What Doctors Want Most From Patients with Diabetes: Blood Sugar Data
Your blood sugar data might as well be a gold mine to your healthcare team. That data is the information they need to help you fine-tune your insulin doses and other diabetes medications you might be taking. That data can help them help you.
Whether you check your blood sugar using a blood glucose monitor (BGM) or a continuous glucose monitor (CGM), you can share that data in a variety of ways:
- Downloading BGM or insulin pump data
- Sharing reports from your CGM app directly to your healthcare team
- Logging blood sugars and insulin doses in apps like mySugr
- Using a regular ol’ logbook and a pen
Sharing that data can be scary—it’s like a glimpse into your personal diary! Those numbers feel very personal, but taking the step to share that data can help you reach your diabetes goals.
Sharing your blood sugar data can be scary or embarrassing
“I’ve definitely had patients in the past who did not wanna share their CGM data, or just felt like they had been judged in the past by other health care providers about their blood sugar trends,” says Maya Perko, RD, CDCES who also lives with type 1 diabetes and offers diabetes coaching virtually at Maya Perko Nutrition.
“I explain to my patients that the numbers are here solely for information to help us make informed decisions around carbohydrate ratios and other dosing decisions. This is not a pass-or-fail test.”
Perko adds that many people with diabetes have never learned how to review their own CGM data. Doing so with guidance from your health care team means you’ll be more able to review it on your own, too, between appointments.
“When you learn how to read these graphs and trends, you’ll feel more like you’re in the driver’s seat,” explains Perko, always working to frame the entire discussion in a positive light.
How your blood sugar data helps your health care team help you
Looking at blood sugar data helps your health care team make critical adjustments. For example, a simple adjustment in your mealtime or long-acting insulin dose can have a big impact on your ability to reach your blood sugar goals.
“I look at the data to determine things like: are you getting enough insulin with your carbohydrate-to-insulin ratio? Are your correction doses for high blood sugars working? Does your blood sugar come down after taking that insulin?”
“But this data is just a small piece of the puzzle,” adds Perko. “I never make any suggestions without talking to the patient and getting a better understanding of what was actually happening during the day.”
There are so many variables to consider when reviewing any blood sugar level—high-fat meals, menstrual cycles, changes in physical activity, a stressful day, a day spent in the airport, etc. It’s also important to discuss when a blood sugar fluctuation just happened as a random moment of juggling so many variables versus a recurring daily event that calls for a tweak.
“But it’s really hard to give any suggestions when you don’t have the data. It’s, you know, it’s basically like flying in the dark. It’s super, super important to have either the download from your glucose meter, the handwritten logbook, or the CGM data to see the trends.”
“If we don’t talk about the details,” reminds Perko, “we can’t know what’s really going on.”
Sharing your blood sugar data even if you don’t need help
“I’m fine. I know what I’m doing. I’ve always done it this way,” says Perko, describing the mindset of patients she’s worked with who are sure they’ve got it all figured out.
If you’re reaching your blood sugar goals, then it’s a fair argument to keep your data to yourself. But chances are, things are due for a tweak. Even if you’ve been living with diabetes for decades, the advancements in insulin and technology come with a learning curve. Nearly everyone has more to learn.
In some cases, you may be experiencing frequent highs or lows that you’ve just gotten used to—you’ve told yourself this is just part of diabetes. In reality, there may be small adjustments to make that help prevent those fluctuations.
“Ultimately, I would ask this more reluctant patient if their blood sugars are where they want them to be? And if the answer is no, then it’s not gonna hurt for them to share their data with me. And I think it comes back down to reminding them that I’m here to help you.”
The most common issue revealed by blood sugar data
“There are so many different shapes of blood sugar graphs that I’ve seen and so many different patients with each of their own struggles,” says Perko. “But if I had to pick one most common issue, I would say noticing that people are not timing their insulin properly. If you’re just not taking your insulin in accordance to what you’re eating or timing it properly with that physical activity it can send your blood sugar on a roller coaster or cause a ripple effect for the rest of the day.”
For example: Helping her patients learn about adjusting meal doses for those slow-digesting high-fat meals can prevent taking too much when you start eating, dropping low, then spiking high a few hours later.
Another example: Exercising with too much insulin on board from a recent meal or correction dose of insulin can send your blood sugar crashing. Learning how to time your exercise when you have less insulin on board or adjusting your mealtime dose is critical.
Another common opportunity she sees room for improvement on is the timing of long-acting insulin for those who take multiple daily injections.
“Many people are told at the beginning to take it at night—and for many people, that works really well. But for others, it might be better to take it in the morning. This is a really common issue I can spot when reviewing blood sugar data.”
Learning to look at your own blood sugar data
“The sooner someone can learn how to look at their own blood glucose trends and learn how to look at their reports, the sooner that they can learn how to make some of these adjustments themselves, the smoother their experience is going to be. Is your correction dose working? Did the timing of insulin for your meal match with how that meal was digested?”
While Perko recommends discussing any changes in your diabetes regimen with your healthcare team, she also knows that waiting months and months to see your health care provider (HCP) isn’t realistic in diabetes management. If you’re experiencing frequent severe highs or lows, you shouldn’t be waiting months and months to take action.
“As a health care provider, working in diabetes, the best thing that we can do is get the patient to take ownership instead of just making changes for them,” emphasizes Perko. “We should be explaining to them how and why we’re making a change and really encouraging them to look at their own reports between appointments with your health care team.”
Educational content related to diabetes management is made possible with support from Roche Diabetes Care, an active partner of Beyond Type 2 at the time of publication. Editorial control rests solely on Beyond Type 2.