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Methods of Self Monitoring in Diabetes

The main goal of diabetes treatment is to maintain blood glucose levels as close as possible to normal. Unfortunately, one can hardly feel the blood sugar drops from 4 to 10 mmol/l. That this is the perfidy of diabetes, because high blood sugar levels will inevitably lead to the development of complications. Only regular and frequent self-monitoring of blood sugar will allow you and your doctor to judge the correctness of the treatment of disease. In addition, in the home can be quite accurately determine the level of ketone bodies, glucose and protein in the urine. These indicators will also help your doctor to increase the effectiveness of therapy and prevent complications.

Patients with type 1 diabetes, especially at a young age, it is recommended to carry out daily self-monitoring of blood sugar several times a day (at least before meals and at bedtime, and periodically after eating). Patients with type 2 diabetes, the elderly, who receive diet and hypoglycemic agents may be quite a few definitions in the week, but always at different times of day. Additional measurements would be required when the normal way of life (sports, travel, co-morbidities). Always consult with your doctor how often you need to measure blood sugar.

To determine the blood sugar patients may evaluate the evidence of special test strips as the visual (eyes, by comparison with the scale-standard) and inserting them into portable devices glucometers.

In the case of a blood test for sugar in any of the following methods to obtain a blood sample in the form of drops. It is recommended to use special automatic devices to puncture the skin of the fingers, which are called lancets puncture, or handles. They operate on the basis of a spring mechanism. Injection almost painless, skin trauma, and a small wound heals quickly. Very handy device with the ability of individual selection of the depth of puncture (different position control puncture depth), depending on the thickness of the skin, which is important for children. Prior to puncture a finger to wash your hands and wipe dry with them. Puncture should be done on the side of the terminal phalanx, and not in his pillow. As to the surrounding objects touch, as a rule, fingertips, punctures in this place more painful and wounds heal worse. The resulting drop of blood is applied to the test strip, and the chemical reaction occurs that leads to a change in its color.

The use of test strips for visual inspection is a cheaper but less accurate way. In this case, the color of the test strip is compared with the color scale marked on the bottle that holds the test strip, and thus visually determine the content of glucose in the blood. The range is from 4 to 9 mmol / L corresponds to a stable compensation of carbohydrate metabolism. If the result does not fit into these limits, a more accurate determination of glucose by the meter or in the laboratory.

Blood glucose meters are portable, accurate and easy-to-use devices. Currently, there are many types of blood glucose meters. The use of the device requires no special training is only necessary to turn it on, insert a test strip and apply a very small drop of blood. When buying appliances should pay attention to two points of principle - the accuracy of the results and cost analyzes. Each unit of the same company produced a certain kind of test strips, which are suitable only for a particular meter. So you have to know exactly where you can buy more test strips to your meter and how much it will cost you an analysis. Each strip is designed for only one analysis, so the cost of one bar is the value of a single study.

Do not confuse the visual strip strips for blood glucose meters - they are completely different, but similar only in form.

In carrying out self-monitoring blood glucose levels should strive to figures close to normal, ie, fasting and before meals no more than 6 mmol / l after 1.5-2 hours after eating no more than 8 mmol / l. The recommended range of blood glucose (blood glucose target) must be installed for you by your doctor. All of the measurements it makes sense to write a special diary that you show your doctor at each visit. This blog serves as a basis for correction of the treatment.

In order to evaluate the compensation of carbohydrate metabolism, not only to conduct self-monitoring blood glucose at the required frequency. There is a special indicator that reflects the average blood sugar over the past 2-3 months. It's called glycosylated hemoglobin (HbA1c). It should be determined in the laboratory every 3-4 months. Increased glycosylated hemoglobin (above 6.5%) shows a prolonged hyperglycemia (increased blood glucose levels above normal values).

Between the level of glucose in the urine and blood there is a clear relationship. Sugar in the urine occurs when its blood level above 10 mmol / l. Hence, the situation becomes clear, which causes problems in some patients: why fasting blood sugar is good (for example, 6 mmol / l), and daily urine it is high. This means that during the day the person sugar rose well above 10 mmol / l, and so he appeared in the urine. Thus, in the case of frequent daily blood sugar control sugar in the urine does not carry any additional information and can not define.

With a lack of carbohydrates and / or insulin the body does not get energy from glucose and fat reserves to be used instead of fuel. Ketone bodies are the products of fat breakdown. Therefore, in some cases it is necessary to verify the presence of acetone (ketone bodies) in the urine. This should be done at very high levels of blood sugar (several consecutive determinations above 14-15 mg / dL), concomitant diseases, especially with fever, nausea and vomiting. This will allow time to diagnose the decompensation of diabetes and prevent diabetic coma. To determine the ketones in the urine, there are special visual test strips.

The amount of protein in the urine is determined to prevent the development of diabetic nephropathy - a very dangerous complication of diabetes. Protein in the urine comes from the damage of blood vessels and kidney dysfunction filtering. Nephropathy does not manifest itself in the early stages and therefore it is important to regularly review the microalbuminuria (minimum concentration of protein in the urine). You can pass urine to the lab or use a special test strip. In type 1 diabetes, such analyzes do one every six years, with type 2 diabetes every year.

Routine measurement of blood pressure (BP) will also help you to monitor your condition and prevent the development of nephropathy. Discuss with your doctor what level of blood pressure, you should maintain. Usually, blood pressure should not exceed 130/80 mm Hg The easiest way to measure blood pressure using an electronic tonometer.