Part 7 of 12
This is a difficult topic to explain to
people and at the same time not confuse them. I have talked about
testing in pairs and how important this is. Again, I will advise
people to set their own goals based on what they are willing to
tolerate for blood glucose numbers. I would urge everyone to manage
their goals below or near those promoted by the American Association
of Clinical Endocrinologists (AACE).
The medication you are taking will also
affect your goals. This means that you should discuss this with your
doctor for ideas – if your doctor will allow this. Many doctors
are not knowledgeable about the diabetes medications and their
effects on the body. Most doctors refuse to allow patients to use
insulin and make insulin the medication of last resort. This means
that many doctors will harm patients by prescribing insulin only when
the complications are happening and oral medications are no longer
effective. If your doctor has stacked (prescribed) three or more
oral medications, it is time to become knowledgeable about insulin
and seriously consider using it before the complications set in.
This blogger uses the AACE guidelines
and has some well thought out blogs about the ranges and why they are
important. Again, many doctors only follow the ADA guidelines and
become extremely anxious when patients obtain lower readings. This
is because of their fear of hypoglycemia and they have not taken time
to read many of the follow-ups to the ACCORD study. Studies are
good, but when they are using targeted participants and not a range
of different medications, they are not reliable.
I also suggest reading my blogs from
January 23, 2015 and January 24, 2015. Testing in pairs is important if you can afford
the test strips. The before meal test and the test at your best time
after meals will tell you how your blood glucose level is based on
the two tests. If your preprandial is 83 mg/dl and at 90 minutes,
your postprandial is 153 mg/dl, this means that you had a total
increase in blood glucose of 70 mg/dl. This says you ate too much
food or grams of carbohydrates. This will vary by individual and how
each body reacts to carbohydrates and the medication the person is
taking.
I try to eat between 20 and 25 grams of
carbohydrates at each meal so I would expect to have an increase of
24 to 30 mg/dl in my blood glucose level. Again this would depend on
the food, the type of carbohydrates, and how I was feeling. Always
remember to wash your hands and fingers with soap and warm water and
dry before testing.
The other factor to remember is your
health and recording this in a health log. This can have an effect
on your blood glucose. A fever can increase your blood glucose
reading and can even extra pain or stress. These are all factors
that must be resolved to know what your blood glucose increase is and
how best to treat it.
In the 70 mg/dl increase, was the count
really 70 grams of carbohydrates, or were your wife and you have a
verbal battle of some not so nice words? Were the carbohydrates the
kind that really spike your blood glucose? There is always a
variable that needs to be resolved. Sometimes it can be two or more
variables. Read my blog here for some of the variables.
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