February 5, 2015

Help in Diabetes Management Education – Part 7

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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