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Skills BG Check & Treat

Diabetes Self-Care: What Does My Child Need to Know???

Part 3: Blood Glucose Monitoring and TreatmentLittle girl testing own blood sugar

For background information for this article, see:
Part 1: Introduction to Diabetes Self-Care Task Analysis
Part 2: Overview of Skills

Task Analysis for Common Diabetes Self-Care Skills:

This breakdown is an outline of skills (related to blood glucose monitoring and results) to consider when handing diabetes care over to your child. It is only a suggested starting point;  we recommend you consult your child’s diabetes health care team and adapt them for your family’s own individual situation, adding, deleting and/or further breaking down the steps as needed, to create a diabetes self-care task analysis that is individualized for you and your child or teen.

Tasks and Steps:

1. The Physical Process:

a. Washes hands.

b. Finds and opens the blood glucose monitor kit.

c. Takes the monitor out of the case.

d. Takes the strip out of the container and closes the lid.

e. Puts the strip in the monitor.

f. Takes the lancing device out of the case.

g. Preps the lancing device by pulling the spring back.

h. Chooses an appropriate test spot. (Which finger or toe will be effective? not over-used?)

i. Pricks the finger/toe:

i. Firmly places the lancing device against the skin.

ii. Pushes the button.

iii. Milks the finger or toe until blood drop is big enough.

j. Puts the strip next to the drop of blood to draw the blood into the strip.

k. Reads the resulting number accurately.

l. Determines if that number is: “within target”, “high”, or “low”.

m. Knows what to do next for blood glucose reading that is:

i. In range (no extra care needed).

ii. Low.

iii. High.

n. Returns the monitor to its case.

o. Puts the monitor case back in the place it is stored.

p. Replaces lancet when necessary:

i. Knows when to replace lancet. (ex. every 12 hrs)

ii. Decides if lancet needs to be replaced at this time.

iii. Replaces used lancet with new one, if needed.

a) Removes lancet case cover.

b) Removes used lancet.

c) Disposes used lancet in sharps container.

d) Inserts new lancet.

e) Removes protective cover from new lancet.

f) Replaces lancet case cover.

2.  Treating Lows:

a. Identifies:

i. that a blood glucose reading below 4.0 mmol/L is low, OR

ii. that he is experiencing signs and symptoms of low blood glucose; checks blood glucose to confirm or rule-out.

b. Decides on an effective source of rapid-acting sugar.
(For more information, see Level1/Basics/Lows)

c. Determines how much of that product is needed to treat the low.
(For more information, see Level1/Basics/Lows)

d. Consumes all of the product.

e. Remembers to re-check blood glucose 15 minutes later.

i. After the re-check, decides if another low treatment is needed. (That is, blood glucose still below 4.0 mmol/L.)

ii. If yes, repeats the process.

f. Decides if a supplementary carb/protein snack is needed.
(For more information, see Level1/Basics/Lows)

i. If yes, follows through with an appropriate snack.

3.  Treating Highs:

a. Detects signs and symptoms of high blood glucose; completes a blood glucose check (as above).

b. Identifies that a correction is needed when the blood glucose reading is above the target range.

c. Identifies the need to check for ketones if blood glucose greater than 14.0 mmol/L.

d. Decides how much rapid insulin is needed for the correction, by:

i. If using injections: Properly using the “sliding scale”, correction formula or correction factor and adding this to the meal rapid insulin (if it’s mealtime).

ii. If using an insulin pump: correctly interpreting insulin dosing recommendations.

What If These Steps Are Too Big?

If a step seems unmanageable for your child or teen, or if you have been trying to teach a given step without success, consider ways to break that skill down into smaller component steps, and then teach one of those sub-steps at a time.

For additional task analyses, see:

Part 4: Insulin
Part 5: Managing Insulin Pumps
Part 6: Carbs and Exercise

Any questions? Comments? Feel free to Contact Us.

The above information was reviewed for content accuracy by clinical staff of the Alberta Children’s Hospital Diabetes Clinic.

This material has been developed from sources that we believe are accurate, however, as the field of medicine (in particular as it applies to diabetes) is rapidly evolving, the information should not be relied upon, as it is designed for informational purposes only. It should not be used in place of medical advice, instruction and/or treatment. If you have specific questions, please consult your doctor or appropriate health care professional.

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