Do You Need a Blood Sugar Test?

by Dr. Julian Whitaker
Filed Under: Blood Sugar, Blood Sugar Testing
Last Reviewed 03/25/2014

Do You Need A Blood Sugar Test?

Virtually everyone with diabetes is familiar with the blood sugar test, also known as the finger stick, used to monitor blood sugar levels.

The blood sugar test makes perfect sense for people with type 1 diabetes, because the results help them determine when and how much insulin to take. But for the overwhelming majority of people with type 2 diabetes, daily finger sticks are a waste of time and money. I don’t recommend it unless you also have a plan of action for when your blood sugar levels are too high.

Why the Blood Sugar Test Doesn’t Work for People with Type 2 Diabetes

Dozens of studies show that routine self-monitoring does not improve blood sugar control and is associated with poorer quality of life and higher risk of depression in people with type 2 diabetes. Here’s why:

  • Treatment plans don’t change based on blood sugar test results. Almost all of my new patients who have type 2 diabetes tell me that they do, in fact, perform routine finger-stick testing. But when I ask what they do if their blood sugar is too high or too low, they all tell me the same thing—nothing. They don’t change the dosage of their oral diabetes drugs, and they don’t alter their insulin use (which one-quarter of people with type 2 diabetes are on).
     
  • Self-testing drives up the cost of having diabetes. Although glucose meters are often heavily discounted and, in some cases, provided for free, test strips have a price tag of up to $1 apiece—despite costing just pennies to make. Many patients perform the blood sugar test several times a day.
     
  • Even doctors don’t pay attention to the blood sugar test. Instead, they base treatment decisions on hemoglobin A1C, a test that measures your average blood sugar levels during a six- to eight-week period. If the A1C is going up, therapy is intensified. Conversely, if A1C is falling, medication dosages may be revised downward.

Exercise Could Make the Blood Sugar Test Work for You

If you are going to self-test, then have a plan for those times when your blood sugar is high.

I advise that you engage in some type of physical activity. Exercise, like insulin, has the ability to quickly lower blood sugar levels. When you’re at rest, your large muscles require insulin in order for glucose to enter the cells. But if those same muscles are exercising, glucose and other nutrients can enter the cells without insulin. This is a well-known but little-used method of lowering blood sugar, and it is ideal for individuals with type 2 diabetes.

For instance, if you perform a blood sugar test and your level is 280 (substantially higher than is healthy) then simply walk for about a half hour, wait another hour, and then repeat the finger stick. More often than not, you’ll see a dramatic drop—sometimes below 200. That’s how powerful exercise can be.

Then do a little paperwork. Record you initial blood sugar level, the type and duration of physical activity, and the results of your repeat blood sugar test an hour after exercising. Not only will this give you something to do in response to a high blood sugar reading, but it will promote an action that substantially improves diabetes control.

Used in this way, self-monitoring becomes a tool for engendering therapeutic activity, not an uncomfortable and pricey waste of time and effort.

More Dr. Whitaker Advice on Diabetes Testing and Treatment

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