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 the glucose level in the blood with a home glucose meter. These readings are used to gauge the severity of the diabetes. Glucose levels can be too high or too low. People that take insulin use these readings to gauge the amount of insulin they need to inject.
Glucose is the primary energy source utilized by the body, and is obtained from carbohydrates. For it to be metabolized, it must first enter the bloodstream. Then, the pancreas releases the hormone insulin into the blood, so the glucose can be transported into the cells. Both factors can be disrupted by diabetes.
The symptoms of diabetes may 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 several 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 themselves with insulin before eating. With Type 2 diabetes, the cells do not respond to insulin, and sugar accumulates in the blood. This type of diabetes is frequently associated with obesity and can sometimes be controlled by lifestyle changes, such as increased exercise, weight loss, and diet modification. Gestational diabetes can occur during pregnancy and is often limited to the duration of the pregnancy, although affected women can go on to develop Type 2 diabetes.
Glucose is measured in the blood 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 at extreme levels. Glucose management involves striking a balance between these two extremes and keeping blood sugar levels in the moderate range.
Initial lab 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) can indicate prediabetes, a predisposition for Type 2 diabetes. People with this condition frequently try to manage their blood sugar levels to keep from getting the disease.
Much of glucose management involves monitoring with home glucose meters. Diabetics generally perform a glucose test at least once daily, and test their glucose after waking to give a fasting blood sugar level. They 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 food high in sugar.
Many people test again two hours after eating. Some test randomly throughout the day. People taking insulin generally test themselves before they eat to know how much insulin to inject, although automatic insulin pumps are becoming more common.
Monitoring blood sugar regularly allows the person to track the effects of changes in diet and exercise. This can help to manage diabetes. Regular testing is especially important since there are generally no symptoms for hyperglycemia, and testing is required to detect it. It is important to keep records of the blood sugar levels to share with one’s doctor.
Blood sugar readings can vary over the course of the day. More reliable blood sugar readings are given 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 that is bound to sugar. The reading gives the average for the past three months. For non-diabetics, the average is 4-6%, and for diabetics, readings under 6.5% indicate good blood sugar control.
If glucose management is neglected when blood sugar levels are high, the symptoms can be severe. Diabetes is a strong risk factor for cardiovascular disease, and diabetics are often treated like heart patients. Other side effects can include severe kidney damage, blindness, amputation, and chronic nerve pain. If blood sugars are kept under control, however, the chances of complications are greatly minimized.