* In this summary, the term “doctor” refers to the health care professionals who may take care of you, including your physician, endocrinologist, diabetes educator, nurse practitioner, or physician assistant.
This summary discusses what research says about different ways to measure blood sugar and take insulin. It describes what researchers know about how each option compares to the others to help you control your blood sugar level. This summary does not discuss other ways to treat diabetes such as taking pills, changes in diet, or exercising.
This summary also does not discuss all the basic information about diabetes that you may want to know if you have just learned you have diabetes. For general information about diabetes, go to www.nlm.nih.gov/medlineplus/diabetes.html.
The information in this summary comes from a report of 41 studies published through July 2011 that compared ways to check blood sugar and deliver insulin for people with diabetes. The report was funded by the Agency for Healthcare Research and Quality (AHRQ), a Federal Government research agency.
Diabetes (also called “diabetes mellitus,” pronounced DI-ah-BEEteez MEL-eh-tuhs) is a condition in which your body has trouble managing the level of sugar (or glucose) in your blood. This causes your blood sugar to be too high.
There are two main types of diabetes. The type you have is based on the reasons that you have high blood sugar.
Currently, 8 out of every 100 people in the United States (approximately 26 million people) have diabetes. That number is expected to increase to nearly 10 out of 100 people by 2050.
Out of 100 people with diabetes:
You can manage the effects of diabetes on your health by controlling your blood sugar. Controlling your blood sugar means making sure your blood sugar level does not get too high.
Serious health problems caused by high blood sugar (a condition called “hyperglycemia,” pronounced hi-per-gli-SEE-me-ah) include:
Treatment can help lower your high blood sugar. If your blood sugar gets too low (a condition called “hypoglycemia,” pronounced hi-po-gli-SEE-me-ah), you may become dizzy, weak, or black out (lose consciousness). If not treated right away, hypoglycemia can even lead to death. It is important to monitor your blood sugar so it does not get too low. Some people with diabetes may drink orange juice or eat candy if their blood sugar gets too low. It is important to discuss hypoglycemia with your doctor.
There are two types of tests that tell you your blood sugar level:
Doctors use a special blood test, called an A1C test, to check how high your blood sugar level was during the past 3 months. Having an A1C level of 7 percent or below means that your blood sugar has been well controlled over the past 3 months.*
When taking insulin, you need to use a different type of test called a blood sugar test—often done with a fingerstick—to help you adjust the amount of insulin you take during the day. This test measures the amount of sugar in your blood at any one time. This measurement is given in milligrams per deciliter (mg/dL). The normal blood sugar levels for people who do not have diabetes are:
Talk with your doctor about setting a goal for your blood sugar level.
* This information comes from the National Institute of Diabetes and Digestive and Kidney Diseases/National Institutes of Health Web site.
There are two ways to check your blood sugar level:
You can use a blood glucose meter to test your blood sugar level. You put a small drop of blood from your finger or forearm onto a testing strip. The meter reads the strip, and the result appears as a number on the meter’s screen. Some meters can store the results for several months. There are many types and styles of blood glucose meters.
A real-time continuous glucose monitoring system automatically tracks sugar-level changes all day and night. It is a small device that you wear on your belt. The device has sensors that attach to your belly with a small needle held in place with tape. The system checks your sugar level as often as every 1 to 5 minutes. The monitor displays your blood sugar readings and can store them for your doctor. The results can help you and your doctor adjust your insulin to the right amount.
The sensors on automatic monitors have to be replaced regularly. You may need to move the sensors to different locations around your belly to avoid irritation or infections.
Doctors may suggest automatic monitoring only for people who have difficulty controlling their blood sugar and people who may not know when their blood sugar gets too low.
Children, teens, and adults with type 1 diabetes who use automatic monitoring:
There was not enough research to compare automatic monitoring with self-testing for people with type 2 diabetes or for pregnant women who had type 1 diabetes before becoming pregnant.
There are two ways to take insulin:
You can give yourself insulin shots in one of two ways:
You may have to change the place on your body where you stick the needle to avoid irritation or bruising.
An insulin pump is a small device with a tube connected to a needle that goes under the skin on your belly. Tape holds the needle in place. You may need to move the needle to different places on your belly to avoid irritation and infections. You set the amount of insulin you need the pump to give you. Then, the device gives you insulin throughout the day or night. You may also use the pump to give you additional insulin at meals or other times.
There are two types of insulin pumps:
Children or teens with type 1 diabetes who use insulin pumps:
Adults with type 1 diabetes who use insulin pumps:
Adults with type 2 diabetes who use insulin pumps:
Insulin pumps and shots appeared to work about the same to improve A1C levels for pregnant women who had type 1 diabetes before becoming pregnant, but there is not enough research to know this for certain.
Children and adults with type 1 diabetes:
There are several things to consider when deciding the best way to measure your blood sugar or give yourself insulin.
Talk with your doctor about:
The cost to you for these devices depends on your insurance plan. You will also need to buy any parts of the devices that need to be replaced (such as sensors), any supplies you will need for the devices (such as testing strips), and the amount of insulin you need.
* Prices are the average wholesale prices listed from RED BOOK Online®.
The information in this summary comes from the report Methods for Insulin Delivery and Glucose Monitoring: A Comparative Effectiveness Review, July 2012.
The report was produced by the Johns Hopkins University Evidencebased Practice Center through funding by the Agency for Healthcare Research and Quality (AHRQ).
Additional information came from the MedlinePlus® Web site, a service of the National Library of Medicine and the National Institutes of Health.
This summary was prepared by the John M. Eisenberg Center for Clinical Decisions and Communications Science at Baylor College of Medicine, Houston, TX. Patients with type 1 and type 2 diabetes reviewed this summary.