Managing Your Diabetes
Controlling diabetes is all about keeping control of our blood glucose levels. The problems of diabetes are caused when your control slips.
Blood glucose (sugar) monitoring is an important part of the management of diabetes. It allows a profile of glycaemic control to be identified which the patient or Health Care Professional (HCP) can use to adjust dietary intake and drug treatments. Furthermore, self blood glucose monitoring (SBGM) is a useful tool for patients to identify the effects of treatment, diet, exercise and sickness such as infections on blood glucose levels and give them greater insight into their disease.
The normal range of fasting blood glucose for people without diabetes is 3 - 5 mmols/l whilst a random blood glucose level should be less than 7 mmols/L. In the person with diabetes blood glucose levels are elevated unless treatment is instituted. One of the aims of treatment is to achieve normoglycaemia or blood glucose levels as near normal as possible.
Health Care Professionals such as the doctor, nurse or dietitian often request that patients test their diabetes blood glucose levels over an extended period of time. Single results give little information about overall control. Furthermore, a variety of results offers information to spot trends and patterns which is more meaningful in assessing glycaemic control. The results may be documented in a diary or blood glucose chart which is then reviewed in conjunction with food intake, medication changes and activity.
Fasting blood glucose levels provide a simple, inexpensive way of monitoring glycaemic response to diet. In the UK, the range for fasting blood glucose for people with diabetes is 4 - 7 mmols/L. Another way to assess blood glucose levels is to test two hours after every meal. The target range is between 6 - 9 mmols/L. Blood glucose levels can fluctuate throughout the day in response to drug therapy, diet and exercise but the overall aim is to achieve near normal blood glucose levels.
Understanding the reasons for fluctuations in blood glucose can influence the need for change of behaviour or review of drug therapy. When the blood glucose levels are persistently greater than 10 mmols/L there should be investigations and discussion to ascertain the causes for this. Blood glucose will rise during periods of illness, high carbohydrate intake or omission of drug therapy. It is important to address high blood glucose early because the longer it is left raised, the more likely it is to cause acute and chronic complications which may require hospitalisation in both type 1 and type 2 diabetes. The deterioration in clinical status is more readily apparent in type 1 diabetes and the patient may become symptomatic and unwell in a matter of hours if the blood glucose is persistently high. Gathering all of the data including how to test, food intake and activity levels are important things to consider when managing day to day lifestyle. Several medical studies have shown that the higher the blood glucose levels, the greater the risk of damage to small blood vessels, large blood vessels and nerves. Keeping blood glucose levels within the targets of 4 - 9 mmols/L reduces the risk of complications.