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Glucose Monitoring for Diabetes Management
 

A very important part of diabetes management is the regular monitoring of blood glucose levels to ensure that glucose levels remain in a safe range so that you stay healthy and prevent serious complications which can result from prolonged elevated glucose levels and also prevent complications which can result from having blood glucose levels which are too low. The target glucose levels for diabetics as stated by the American Diabetes Association are:

  • 70-130 mg/dL for glucose levels tested before meals
  • less than 180mg/dL for blood glucose levels tested after meals.

Glucose levels should be monitored regularly such as pre and post meals, before taking medications and pre  and post exercise. Your doctor and other healthcare team members can give you specific guidelines on how often to measure your glucose. When glucose monitoring is combined with an effective diabetes management program which includes daily exercise, a healthy diet, keeping a fitness journal and if required diabetes medications then glucose levels can be safely controlled over the long term.

Hyperglycemia

If your glucose level is too high, called hyperglycemia, then actions can be taken immediately within the guidelines developed with your healthcare team but if your daily glucose readings are consistently high and you have been compliant with your healthcare provider’s interventions then you should evaluate your diabetes management program in its entirety with your doctor and healthcare team.

These immediate responses to hyperglycemia can be taken:

  • Modified your eating plan
  • Increased exercise because exercising muscles use glucose for energy and exercise also increases the sensitivity of insulin to better utilize the blood glucose. If your blood glucose is above 240 mg/dL then you need to complete a urine test for ketones. If you have ketones, do not exercise because in this situation exercise could cause your glucose levels to go higher. You should contact your doctor and together with your doctor determine the safest way to bring down your glucose level.
  • Take Glucose lowering medication as prescribed by your physician

To help prevent hyperglycemia, you should eat well balanced meals which are low fat, high in fruits and vegetables and high in whole grains. Also eat consistently-similar portions, the same amount of carbohydrates and eat at about the same times each day. In addition, you should make sure to take your medications at optimal times relative to meals per your doctor’s prescription and guidance.

Hypoglycemia

If your glucose level is too low-below 70 mg/dL, this is called hypoglycemia and it is very important that you treat this condition quickly. You increase your blood glucose by consuming carbohydrates equivalent to one of the following:

  • 3-4 tablets of glucose
  • 1 glucose gel serving-15 grams of carbohydrate
  • 1/2 cup of fruit juice (4 oz)
  • 1 cup of milk (8 oz)
  • 1 tablespoon of sugar or honey
  • 5 or 6 pieces of hard candy

After consuming approximately 15 grams of carbohydrate, check your blood glucose level. If you do not feel better or your blood glucose is still below 70 mg/dL then consume another 15 grams of carbohydrate. If you still do not feel better or your blood glucose remains below 70 mg/dL then you will have to take or be given the prescription injection glucagon and/or call your doctor.

If you experience hypoglycemia, write down a record of what occurred prior to the experience including the details of your exercise activities, what you ate during the day and the medication you took. Also include any special circumstances which you may have experienced prior to the event such as illness or a stressful situation.

HbA1c Test

In addition to the daily glucose checks, there is another important test which measures longer term glucose control. It is called the HbA1c Test which measures the amount of glucose attached to the haemoglobin in red blood cells. This test gives an indication of glucose control over an 8-12 week period.  Diabetics who are effectively controlling their glucose level should have an HbA1c Test result of 6.5% or lower. For diabetics who have been effectively managing their diabetes, the HbA1c Test should be completed at least every 6 months. For diabetics who have not been effectively managing their diabetes through regular glucose monitoring, healthy eating, daily exercise and medication compliance, the HbA1c Test should be performed every 3 months. The HbA1c Test is an important test for helping diabetics and their healthcare team establish, implement and evaluate the most effective lifestyle and medication interventions to achieve the best glucose control for each individual diabetic.

Glucose Monitoring Summary

If you monitor your glucose you will be able to react to episodes of hyperglycemia and hypoglycemia to help avoid complications associated with both. Additionally, you will have more information to share with your healthcare team to help ensure your prescribed treatment plan is  the most comprehensive and effective treatment plan to promote your health.  Glucose monitoring is a very important part of your over all diabetes management.

References:

http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/di19-diabetes-blood-glucose-control.pdf

http://www.rcn.org.uk/development/practice/diabetes/treatment_and_lifestyle/blood_glucose_monitoring

http://www.nlm.nih.gov/medlineplus/ency/article/003640.htm

http://medweb.bham.ac.uk/easdec/prevention/what_is_the_hba1c.htm

http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/tight-diabetes-control.html

http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hyperglycemia.html

http://www.mayoclinic.com/health/diabetes-management/DA00005/METHOD=print

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001423/

http://diabetes.niddk.nih.gov/dm/pubs/hypoglycemia/#treatment

http://diabetes.webmd.com/diabetes-hypoglycemia?page=2

 
 
 
 
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