Your Logbook: How to write the book on good control
How to write the book on good control
When it comes to controlling your blood glucose levels, one book will serve you better than any other—the one you write yourself! Once you understand how your glucose numbers reflect what you’re doing, feeling and eating, your logbook can become your best tool for solving your diabetes mysteries and mastering glycemic control.
Tracking A1C levels isn’t enough
Do you really need a logbook if your doctor tests your A1C level every few months? You do, says Christine McKinney, a certified diabetes educator at the Johns Hopkins School of Medicine.
Your A1C level provides a 30,000-foot view of your glucose level over two to three months. But it doesn't tell you when and why, on any given day, your glucose level may be too high or too low. Without testing and recording those levels daily, McKinney explains, your blood glucose level "could be consistently high before dinner and you wouldn’t know it. Later, if your A1C is above the recommended 6.5 percent*, you won’t know why and where to look for clues to get it within range."
Testing regularly will get you started
The benefits of keeping a log go beyond getting an accurate record of your glucose levels. Studies show that people who closely monitor their glucose levels by testing regularly can reduce A1C levels and the risk of diabetes complications like eye and kidney damage, heart attack and stroke.
But testing alone won’t lower your A1C—you need to know what your blood glucose levels are, day in and day out, and record them so you have the information to make good decisions. Your doctor or diabetes educator can help determine a testing schedule that’s right for you.
Complete the picture with your notes
Testing regularly and recording the results provide only half the clues you need to understand your body’s glycemic responses. Adding relevant notes to the numbers in your logbook completes the picture.
“A logbook with the proper information in it can help you understand how food, stress, exercise, sickness and medications affect your glucose levels,” says McKinney. For example, if you treat yourself to a piece of cake at lunch one day, write it down in your logbook. Another day, if you spend your lunch hour doing errands and skip lunch, write that down, too. Both of these situations may affect your glucose levels later. Also note any adjustments in insulin timing or dosage you make based on your test results.
Look for trends
Having this information in your logbook may help explain any trends in your glycemic responses and indicate where you need to focus your efforts (a trend is three consecutive high or two consecutive low blood glucose readings). If you notice your glucose is generally too high before dinner, perhaps exercising after lunch can help. Or if it’s too low when you wake up, maybe having a snack before going to bed will get your morning levels back on target.
To get the most out of your monitoring, you need to be flexible. This may mean testing your postprandial (after-meal) glucose for a while rather than preprandial (before meal) levels, or testing at different or additional times of the day. “Even a week’s worth of readings can be helpful,” says McKinney. Always talk with your doctor or diabetes educator before changing your testing schedule.
Share the results
Once you’ve recorded your glucose levels and notes, share them with your doctor and diabetes educator. They can help you spot trends in your glucose levels and make any needed adjustments in your diabetes management habits. You’ll soon become adept at recognizing factors that affect your glucose levels and adjusting food, insulin and physical activity as necessary to keep them at target.
Top tips to avoid glucose highs and lows
- Test regularly. Talk to your doctor or diabetes educator to develop a testing schedule that’s right for you. Take your logbook to every appointment.
- Add context to your meter readings. If you ate a late lunch one day, most meters won’t tell you whether that day’s 3 p.m. reading was taken right after lunch (when blood glucose may spike) or two hours after lunch (when it should be in your target range). It’s still important to write the results, with your notes, in a logbook.
- Make your logbook your own. Your logbook tells a personal story that will help you manage your diabetes. Get a free logbook at your doctor’s office, use one supplied with your glucose meter or buy one in a format that’s easy for you to use and carry.
- Go high-tech. Most meters let you download results into a program on your desktop or laptop. To learn more about this feature of your meter, call the toll-free telephone number on the back of your meter.
*As recommended by the American Association of Clinical Endocrinologists.