why? The FastTake meter needs a smaller blood sample (equates to smaller needle holes and less pain), is faster, and had the ability to upload data to my PC with the $20 LifeScan InTouch software and cable kit that I purchased at a local pharmacy; it was going to cost me about $75 to get the cable and software for the Advantage meter. I also seriously considered the TheraSense Freestyle meter, but I couldn't find a Canadian supplier (the FreeStyle became available locally in April 2002 and I exchanged my Precision QID for a FreeStyle in August 2002).

LifeScan Ultra meter

On March 9, 2001, I exchanged my Roche Advantage meter for a new LifeScan Ultra meter kit, at no cost, and started using it on March 26. The Ultra kit includes: meter, UltraSoft lancet device (same as Penlet Plus), 10 test strips, 10 lancets, control solution, Owner's Booklet, Quick Reference, Logbook, and carrying case.

Specifications. Blood sample size=1 microliter; time to get a result=5 seconds; storage capacity=150 test results with date, time, and 14-day and 30-day averages; assay method: glucose oxidase biosensor; assay range=1.1 to 33.3mmol/L (20 to 600mg/dL); selectable mmol/L or mg/dL units; operating ranges: temperature =6-44 °C (43-111°F), relative humidity=10-90%, hematocrit=30-55%; replaceable 3.0V (#2032) lithium battery life=1,000 tests; data transfer port.

Evaluation. The LifeScan Ultra kit contains eveything you need to start testing immediately. I really like the physical design of the Ultra, in addition to a very modern look (for some reason, it reminds me of the face of an alien) it is also very functional: it is easy to hold and it feels very secure in your hand; obtaining a blood sample is very easy at all times; and the large display makes it very easy to read test results, even without glasses. Handling test strips and inserting them into the test port can sometimes be challenging. The small blood sample size and the new and thinner UltraSoft lancets equates to smaller holes and less pain. In addition, you only have to wait 5 seconds to get a result. The UltraSoft lancets are 28 guage compared to 25 guage for the LifeScan FinePoint lancets; only the BD Ultra-Fine II and Latitude lancets are thinner at 30 and 33 guage and you can use them with the UltraSoft lancing device. However, even though the lancets are 28 guage, I find the SoftClix lancing device the least painful. I occassionaly had problems, during the winter, in operating the FastTake meter after only a short, 20 minute, trip into my office; with the wider operating temperature of the Ultra, I no longer have the problem.

Although you don't get it in the box, you can also get a new cap, free from LifeScan, for the UltraSoft lancing device which makes it easier to obtain blood samples from your arm. The Ultra can store up to 150 test results but this is still not enough to store a month's set of results if you test more than 4 times/day (I think the Precision Xtra meter capacity of 450 test results is far superior). The color of the control solution is red, this makes it very easy to see that the test strip is working (other manufacturers commonly use a clear control solution). The User's Booklet is well organized and written. The Quick Reference omits two common tasks: using the control solution to perform a quality check and setting the date and time. The carrying case is also well designed and holds the meter, a vial of 25 test strips, the UltraSoft lancing device, about 25 lancets in a zippered mesh pocket, the Quick Reference and Logbook, and a small pen. Warning: Whenever the meter loses power for any reason it will enter the setting mode and stored test result values and sequence can be lost.

Uploading and viewing test results. You need an RS232 ONE TOUCH Interface cable to attach the Ultra to a computer serial port and the IN TOUCH® Diabetes Management Software to upload, analyze, and report test results. The software is free but you have to purchase the cable; LifeScan directs you to http://www.drugstore.com/ where the cost is US$19.99. The IN TOUCH software has 10 different pre-formatted charts and graphs to help you analyze your blood glucose data in detail; I've been using the IN TOUCH software since February 2001 and find it integrates very well with the Ultra, is very easy to use, and the reports good enough to provide useful insights into where I need to improve my blood glucose control; see my test results.

Web site support. I find the mylifescan.com, mylifescan.ca, and lifescan.co.uk sites very simple to navigate and find detailed product descriptions and support materials. I also like the feel of the LifeScan sites and receive the impression that LifeScan is interested in personally helping me deal with my diabetes more effectively. This same feeling has been reinforced whenever I've contacted LifeScan.

Conclusion. I find the LifeScan Ultra very easy to use and think that it is, with the InTouch cable & software, and the SoftClix lancing device, the best blood glucose monitoring system currently available.

Note: In March 2003, LifeScan introduced a new meter called the UltraSmart with all the benefits of the Ultra plus electronic logbook features. LifeScan has also released Version 2.0 of the OneTouch software that supports all LifeScan meters that include a data port, including the UltraSmart. A major shortcoming of the new software is it's inability to print reports in color!

Roche Accu-Chek Compact meter

On November 5 2001, I purchased for $65 (which my insurance company reimbursed) a Roche Accu-Chek Compact blood glucose monitoring kit. The kit comes with the meter, 2 AAA batteries, 1 drum containing 17 test strips, two bottles of control solution, 17 lancets, SoftClix lancing device, protection tube for an extra test strip drum, carrying case, carrying holster, User's Manual, Quick Reference Guide, and Logbook.

Specifications. Glucose level determined by reflective photometry (Ultra uses an oxidase biosensor); measurement range 0.6 to 33.3 mmol/L; sample size 3 to 3.5 microlitres (Ultra 1-microlitre); measurement time 15 seconds (Ultra 5 seconds); test result storage capacity 100 (Ultra 150).

Evaluation. High-tech looking meter with a flip-up cover looks more like a cell phone than a glucose meter. It has a solid feeling but is quite bulky (compared to the Ultra). The carrying holster is gimmicky and impractical. Standard AAA batteries are used to power the meter and have a claimed life of at least 500 tests. If you test 6 times/day, one month of test results needs a storage capacity of about 250; the meter storage capacity of 100 is simply not enough, even the 150 capacity of the LifeScan Ultra is insufficient. Coding of test strips is automatic and the excellent 17 test strip drum is very easy to load and use (especially so if you are arthritic and have trouble handling test strips). However, I find myself wondering how reliable the motorized drum will be; I haven't been able to find any MTBF (mean time between failures) data. I was confused by the two bottles of control solution having different colored tops (red and blue) and I thought, incorrectly, that you had to use both to perform a quality check. Having to clean the optics system is a turn off. Compared to the LifeScan Ultra, the Accu-Chek Compact seemed to need a large blood sample and take a long time to collect it (it seems that holding the test strip at a 45-degree angle and allowing the strip to only touch the blood, without allowing pressure on the skin, can speed up the process); I even had to squeeze out more blood, but the test strip could take multiple samples and beeped when it had enough. The Ultra lacks the multi-sample and audible confirmation features; while I don't think the multi-sample feature is needed, simply because the sample size required is so small, I do think an audible confirmation would be useful. I had to wait for what seemed like a long time to obtain the test result. An infrared port is provided for connecting to a computer, this means that a cable is not needed to upload test results to a Windows-based computer. The SoftClix lancing device is excellent and the least painful of any lancing device that I've used to date, but you have to use the SoftClix lancets (which are 28 guage, the same as the LifeScan UltraSoft).

The User's Manual uses some annoying text layout features which make it difficult to read. The Quick Reference Guide will not fit in the carrying case without being folded; in addition, it omits any mention the common task of using the control solution to perform a quality check. Meter measurement units were preset on my unit to mmol/L and I couldn't change the units. I presume that meters for the USA market will be preset to mg/dL units. Oops! I just discovered that it is very easy to press the ON button by mistake and waste a test strip because it can't be retracted back into the drum! The meter also skipped a beat with the last test strip, the motor whirred but no test strip appeared! I turned the meter off and back on, the motor whirred and the last test strip appeared. Signs of possible problems in the future? Because of the bulk of the meter, getting a blood sample onto the test strip is a bit awkward, again this is in comparison to the relative ease of the LifeScan Ultra.

Uploading and viewing test results. You will need an infrared port on your computer to upload test results. Connecting by cable is not an option. You will have to purchase the Accu-Chek Compass PC-based or Palm-based software (US$29.99) to upload, analyze, and report test results. If you use software like Diabetes Diary, which requires the manual input of test results, you don't need the ability to upload.

Web site support. I find the Roche.com and Accu-chek.com sites difficult to navigate and find detailed product descriptions and support materials. Even though the sites do contain some useful information, my overall feeling is that their focus is more on marketing than support. I find the sites very slow even when accessed over a high-speed connection. My overall impression is that Roche is only interested in providing minimal product descriptions and support through their web sites.

Question. Are there any benefits to using reflective photometry over an oxidase biosensor for determining blood glucose level? All I'm seeing at present is a negative-having to clean the optics.

Conclusion. I like the look and feel of the Roche Accu-Chek Compact but think it is misnamed especially when compared to the LifeScan Ultra which is about half the size. I also really like the 17 test strip drum and how easy it is to use, especially so if you currently have trouble handling individual test strips. I also love the SoftClix lancing device. However, I find the meter and software too expensive, the blood sample required too large, getting the sample awkward, and time to get results too long. I think the LifeScan Ultra system (with the SoftClix lancing device) is the best choice for most people because it is cheaper, more practical, and easier to use.

Precision QID pen model meter

On November 22, 2001, I saw an advertisement at a local pharmacy for a free Abbott MediSense Precision QID blood glucose meter. For some time I'd been considering buying the QID pen model simply because of its convenient size. The advertisement was for a regular-sized meter but the pharmacist agreed to give me the pen model instead.

Specifications. Blood sample size=3.5 microliters; time to get a result=20 seconds; viewable capacity=10 results; assay range=1.1 to 33.3mmol/L; strip operating temperature range=18-30 degrees Centigrade; non-replaceable battery life=4,000 tests. Test results are automatically adjusted for common medications, vitamins and endogenous substances including up to 100 micrograms of acetaminophen, 20mg/dL uric acid, 3mg/dL ascorbic acid, 500mg/dL cholesterol, 3000mg/dL triglycerides. Test results may be too low if you are severely dehydrated or hypotensive, in shock, or in a hyperglycemic-hyperosmolar state. Test strips can accept multiple blood samples within a 30-second period.

Evaluation. The most attractive feature of this meter is that it looks like and is the same size as a pen! The meter comes with a lancing device, 10 lancets, quick reference guide, user's manual, journal, and carrying case. My first disappointment came when I realized that I couldn't use the meter! Why? Test strips are not included with the meter, you have to buy them separately. In addition, you will also have to purchase control solution to test meter performance. Contrast this with the LifeScan, Roche and TheraSense meters that come with everything you need to get started. The meter is calibrated for mmol/L with no way to change, I presume that mg/dL will be used for the USA model. The User's Guide and Quick Reference Guide do not show or even mention the QID pen model! The carrying case has space for the meter, lancing device, 6 lancets, journal, and up to 25 individually foil-wrapped test strips; it will not fit in shirt or pant pockets, but it will fit easily in a jacket pocket or a small purse. I find the meter display rather small and difficult to read. A blood sample size of at least 3.5 microlitres is required and getting a result takes 20 seconds. Contrast this with 1-microlitre and 5 seconds for the LifeScan Ultra. Compared to the LifeScan Ultra, getting enough blood onto a MediSense Precision Plus test strip is really difficult; I find this factor alone reason enough to avoid this or any other meter that uses this kind of test strip.

Uploading and viewing test results. The QID pen version does not have a data port. The regular-sized QID meter does and results can be uploaded and viewed with the Precision Link cable and software.

Web site support. Meter information and support from the MediSense site is difficult to find and is clearly focused on supporting their marketing efforts. For example, I couldn't find any information on the QID pen version or the MediSense lancing device.

Conclusion. I like the small size of the QID pen model meter and the individually foil-wrapped test strips; if you have good eyesight, it is an excellent choice if portability is your primary concern. However, although the LifeScan Ultra is larger, it is a better choice. I exchanged my Precision QID meter for a TheraSense FreeStyle meter in August 2002.

MediSense Precision Xtra meter

On January 16 2002, I exchanged a spare LifeScan Ultra meter for an Abbott MediSense Precision Xtra meter kit. The kit comes with the meter, 2 AAA batteries, 10 "True Measure" test strips, 10 lancets, an adjustable lancing device, carrying case, user's manual, quick reference guide, and data log; 30-day money-back guarantee; 4-year warranty; no control solution is included.

Specifications. Glucose level determined by an oxidase biosensor; glucose measurement range 1.1 to 27.8 mmol/L (20 to 500mg/dL); sample size 3.5 microlitres (Ultra 1-microlitre); measurement time 20 seconds (Ultra 5 seconds); blood ketone measurement range 0 to 6.0 mmol/L; test result storage capacity of 450 (Ultra 150) with 7-day, 14-day, and 28-day averaging; backlit display with a test-strip light and an illumination button; glow-in-the-dark case.

Evaluation. The main attractions of this meter for me were the backlit display with test-strip light, illumination button, a case that glows in the dark, the 450 test results storage capacity, and the ability to test for blood ketones. The backlit display is excellent and the lights make it very easy to read test results which is very important for many diabetics whose eyesight is typically less than optimum. If you test 6 times/day, one month of test results needs a storage capacity of about 250; the meter storage capacity of 450 is far superior to the 150 capacity of the LifeScan Ultra.

The ability to test for ketones is certainly an added benefit and the main reason I was interested in this meter. Just like glucose testing, blood is applied to special Ketone test strips and the meter takes 30 seconds to process the sample to produce a Ketone test result. The Ketone test measures Beta-hydroxybutyrate which is normally less than 0.6 mmol/L; this level may increase with illness, increased stress, or uncontrolled blood glucose levels. If your level becomes greater than 1.5 mmol/L you may be at risk of developing diabetic ketoacidosis (DKA) and you should contact your doctor. A Ketosis test should be performed every 2-4 hours whenever you are sick, when your level of stress has increased significantly, or when your blood glucose level is 16.7mmol/L (300mg/dL) or greater. Also see the MEDLINEplus Serum ketones article.

Standard AAA alkaline batteries are used to power the meter and have a claimed life of at least 1000 tests. The meter has to be coded for each new box of blood glucose or ketone test strips using a calibration strip provided with the strips. Each test strip is individually wrapped in foil. The meter automatically detects the type of strip inserted. Compared to the LifeScan Ultra, the Precision Xtra needs a large blood sample (3.5 compared to the Ultra's 1-microlitre) and a long time to collect it; I even had to squeeze out more blood, but the test strip could take multiple samples and the meter verifies that the blood sample is large enough. I had to wait a relatively long time to obtain the test result (20 compared to the Ultra's 5 seconds ). Meter measurement units can be set to mmol/L or mg/dL units. Removal of the lancet from the lancing device is inconvenient, you have to unscrew the top and manually pull out the lancet. A special cable is needed to upload test results.

The User's Guide is well designed and easy to use. The User's Guide states that control solution is required to perform a quality check but none is provided. The Quick Reference Guide fits in the carrying case but lacks information on Ketone testing or performing a quality check using the control solution. While the shape of the the carrying case is trendy, it is impractical; lancets and test strips have to be stored together and removal of them is awkward, also because of its shape you can't store the provided Logbook in it.

Uploading and viewing test results. Results can be uploaded and viewed with the Precision Link cable and software. The cost of the software and cable is US$69.99. I tried to convince the MediSense representative to provide me with the software free just like LifeScan does and by stating that I wouldn't use the meter on an ongoing basis if I couldn't upload and view my results online. After 7 months, I received an email from a MediSense representative and met with him in September 2002; he supplied me with a free cable and software. I was not impressed with the software; in comparison with the LifeScan software it looks very unprofessional, don't waste your money. If you decide to use the meter and you need electronic record keeping and analysis capability, I recommend you enter your data manually and use the BalancePC program.

Web site support. Meter information and support from the MediSense site is difficult to find and is clearly focused on supporting their marketing efforts. In other words it is not focused on supporting the end users of their products. For example, I couldn't find information on the operating temperature range or what the blood test sample size was.

Conclusion. Overall, this is an excellent meter with many well thought out and useful features and a very good choice as your main blood monitoring meter. I find the cost of the Precision Link cable and software too expensive and unprofessional, and Web-site support weak. This meter is worth having just for the ability to test your blood ketone levels. Overall, I still think the LifeScan Ultra (with the SoftClix lancing device) is easier to use and the best system overall for monitoring your blood glucose levels.

Note: In September 2002, the MediSense representative stressed the superiority of True Measure test strips over other strips leading to more consistent and accurate test results. He also asked me to try the Sof-Tact meter. The meter is large, getting a blood sample, while painless from my arm, was awkward and very slow, it needs to be cleaned on a regular basis, and getting test results is very slow; overall, I found it very impractical. However, if you have problems getting blood from your fingers and must have a meter with the ability to get blood from an alternative site, the Sof-Tact is probably the best choice (full review). The MediSense representative also mentioned that MediSense is bringing out a new meter later this year that requires a smaller blood sample and produces a test result in 5 seconds.

TheraSense FreeStyle meter

On August 16 2002, I exchanged my Precision QID pen model blood meter for a TheraSense FreeStyle meter kit at my local Pharma Plus Pharmacy. The kit comes with the meter, 2 pre-installed AAAA batteries, 5-year warranty, 10 test strips, 10 lancets, an adjustable lancing device with dark blue (finger) and clear (off-finger) caps, control solution, carrying case, Getting Started Guide, Owner's Booklet, Quick Reference Guide, and Logbook.

Specifications. Blood sample size=0.3 microliter (Ultra 1 microliter); time to get a result=15 seconds (Ultra 5 seconds); storage capacity=250 test results with date, time, and 14-day average; assay method: coulometric electrochemical sensor; assay range 1.1 to 27.8 mmol/L (20 to 500mg/dL); selectable mmol/L or mg/dL units; operating ranges: temperature=5-40 °C (41-104°F), relative humidity=5-90%, hematocrit=0-60%; replaceable AAAA battery life=1,000 tests; data transfer port.

Evaluation. The main attractions of the FreeStyle for me were the smaller blood sample required and the 250 test results storage capacity. If you test 6 times/day, one month of test results needs a storage capacity of about 250; so the FreeStyle meter storage capacity of 250 is about right and superior to the 150 capacity of the LifeScan Ultra. Another attraction was the lower cost of the test strips and lancets over those used with the meter I currently use daily (LifeScan Ultra).

The meter has to be coded to match the code number on the test strip vial. The meter automatically turns on when a test strip is inserted. The FreeStyle uses a small blood sample (0.3 compared to the Ultra's 1-microlitre); test strips can take multiple samples and the meter verifies that the blood sample is large enough by beeping once. The meter processes the blood sample and after 15 seconds beeps twice when it has produced a result. Compared to the LifeScan Ultra, getting a blood sample and test result is not as convenient. The reasons for this are: although a smaller blood sample is required, it takes longer to get a blood sample; sampling at the edge of the test strip is not as convenient; there is no visual indication of the blood being acquired by the test strip; and having to wait a relatively long time to obtain the test result (15 seconds compared to the Ultra's 5).

Initially, I thought the meter's screen was faulty because it was difficult to read because of ghost images. I even returned the meter and replaced it with another one. It turns out that the problem only occurs under a very bright halogen light (which I have on my desk); under normal incandescent and fluorescent lighting there are no problems reading the meter.

The carrying case is well designed and holds the meter, a vial of 25 test strips, control solution, the lancing device, about 25 lancets in a zippered mesh pocket, the Quick Reference and Logbook, and a small pen. The Owners's Guide is poorly designed; for example, one of the first, and frequent, tasks you need to do is to set the test strip code number, this is not even mentioned until page 16 which references pages 27-28. The Quick Reference Guide fits in the carrying case but lacks information on performing a quality check using the control solution or on setting the test strip code number.

Note: TheraSense also market a palm-based version of the FreeStyle, called the Tracker.

Uploading and viewing test results. Results can be uploaded and viewed with the FreeStyle Connect Data Management System cable and software. The cost of the software and cable is US$75.00 and the cable alone costs US$60.00! This is very high when compared to the US$19.95 for a cable with a free software download for a LifeScan Ultra! Review comments on the FreeStyle software include "amateurish" and "cheesy" which don't encourage me to buy it at any cost! Since I need to upload my test results to my computer and web site on a monthly basis, the cost of the cable and software alone will prevent me from using the FreeStyle on a daily basis as my main meter.

Web site support. Meter information and support from the TheraSense site is weak but excellent phone support is provided at 1-888-519-6890 (Canada) and 1-888-522-5226 (USA). For example, online copies of the user manuals are not provided and online support for the FreeStyle Connect software is not provided. I couldn't find any mention at all on the Canadian site about the FreeStyle cable or software.

Conclusion. The TheraSense FreeStyle is an excellent meter for monitoring your blood glucose levels on a daily basis. The FreeStyle cable and software are expensive; they cost more than the meter! In addition, the FreeStyle meter display is difficult to read under certain lighting conditions and it is not as convenient to use as the LifeScan Ultra. There are some indications that the FreeStyle produces more consistently accurate test results than any other meter. However, I think the LifeScan Ultra (with the SoftClix lancing device) is the best meter choice for most people especially if you need to upload your results to a computer.

Diabetes tracking software

For reviews of diabetes tracking software, see http://www.mendosa.com/software.htm. I personally use the LifeScan InTouch software and cable to upload, analyze, and report my test results. I also tried, but didn't continue with, the Glucose32 software and uploaded my results to the GlucoWeb site.

I feel the need to gain more control over what I eat. After reviewing the software products currently available for setting up a diet plan and tracking what you eat, I decided that Diabetes Diary and BalancePC/LightenUP offered the best set of features and ease-of-use to help me gain greater control over what I eat on a day-to-day basis; so I purchased all three. I started using Diabetes Diary in January 2002 (see my Nutrition Reports) but didn't use it much during 2002. For tracking and analyzing your blood test results and diet on a Windows-based computer I highly recommend BalancePC.

I've used a Sharp Zaurus ZR-5800FX digital organizer for many years but have now changed, in September 2002, to a PalmOS-based organizer (a Sony Clie SJ-22 and now a Sony Clie SJ-33) and am investigating software that runs on a Palm Pilot for tracking my blood glucose results and diet; the current Palm-based software that look most promising to me are: Accu-Chek Pocket Compass, Diabetes Pilot, Diet & Exercise Assistant, CarbCheck, GlucoPilot, BalanceLog, CalorieKing Diet Diary, RMRdiet, UltimateCalorieMeter, and USDA National Nutrient Database for SR15. Also see the John Hughes review of various palm-based software packages. I'm also considering creating a database for tracking my diabetes using SmartList-To-Go (formally thinkDB). In February 2003, to help me select low glycemic index and glycemic load foods, I've created a Glycemic Lists database. I've also decided to continue tracking my blood glucose readings using the Windows-based Lifescan InTouch software and to start tracking my diet, using my Sony Clie SJ-33 as the main input device, using Diet & Exercise Assistant and transferring results to my PC for analysis and report creation using Microsoft Excel.

Using your meter

I use my meter as a tool to help determine what, the amount, when, and if, I eat. How?

  1. Set a premeal blood glucose level to determine when you eat. The premeal blood glucose level for normal nondiabetics is 3.8-6.1mmol/L (68.5-109.9mg/dL); the optimal premeal goal for diabetics is 4-7mmol/L (72-126mg/dL). Personal Guideline: My premeal blood glucose target level is below 6mmol/L (108mg/dL); I don't eat until it is below 6 and I'm trying for below 5 (90).
  2. Set a postmeal blood glucose level (2 hours after meals) to help you determine the type of food and amount to eat. The postmeal blood glucose level for normal nondiabetics is 4.4-7.0mmol/L (79.3-126mg/dL); the optimal postmeal goal for diabetics is 5.0-11.0mmol/L (90-198mg/dL). Personal Guideline: My postmeal blood glucose target level is below 9mmol/L (162mg/dL); I adjust what and the amount I eat to keep below 9, and I'm trying for below 8 (144).
  3. Eat whenever your blood glucose level is below 4mmol/L (72mg/dL). Clinical hypoglycemia is diagnosed when your blood glucose level is 3.3mmol/L (59.5mg/dL) or below.
  4. Have your HbA1c and lipid levels checked every 3 months to check how well you're doing (see mine). Target levels: HbA1c < 6; LDL < 2.5mmol/L (45.1mg/dL); Total Cholesterol/HDL < 4; Triglycerides < 2mmol/L (36mg/dL).

Reference: Canadian Medical Association's 1998 Clinical Practice Guidelines for the Management of Diabetes in Canada and Canadian Diabetes Association’s 2003 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada.

Updated: March 24, 2004