More on Blood Glucose Variables

This article from the Mayo Clinic covers some of the variables that I missed in my blog here on variances in blood glucose levels. This was written by a female and covers more than I hinted at in my blog.

Most of us understand that increased carbohydrate intake or decreased physical activity will raise our blood glucose level. When these are relatively consistent, then we need to think about the other variables that will affect our blood glucose levels. And yes, hormonal fluctuations caused by illness, injury, surgery, emotional stress, puberty, menses, and menopause can affect blood glucose levels.

Physical or emotional stress – This can cause the release of hormones called catecholamines, which often cause hyperglycemia or high blood glucose. Even if you don't have diabetes, you can develop hyperglycemia during severe illness. For those of us that have diabetes, we may need more insulin or oral diabetes medications during illness or stress. This should be something you talk to your doctor about if this happens to you.

The puberty variable – For children, insulin requirements increase during growth and especially during puberty. The cause, in part, can be attributed to the growth hormone as well as the sex hormones, estrogen and testosterone.

The menstruation and menopause variable – For girls and women, these times in life present unique challenges to blood glucose management. Estrogen and progesterone can induce temporary resistance to insulin, which can last up to a few days and then drop off.

Many women report having higher blood glucose levels a few days before beginning their period. Then when menstruation begins, some women continue to have hyperglycemia while others experience a sharp drop in blood glucose levels. During menopause, women often notice their blood glucose levels are more variable or less predictable than before.

For women with type 1 diabetes, significant hyperglycemia can lead to emergency complications such as diabetic ketoacidosis or diabetic hyperosmolar syndrome. For these conditions, immediate treatment is needed. Persistent hyperglycemia puts you at increased risk for long-term complications such as cardiovascular disease, blindness, or kidney failure.

Contrary to the advice of the American Diabetes Association and the American Association of Clinical Endocrinologists, frequent testing and recording of your blood glucose values will show patterns and make it easier for you and your doctor to manage your diabetes.

Always be proactive and ask your doctor to help you establish a 'sick day plan' to help you respond in the event of illness or injury. If you experience continued hyperglycemia, don't hesitate to ask your doctor to help you adjust your diabetes treatment regimen.

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.