Studies in various parts of the country have indicated that the single blood-glucose measurement, done in the physician’s office every few weeks or months, is still the most common method of diabetes management in the United States. However, other studies have demonstrated the futility of this type of management, and more and more people are being treated by physicians who weigh the results of self testing of blood glucose (SMBG) and glycosylated hemoglobin of some form (such as HgAic or HgAi), rather than having a single blood-glucose measurement done.
The philosophy of obtaining a fasting or postmeal blood-glucose measurement in the doctor’s office is that blood glucose is relatively stable and that the measurement obtained thus reflects the level over the past few weeks and predicts the level for the next few weeks. Nothing could be further from the truth. We reviewed a patient’s chart recently and found the following office blood sugars at 3-month intervals: 217, 67, 197, 46, and 125 mg/dl.
If management is based on these measurements, the medicine would have been increased at blood sugars of 217 and 197, decreased at 67 and 46, and kept the same at 125. In actual fact, in comparison with the HgA1c the blood-sugar (glucose) averages obtained through self testing were about the same for each visit, indicating that there was no need for any change in the diabetes medication. Blood sugar is constantly changing, so a blood-sugar test in the doctor’s office measures the blood sugar only for that moment in time.
The frequency of self-blood testing suggested that testing is different for different clinics. Researchers have shown that the more testing done (and responded to), the better the control and the fewer the complications. Lower blood-glucose levels are found before each meal and at bedtime. Higher blood sugars are found after meals. One hour after a meal, the blood sugar would be higher than 2 hours after a meal. If a person could remember to test for blood-sugar levels on arising and 2 hours after a meal, more information for control would be obtained than if the more easily remembered pre meal and bedtime blood-sugar tests are used.
Again, physician preference may guide the person into testing one way or another that is, testing the fasting blood sugar and 2 hours after each meal, or before meals and at bedtime. If the physician does not ask you to do blood-sugar tests at home but does them in the office only, be suspicious that you are not receiving the best of care as recommended by the American Diabetes Association and the American Association of Diabetes Educators.
By: Robin Brain
Posts Tagged ‘Diabetes Management’
Diabetes – Frequency of Testing Diabetes
April 4th, 2010Diabetic Meal Planning Is A Must For All Diabetes Sufferers!
March 4th, 2010
Healthy eating through diabetic meal planning is an important aspect of diabetes management. In most cases, your doctor is likely to recommend a dietitian or a diabetes educator to help you with your diabetic meal planning. A meal plan will be developed according to your specific needs such as the kinds of foods that you enjoy and current lifestyle. In addition, your meal plan will also focus on controlling calories to help you lose excess weight if you are facing obesity issues.
When you have type 2 diabetes, the type and amount of food you eat and when you eat affects your blood sugar levels. Blood sugar levels go up after eating. You should try to eat about the same amount of food at about the same time each day to keep you blood glucose near normal levels. If you eat a big dinner one day and a small dinner the next, your blood glucose levels may fluctuate too much.
You should note that there is no single diabetes diet that is right for everyone. However, there are a few points that you should remember during your diabetic meal planning. Firstly, carbohydrates are especially important because they have the largest influence on blood glucose. You should eat about the same amount of carbohydrate-rich foods at about the same time each day. For instance, you can consume foods such as fruits, milk, starches (whole-grain bread, cereal or rice) and starchy vegetables (corn or potatoes) during your meal times. In addition, ensure that your starches come from whole grains because they contain fiber and many other nutrients and are digested and absorbed by the body more slowly than refined starches. This can help to maintain a steady glucose level in your body.
Another important aspect of diabetic meal planning involves the appropriate ratio of total calories to nutrients such as proteins and healthy fats. Depending on you circumstances, your dietitian may recommend slightly different percentages for you. The typical recommendations for the ratio of total calories to nutrients are as follows:
1. 45 to 65 percent consisting of carbohydrates
2. 12 to 20 percent consisting of proteins
3. 10 to 30 percent consisting of fats
In addition, you should limit your intake of foods that are high in cholesterol, such as egg yolks. Avoid high-fat foods and sweets because they provide a lot of calories but few nutrients. Keeping track of your calories intake can help you keep your blood sugar at as steady level and help you make adjustments for reaching weight goals.
By following the above guidelines, you should be able to easily develop an appropriate meal program to control your glucose level. Most important of all, you really have to diligently follow the plan for effective results to be seen from diabetic meal planning!
By: Sky Joe
