If a person has diabetes, it is necessary to measure the level of glucose in the blood, there are two basic therapeutic facts:

First, monitoring blood sugar (glucose) and determining high or low blood sugar levels is necessary to know the success of the current treatment plan, by monitoring the effect of diabetes treatment drugs on blood sugar levels, it provides important information about how. managing diabetes management on a daily, sometimes hour-by-hour basis; Especially when receiving insulin therapy. It also monitors progress toward meeting treatment goals.

Second, understand how diet and exercise affect blood sugar levels. Understanding how other factors, such as fluctuations in health, illness or stress, affect blood sugar levels. The results of glycemic control help inform decisions about what a diabetic should eat, diet by diet, how much physical activity they can do, and how much insulin they should take.

blood sugar

It is known that many things can affect blood sugar. Some of them can be learned to predict their effects, with the practice of measuring time and blood sugar, while others are more difficult or unpredictable. That is why it is important to check your blood sugar regularly as advised by your diabetes doctor.

High blood sugar: For example, the following conditions commonly cause high blood sugar levels:

Eat carbohydrates, whether they are sugar (single or double carbohydrates) or no sugar (complex carbohydrates).

Not taking enough diabetes medications or insulin or not taking the first dose.

Less exercise or less activity than you normally do.

Take corticosteroid medications (cortisone derivatives).

Sudden illness (eg, respiratory or urinary tract infection) or surgery.

The dawn phenomenon is a phenomenon in which blood sugar levels rise in the morning. This is believed to occur as a result of lack of sleep, and the body works to eliminate this by conducting several biochemical processes in the body, leading to high blood sugar. This is indicated in the morning when you measure your glucose. There are several medical explanations for the causes of this phenomenon in some diabetics.

– Smoking

– Dehydration of the body due to lack of fluid.

Low blood sugar: The following conditions can cause low blood sugar:

Does not eat food for any reason.

Taking large amounts of insulin or medications to treat high blood sugar.

– Excessive physical activity without compensating for hypoglycemia.

> High and low blood sugar: Blood sugar levels can rise or fall, depending on many interrelated and overlapping factors in their effects:

Menstrual period during the menstrual cycle.

Improper timing of insulin or diabetes medication intake with meal timings.

Interactions and adverse interactions between diabetes medications and other medications that diabetics may take.

And because of these various factors in their effects on blood sugar, it is necessary to monitor the blood sugar of a diabetic patient by measuring its percentage in the blood; Simply put, this is the only way to make sure your blood sugar levels are changing.

Checks sugar level

Mayo Clinic doctors explain this: “The doctor will tell you how often to check your blood sugar. The frequency of testing usually depends on the type of diabetes and the treatment plan.

Type 1 diabetes: For example, if you have type 1 diabetes, your doctor may recommend that you check your blood sugar 4 to 10 times a day. Therefore, the patient may need to be tested for:

Before the main meal and snack.

Before and after exercise.

– Before sleeping.

At night (sometimes).

Often if you are sick.

Change your daily routine frequently.

A higher rate if you start taking a new drug.

Type 2 diabetes: They add: “If you’re receiving insulin to control type 2 diabetes, your doctor may recommend checking your blood sugar several times a day, depending on the type and amount of insulin you’re using. If you’re getting multiple injections each day, usually before meals.” or bedtime testing is recommended. If you use intermediate- or long-acting insulin, you may only need to test before breakfast and sometimes before dinner or bed. If you are trying to control type 2 diabetes with non-insulin medications or diet and exercise, your blood It is not necessary to check sugar daily.

Home Monitoring: There are two main ways to monitor your blood sugar at home:

Using a hand-held electronic device called a blood glucose meter, prick your finger and get a drop of blood.

Use of a continuous glucose monitoring device (CGM).

According to the advice of the attending physician, a diabetic patient may choose one or both of the two methods for several reasons:

– Physical capacity and availability of any equipment.

– Ability to use any of them efficiently (from patient or household member).

Age of the patient

Diabetic status of the patient.

How often does your doctor recommend checking your blood sugar?

General health status of the patient.

Target measurements

A doctor determines the correct blood sugar level for a diabetic patient (not a healthy person), which means that treatment targets measures to control blood sugar levels. The doctor sets the target readings for blood sugar based on several factors, the most important of which are:

Type and severity of diabetes.

– Age range.

Duration of diabetes.

Complications of diabetes.

– General health status and extent of other medical conditions in the diabetic patient. In general, the American Diabetes Association (ADA) recommends the following target blood sugar levels:

Before meals, 80 to 130 milligrams per deciliter (mg/dL), or 4.4 (four point four) to 7.2 (seven point two) millimoles per liter (mmol/L).

Two hours after a meal, it is less than 180 mg/dL (10 mmol/L).

But as a practical approach, the American Diabetes Association explains that these goals often vary depending on the patient’s age and their personal health. Therefore, therapeutic target measures of blood sugar should be established for each person individually. Therefore, some people may have slightly higher goals for controlling their blood sugar levels and specifically preventing the effects of low blood sugar:

60 years or older.

People with other medical conditions such as kidney, heart or lung disease.

Diabetic neuropathy results in a decreased ability to sense low blood sugar levels.

Using a conventional device

Using a conventional glucose meter requires a small blood sample, usually taken from a fingertip. This drop of blood is then placed on a single-use tape measure. According to Mayo Clinic doctors, the right way to do this is to:

– Wash and dry your hands thoroughly. (Food and other substances can cause false readings.)

Insert the tape measure into your scale.

Prick your fingertip with the needle (lancing device) provided with the measuring device.

Touch the edge of the tape measure to the spot of blood while holding it.

– The meter will display your blood glucose level on the screen after a few seconds.

They say blood glucose meters should be used and maintained properly. Follow these tips to ensure proper use:

Consult your device’s user manual for instructions, as steps may vary from one device to another.

– Use only test strips for your meter that do not expire, and store them according to the instructions provided.

– Perform quality assurance checks as directed, bring the meter to your doctor’s office to answer any questions, and show you how to use it.

Sugar testing times

Because symptoms and prediabetes may come on gradually or go undetected, the American Diabetes Association (ADA) has developed screening guidelines. He recommends testing the blood sugar of any of the following people for diabetes:

– Any person, regardless of age, with a BMI of 25 (above normal), and one of the additional risk factors (high blood pressure – disturbed cholesterol levels – physically inactive lifestyle – history of PCOS or heart disease – a presence associated with diabetes).

Anyone over the age of 35 is advised to get an early blood sugar test. If the results are normal, they should be checked every 3 years thereafter.

If the results are abnormal, it is:

> An increase in blood sugar levels sufficient to diagnose diabetes, treatment and medical follow-up begin here, and the doctor will decide when to measure blood sugar levels and repeat them.

An increase in blood sugar is enough to diagnose prediabetes, and here it is recommended to measure blood sugar once a year.

Women with gestational diabetes are advised to have their blood sugar checked every 3 years.

Continuous Glucose Monitoring Devices…Steps to Use and Follow Up

For a number of reasons, a diabetic may choose to use CGM continuous glucose monitoring devices. It measures your blood sugar levels repeatedly every few minutes with a sensor placed under your skin. The patient usually wears this sensor for a week or two and then has to replace it. There are modern variants of it, the advantage of which is that the sensor stays up to three months. It can wirelessly transmit blood sugar information from the sensor to a mobile app, smartwatch or receiver. So, if your blood sugar level rises or falls too fast, you will get an alarm. Another important aspect to watch out for and deal with is that some medications (as simple as acetaminophen or Tylenol for pain and fever relief and Ventolin for asthma) can affect accuracy. Readings from some continuous glucose monitors. Although most of them can occur when using older models of glucose monitoring devices, even with modern models it can happen when taking certain types of drugs. Therefore, the doctor takes precautions when the patient needs to take certain types of drugs. Based on the accuracy of the measurements, it is recommended to measure blood sugar using a traditional blood glucose meter. It is worth consulting a diabetologist about using a continuous glucose monitoring device if the woman is pregnant or a patient. Undergoing dialysis, or have any advanced disease that may affect the accuracy of blood glucose readings on continuous glucose monitoring devices.

* Consultant in Internal Medicine