Managing Diabetes: Importance of Regular Blood Sugar Monitoring, Understanding Diet and Exercise’s effects on Glucose Levels

Managing Diabetes: Importance of Regular Blood Sugar Monitoring, Understanding Diet and Exercise’s effects on Glucose Levels

2023-06-03 00:31:18

When a person has diabetes, and the need to measure the level of glucose in the blood, there are two basic therapeutic facts:

The first is that monitoring blood sugar (glucose) and determining high or low blood sugar levels is essential to know the success of the current treatment plan, by monitoring the effect of diabetes treatment drugs on blood sugar levels, as it provides important information about how managing diabetes management on a daily basis, sometimes hour by hour; Especially when receiving insulin treatment. It also tracks progress in achieving therapeutic goals.

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

Blood sugar

It is known that several things can affect blood sugar. Some of them can be learned to predict their effects, with time and practice of measuring blood sugar, while others are very difficult or impossible to predict. This is why it is important to check your blood sugar regularly, according to the advice of your diabetes doctor.

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

Eat carbohydrates, whether they are sugary (single or dual carbohydrates) or not sugary (complex carbohydrates).

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

Less exercise, or less activity than you normally do.

Take corticosteroid medications (cortisone derivatives).

Sudden illness (for example, respiratory or urinary tract infections) or surgery.

Dawn Phenomenon, which is a phenomenon in which blood sugar rises early in the morning. It is believed that this occurs as a result of a decrease in sleep, and the body works to remove this by conducting several biochemical processes in the body, which lead to high blood sugar. This is noted in the morning when you measure your glucose. There are several medical explanations for the reasons for this phenomenon in some diabetics.

– smoking

– Dehydration of the body due to lack of fluid availability.

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

Not eating meals, for any reason.

Taking high doses of insulin or medications to treat high blood sugar.

– Excessive physical activity, without compensating for the decrease in blood sugar.

> High and low blood sugar: There are cases in which the blood sugar level may rise or fall, based on several intertwined and overlapping factors in their effects, such as:

Menstrual period during the menstrual cycle.

Imbalance in the timing of receiving insulin or diabetes medications, in accordance with adjusting the times of eating meals.

Interactions and adverse interactions between diabetes medications and other medications a diabetic patient may take.

And because of all these different factors in their effects on blood sugar, it is necessary to monitor blood sugar in a person with diabetes, by measuring its percentage in the blood; Simply put, it’s the only way to make sure your blood sugar levels are changing.

Checking sugar levels

Mayo Clinic doctors explain this by saying: “The doctor will tell the number of times to check blood sugar levels. The frequency of testing usually depends on the type of diabetes and treatment plan.

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

Before main meals and snacks.

Before and after exercising.

– before sleep.

During the night (sometimes).

More often if you are sick.

More often if you change your daily routine.

At a higher rate if you start taking a new medication.

Type 2 diabetes: They add: “If you are 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 use. The test is usually recommended before meals or at bedtime if you receive many injections each day. You may need to test only before breakfast and sometimes before dinner or bedtime, if you are using intermediate or long-acting insulin. And if you’re trying to control type 2 diabetes with non-insulin medications or just diet and exercise, you may not need to test your blood sugar daily.

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

Using a portable 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 consultation with the attending physician, the diabetic patient can choose either or both of the two methods for several reasons, such as:

– Physical capacity and availability of any devices.

– The ability to skillfully use any of them (whether from the patient or a household member).

The patient’s age

The patient’s diabetes status.

How often does the doctor recommend checking your blood sugar?

The patient’s general level of health.

Target measurements

The doctor determines for the diabetic patient (and not for the healthy person) the appropriate blood sugar range for him, that is, the therapeutically targeted measures for the blood sugar level. The doctor sets the target measurements for blood sugar based on a number of factors, the most important of which are:

Type and severity of diabetes.

– the amount of age.

Duration of diabetes.

Complications due to diabetes.

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

Before meals, between 80 and 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 how old the patient is and their personal health. Therefore, therapeutically targeted measures of blood sugar should be established for each individual separately. Thus, some people may have slightly higher goals for controlling their blood sugar level, to prevent the effects of low blood sugar, in particular:

Those who are 60 years of age or older.

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

Decreased ability to sense low blood sugar levels as a result of diabetic neuropathy.

using the conventional device

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

– Wash and dry your hands well. (Food and other substances may cause an inaccurate reading.)

Insert a tape measure into your scale.

Prick the side of your fingertip with the needle (lancing device) supplied with the measuring kit.

Touch the point of blood with the edge of the tape measure while holding it.

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

They add that blood glucose meters should be used and maintained in an appropriate manner. Follow these tips to ensure proper use:

Refer to the instructions of your device’s user manual, as the steps may change from one device to another.

– Use only test strips intended for your meter, that are not expired, and store them according to the directions provided.

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

Sugar check times

Because symptoms and prediabetes come on gradually, or may not be easy to spot, the American Diabetes Association (ADA) has developed screening guidelines. She recommends checking the blood sugar of any of the following people for diabetes:

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

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

If the results are abnormal, it is either:

> A rise in the level of blood sugar sufficient to diagnose diabetes, and here begins the treatment and medical follow-up, and the doctor will decide when it is necessary to measure the level of sugar in the blood, and repeat it.

A rise in blood sugar sufficient to diagnose prediabetes, and here it is recommended to measure blood sugar once a year.

Women who have gestational diabetes are advised to have a blood sugar test every 3 years.

Continuous glucose monitoring devices… Steps for use and follow-up

For several justifications, a diabetic patient may choose to use CGM continuous glucose monitoring devices. It provides repeated measurements of your blood sugar level every few minutes, via a sensor placed under your skin. The patient usually wears this sensor for a week or two, and then it needs to be changed. There are modern types of it, with the advantage of staying the sensor for up to three months. It can also wirelessly send blood sugar information from the sensor to a mobile app, smartwatch, or receiver. Thus an alarm is available if your blood sugar is rising or falling too quickly. Another important aspect to note and deal with is that some medications (the simplest being acetaminophen or Tylenol for pain and fever reduction, and Ventolin for asthma) may affect accuracy. Readings from some continuous glucose monitors. Although the majority of this may occur when using old models of continuous glucose monitoring devices, this can happen when taking some types of medications, even with modern models. Therefore, the doctor takes precaution when the patient needs to take certain types of medications that may affect Based on the accuracy of the readings, it is recommended that the blood sugar be measured using a traditional blood glucose meter. It is also worth consulting the diabetes doctor about using the continuous glucose monitoring device if the woman is pregnant, or the patient is undergoing dialysis, or has any type of advanced disease that may Affects the accuracy of blood sugar readings on continuous glucose monitoring devices.

* Consultant in internal medicine

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