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Diabetes Hub: Guide to Managing Diabetes

National Diabetes Reference Materials - An initiative under the War on Diabetes

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Monitoring

Diabetes Monitoring糖尿病监测Pemantauan Diabetes Penyakit Kencing Manisநீரிழிவு நோய் கண்காணிப்பு
1
How to monitor
Different ways to test your blood sugar level
Done at home using a glucometer
You can test your blood sugar at home using a glucometer
What is blood sugar level?

“At the moment” level of sugar (glucose) in your blood

Done at the clinic
Your HbA1c can be tested at the clinic
What is HbA1c?

(Glycosylated haemoglobin)

  • Sugar (glucose) attached to protein in red blood cells
  • Shows your average blood sugar level over 3 months
Self-monitoring your blood sugar level using a glucometer helps manage diabetes
For individuals with type 2 diabetes, consider self-monitoring (using a glucometer), if you are
  • At increased risk of developing hypoglycaemia (low blood sugar)
  • Pregnant with pre-existing diabetes or Gestational Diabetes Mellitus (GDM)
  • Experiencing acute illness
  • Having difficulty achieving glycaemic goals
  • Fasting for religious reasons (e.g. Ramadan)
2
When to monitor
When to test your blood sugar level
Test your blood sugar level before a meal or after 2 hours for better diabetes management

Before a meal or 2 hours after

Testing your blood sugar level when you experience hypoglycemia helps manage diabetes

When you experience hypoglycaemia (low blood sugar) symptoms (e.g dizziness, hunger

Exercise safely and manage diabetes by wearing comfortable clothing and appropriate footwear

Before or after exercise

See your doctor when you're sick and you're losing appetite to prevent complications

When you are sick and not feeling well

Monitor your blood sugar level before and after meals
Too High

Risk of hyperglycaemia

Monitor your blood sugar level before and after meals to prevent the risk of hyperglycaemia It is unhealthy if you can't target levels of blood sugar, blood pressure and cholesterol
Before food

> 7.0 mmol/L

2 hours after food

> 10.0 mmol/L

Optimal
Monitoring your blood sugar level before and 2 hours after a meal helps manage diabetes Food choices for better diabetes management
Before food

4.0 to 7.0 mmol/L

2 hours after food

4.0 to 10.0 mmol/L

Too Low

Risk of hypoglycaemia

Monitor your blood sugar level before and after meals to prevent the risk of hyperglycaemia It is unhealthy if you can't target levels of blood sugar, blood pressure and cholesterol
Before food

< 4.0 mmol/L

2 hours after food

< 4.0 mmol/L

Your targets may vary depending on your condition; discuss this with your doctor or care team.

3
Hypoglycaemia low blood sugar
Common signs and symptoms of
HYPOglycaemia
(low blood sugar of < 4 mmol/L)
Hunger is a common sign and symptom of hypoglycaemia

Hunger

Hand tremors are common signs and symptoms of hypoglycaemia

Hand tremors

An abnormally fast heartbeat is a common sign and symptom of hypoglycaemia

Abnormally fast heartbeat

Fatigue is a common sign and symptom of hypoglycaemia

Fatigue

Mood changes are common signs and symptoms of hypoglycaemia

Mood changes (e.g. anxiety, irritability, nervousness)

Dizziness or headaches are common signs and symptoms of hypoglycaemia

Dizziness or headaches

Changes in behaviour is a common sign and symptom of hypoglycaemia

Changes in behaviour (e.g. confusion, weakness, unclear speech)

Drowsiness is a common sign and symptom of hypoglycaemia

Drowsiness

If you experience HYPOglycaemia symptoms
or your blood sugar level is low (< 4 mmol/L)
  • Step 1
  • Drink half a glass of sweetened drink if you're experiencing hypoglycaemic symptoms

    Drink half a glass
    of sweetened drink.

    OR
    Eat 3 soft candies if you're experiencing hypoglycaemic symptoms

    Eat 3 soft candies (sugar-containing)
    or sugar (glucose) tablets.

  • Step 2
  • Check your blood sugar level 15 minutes after drinking a glass of sweetened drink

    After 15 minutes, check blood sugar level.

  • For persistent hypoglycaemia symptoms, drink half a glass of sweetened drink and check sugar level after 15 minutes

    If symptoms persist or blood sugar level is low (< 4 mmol/L), repeat steps 1 & 2 one time.

    Seek medical advice if symptoms of hypoglycaemia persist

    If symptoms persist after second attempt, seek medical advice (if your doctor is unavailable and it is an emergency, head to the A&E).

    If symptoms resolve or
    blood sugar level is ≥ 4 mmol/L, go to step 3.

  • Step 3

  • Eat a light snack (e.g. bread, biscuits) or have your next meal earlier to prevent blood sugar levels from dropping again.

  • Keep a record of what happened prior to hypoglycaemia

    Record what happened prior to experiencing hypoglycaemia. If hypoglycaemia is
    frequent, do a medication check with your doctor.

How can I prevent HYPOglycaemia
(low blood sugar)
Do not skip meals even when you're busy to prevent hypoglycaemia

Do not skip meals even when busy.

Bring a few sugar-containing sweets when you go out to prevent hypoglycaemia

Bring a few sugar-containing sweets along whenever you go out

Eat extra carbohydrates before doing any exercise to prevent hypoglycaemia

Eat extra carbohydrates before any exercise or strenuous activity

Don't take diabetes medication or insulin injection in the morning when fasting for a blood test

Do not take diabetes medication or insulin injection in the morning when fasting for a blood test

Follow instructions on taking your medications to prevent hypoglycaemia

Closely follow instructions on when to take your medication, especially in relation to meals

Check with your doctor if you're experiencing hypoglycaemia frequently

If you experience hypoglycaemia frequently, check with your doctor if your medication needs adjustment

4
Hyperglycaemia high blood sugar
Common signs and symptoms of
HYPERglycaemia
(high blood sugar)
Increased thirst is a common sign and symptom of high blood sugar

Increased thirst

Frequent urination is a common sign and symptom of high blood sugar

Frequent urination

Increased hunger is a common sign and symptom of hyperglycaemia

Increased hunger

Blurred vision is a common sign and symptom of hyperglycaemia

Blurred vision

Headaches are common signs and symptoms of hyperglycaemia

Headaches

Weight loss is a common sign and symptom of hyperglycaemia

Weight loss

Slow-healing cuts are common signs and symptoms of hyperglycaemia

Slow-healing cuts

A blood sugar level of greater than 15 mmol/L is a common sign and symptom of hyperglycaemia

Blood sugar level > 15 mmol/L

If you experience HYPERglycaemia symptoms
or your blood sugar level is high (> 15 mmol/L)
1
If you experience hyperglycaemia check your blood sugar level more often

Check your blood sugar level more often

2
Drink plenty of water if you experience hyperglycaemia

Drink plenty of plain water

3
Seek medical help if your blood sugar level is persistently very high

Seek medical advice if your blood sugar level is persistently > 15 mmol/L (i.e. remaining very high for more than 24 hours)

5
Regular checkups
Go for your regular check up to detect and
prevent complications

The frequency of tests may vary depending on your condition

Assessment/Test
At least every 3 to 6 months
  • Weight and height (BMI)
  • Blood pressure
  • HbA1c (blood sugar)
  • Stress, emotional well-being
Assessment/Test
At least once a year
  • Lipid profile (cholesterol)
  • Kidneys
  • Eyes
  • Feet
Regular checkups prevent complications like kidney failure

Kidney failure

Regular checkups prevent complications like blindness

Blindness

Regular checkups prevent complications like amputation

Amputation

Regular checkups prevent complications like heart attack

Heart attack

Regular checkups prevent complications like stroke

Stroke


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