What’s Glucose Management?

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Glucose management is the effort to control blood sugars by people who have diabetes or are at high risk of developing it. Part of this involves testing your blood glucose level with a home glucometer. These readings are used to assess the severity of your diabetes. Glucose levels can be too high or too low. People taking insulin use these readings to measure how much insulin they need to inject.

Glucose is the main source of energy used by the body and is obtained from carbohydrates. To be metabolized, it must first enter the bloodstream. Then, the pancreas releases the hormone insulin into the blood, so that glucose can be transported into the cells. Both factors can be disrupted by diabetes.

Symptoms of diabetes can include uncontrollable thirst, frequent urination, vision loss, numbness in the hands and feet, weight loss, and fatigue. It is typically diagnosed by the presence of abnormally high blood sugar levels. There are different types of diabetes, type 1, type 2 and gestational.

Type 1 diabetes is caused by an autoimmune disease, in which the pancreas produces little or no insulin. Patients must inject insulin before eating. With type 2 diabetes, cells don’t respond to insulin and sugar builds up in the blood. This type of diabetes is often associated with obesity and can sometimes be controlled by lifestyle changes, such as increased exercise, weight loss, and dietary modification. Gestational diabetes can occur during pregnancy and is often limited to the duration of the pregnancy, although affected women may go on to develop type 2 diabetes.

Blood glucose is measured in milligrams per deciliter (mg/dL) in the United States and millimoles per liter (mmol/L) in Canada and Europe. High blood sugar levels are known as hyperglycemia, while low levels are known as hypoglycemia. Each can be dangerous and cause coma and death to extreme levels. Glucose management involves finding a balance between these two extremes and keeping blood sugar levels in the moderate range.

Initial laboratory tests for diagnosis can indicate several conditions. A fasting glucose level of 126 mg/dL (7.1 mmol/L) or higher typically indicates a diagnosis of diabetes and that glucose management is in order. Fasting blood sugar levels between 100-126 mg/dL (5.7-7.1 mmol/L) may indicate prediabetes, a predisposition for type 2 diabetes. People with the condition often try to manage their blood sugar levels to avoid contracting the disease.

Much of glucose management involves monitoring with home glucose meters. Diabetics generally take a glucose test at least once a day and test their glucose after waking up to give a fasting blood sugar level. Strive to keep these levels between 80 and 100 mg/dL (4.5 and 5.7 mmol/L). Persistent fasting blood sugar levels of 230-270 mg/dL (13-15 mmol/L) indicate that the person should seek immediate medical attention. Alternatively, hypoglycemic levels below 70 mg/dL (3.8 mmol/L) are dangerous and should be treated with an immediate dose of glucose tablets or a sugar-rich food.

Many people retest two hours after eating. Some randomly test during the day. People taking insulin generally test themselves before eating to know how much insulin to inject, although automatic insulin pumps are becoming more common.
Regular blood glucose monitoring allows the person to monitor the effects of changes in diet and exercise. This can help manage diabetes. Regular testing is especially important since there are generally no symptoms for high blood sugar and tests are needed to detect it. It is important to keep a record of your blood sugar levels to share with your doctor.
Blood glucose readings may vary throughout the day. More reliable blood sugar readings are provided by a laboratory test for glycosylated hemoglobin. Hemoglobin is a protein in the blood that carries oxygen, and this test measures the percentage of hemoglobin bound to sugar. The reading provides the average for the past three months. For non-diabetics, the average is 4-6%, and for diabetics, readings below 6.5% indicate good blood sugar control.

If glucose management is neglected when blood sugar levels are high, symptoms can be severe. Diabetes is a strong risk factor for cardiovascular disease and diabetics are often treated as heart patients. Other side effects can include severe kidney damage, blindness, amputation, and chronic nerve pain. If blood sugars are kept in check, however, the chances of complications are greatly minimized.

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