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Diabetes is common, but many people don’t know they have it. According to recent data from the Centers for Disease Control and Prevention, there are 37.3 million diabetic people in the U.S., but 8.5 million remain undiagnosed,¹ ² while another 96 million people have prediabetes,³ which is essentially the same condition at an earlier, often reversible stage.
Whether you already know you have diabetes, suspect you may have diabetes, or simply want to assess your risk so you can prevent diabetes, there are at-home testing tools that can help.
What are my diabetes home testing options?
There are two broad categories of common at-home tests:
- Diabetes screening tests: Screening test kits are single-use tests designed to assess your risk of diabetes or prediabetes. Typically they measure fasting blood glucose (how much sugar is in your blood after fasting) and hemoglobin A1C (HbA1c), which is an average measure of blood sugar over several months. Results reveal whether your levels are normal or elevated and can help your doctor make a prediabetes or diabetes diagnosis.
- Blood glucose monitoring devices: Blood glucose monitoring devices such as glucometers and and continuous glucose monitors (CGMs) are daily tests for people who’ve already been diagnosed with type 1, type 2 or gestational diabetes. They’re portable or wearable devices that are used to periodically check glucose, or sugar levels, allowing you to see how your meals, habits and medications affect you, so you can make adjustments and stay in a healthy range.⁴
Why do I have to test my blood sugar?
Testing fasting blood sugar levels and HbA1C with a screening test helps assess your risk (although, your doctor may call for additional testing, like a glucose tolerance test, before making a diagnosis).⁵ And if you’ve already been diagnosed, using a glucose monitoring device is the most important thing you can do to manage your condition.⁶
Many factors can cause your sugars to rise or fall.⁷ Regularly testing with a glucose monitoring device can tell you:⁸ ⁹
- if your blood sugar levels are too high or too low.
- how different foods (and combinations of foods) affect your levels.
- how meal size impacts your blood sugar.
- how your level of physical activity impacts your levels.
- how factors such as sleep quality, stress, illnesses and even your menstrual cycle impact your blood sugar.
- whether you may need to increase or decrease diabetes medications.
- whether you’re making progress on your diabetes management or prevention goals.
With this information, you can make targeted adjustments to your meal composition, portion sizes, exercise routine, daily habits and — with the help of your doctor — to your medication(s), to keep your levels in a healthy range. With the right changes, prediabetes may even be reversible.
When should I test my blood sugar?
Test first thing in the morning if you’re using a diabetes screening test to measure fasting blood glucose levels. These tests often instruct you to avoid eating or drinking anything besides water for at least eight hours prior to testing. Although there is no need to fast before an HbA1C test, you’ll be instructed to do so if your test is also looking at fasting blood glucose (as imaware’s does).
As for monitoring devices, your doctor or endocrinologist will tell you when and how often to test based on individual need (if you have type 1 diabetes or take insulin, you’ll typically test more frequently.)¹⁰ According to the Centers for Disease Control and Prevention, these are the most common times for testing blood sugar:¹¹
- When you first wake up (before eating and drinking)
- Before meals
- Two hours after meals
- At your bedtime
- Before and after you’re physically active (if you take insulin)
Keep in mind that with continuous glucose monitors (CGMs) — wearable devices that automatically test blood sugar every few minutes using a sensor inserted under the skin — you can view your readings at any time without needing to repeatedly test.¹²
How does a diabetes home test work?
At-home tests assess a small sample of blood, often (but not always) from your fingertip. Here’s what to expect from each:
- Screening test kits: Most at-home diabetes test kits include a lancet for pricking your finger, a container for collecting a small sample of blood and instructions for mailing your sample to the lab. Typically, once your results are reviewed by a physician, they'll be made available to you along with feedback on suggested next steps, such as following up with your doctor.
- Fingerstick blood glucose meters (glucometers): Blood glucose meters are small handheld devices with an opening for a test strip and a prominent digital display. After washing your hands, place a new test strip in the glucometer. Then, use a lancet to prick your finger and place a small drop of blood onto the end of the test strip. Within a few seconds, a blood sugar reading will appear. Record your results and make notes about anything that may have pushed you out of your target range.¹³ Some glucose meters allow you to store and export your results for easier tracking.
- Continuous glucose monitors (CGMs): Continuous glucose monitors are blood glucose meters that stay attached to your body. They’re often attached to your belly or upper arm and they automatically test your sugars every few minutes using a sensor inserted under the skin. Newer CGMs transmit these readings to a smartphone so you can track your levels whenever you want. You can even set them to trigger an alarm if your blood sugar goes too high or too low. Depending on your CGM model, you’ll have to replace the sensor every three to seven days.¹⁴
Why is regular testing important?
Alongside targeted dietary and lifestyle changes, regular screening if you’re at risk of diabetes — and blood sugar monitoring if you already have it —can help prevent or delay serious complications such as heart disease, high blood pressure, heart attack, stroke, kidney disease, blindness, nerve damage and serious infections that can lead to amputation.¹⁵
Is testing blood sugar at home accurate?
Yes, you can receive accurate screening results from an at-home test; most people monitor blood glucose levels themselves, but some systems are more reliable than others.
Screening for diabetes at home
Look for screening kits that have Clinical Laboratory Improvements Amendments (CLIA) and Certified Analytics Professionals (CAP) certification, and that offer physician-reviewed results.
It’s important to understand that while screening tests can lead to diagnosis, they are not diagnostic. In other words, you’ll still need to talk with your doctor, who will consider your personal risk factors alongside your results before either diagnosing you or suggesting more testing.
Testing blood sugar at home
Currently, blood glucose meters are the gold-standard of at-home diabetes management and are usually accurate when used correctly. Extreme temperatures, dirt or alcohol on your skin, expired test strips, or too many or too few red blood cells in your sample (due to dehydration or anemia) can all lead to incorrect results. Always follow manufacturer instructions for using and maintaining your device, and try warming up your hands before testing, to improve blood flow.
CGMs are usually fairly accurate, but not as accurate as traditional glucose meters. For this reason, you can’t rely on CGMs alone to make treatment decisions, according to the National Institute of Diabetes and Digestive and Kidney Diseases.¹⁶ You need to perform fingerstick tests often — and especially when you see numbers that look much higher or lower than your average — to confirm the accuracy of your CGM.
What should my blood sugar levels be?
Your ideal level will depend on when you’re testing, your current health status and age. Your doctor can help determine your target range, but here are some typical targets (measured in milligrams per deciliter):¹⁷
- Fasting blood sugar: Below 100 mg/dL (100-125 mg/dL may indicate prediabetes and >125 mg/dL may indicate diabetes).
- Two hours after a meal: Below 180 mg/dL.
An HbA1c test, which is part of many diabetes screening test kits, measures blood sugar as a percentage — the higher the percentage, the higher your average over the last three months. Here’s how doctors typically interpret HbA1C results:¹⁸
- Normal: Below 5.7% (although, some healthcare professionals believe optimal levels are between 4.5% and 5.3% and that negative effects — including increased risk of cardiovascular plaque deposits and heart disease — may begin as low as 5.4% in some individuals).¹⁹
- Prediabetes: 5.7% to 6.4%.
- Diabetes: 6.5% or higher.
If you already have diabetes, the general recommendation is to keep your HbA1C below 7%.²⁰
What should I do if I test positive for diabetes?
At-home diabetes screening tests or monitoring devices aren’t intended for self-diagnosis, but they do provide important data to help your healthcare professional determine the next steps. If you’re diagnosed with diabetes or prediabetes, your treatment plan may focus on lifestyle changes — improvements to diet, fitness, stress and sleep — or it may include medications to help control your blood sugar levels.²¹
Summary
When used correctly, at-home diabetes tests can aid in the prevention, diagnosis and management of diabetes. Together with your healthcare professional, you can use the results of a diabetes screening test to assess your diabetes risk. If you have already been diagnosed with prediabetes or diabetes, a blood glucose monitoring device will help you monitor your results in real time, and adjust your diet and lifestyle habits to minimize complications.
