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LOCAL DIGEST: Meaningful BG testing

Monitoring BG key to understanding diabetes

By Amy Aponick, UF Health Shands Diabetes Education Program and Nutrition Center, with contributions from Lynn Dirk

111016DIABETESAponickSecond of two parts

EDITOR'S NOTE: November is National Diabetes Awareness Month and Certified Diabetes Educator, Amy Aponick, has written a two-part article discussing diabetes and the resources available for persons with diabetes. Amy is assisting the GLOB Master on his journey from bordering on a diabetic coma to learning how to manage diabetes.

111616DiabetesTOPPERUnless we or someone we know is diagnosed with diabetes, we would likely never appreciate how dynamic and complex blood glucose (BG), or blood sugar, is—it is constantly changing in response to everything -- physical activity, sleep, stress, illness, pain, medication, and everything we eat. For those who don't have diabetes, the information here will give you insight into the amazing work our bodies do to keep us healthy – and should motivate you to keep it that way! For those with diabetes, this information is a reminder that communication with your your health care providers is of the utmost importance.

In order to manage diabetes, BG must be measured to learn how various combinations of food and amounts of carbohydrate are affecting BG.

111616MeasureHere are two ways to measure BG:

The A1C test, which is done by a blood sample and lab test and provides an average of BG over 2 to 3 months.

Self monitoring, which is done with a BG monitor at home one or more times a day.

With self-monitoring, an important principle is knowing how to interpret the results: The goal for BG value differs based on when food was consumed and when BG is measured. It is normal for BG to rise after a meal and then gradually fall toward normal over the next few hours.

With self monitoring, Good times to test BG are:

zzGLOBbullet 111616SelfMONFirst thing in the morning before any medications or food or drink ("fasting BG").

zzGLOBbullet Before meals. If breakfast is eaten relatively soon after waking up, then a fasting BG is also considered a before-breakfast BG.

zzGLOBbullet About 2 hours after meals.

zzGLOBbullet At bedtime

The American Diabetes Association (ADA) recommends the following BG values:

zzGLOBbullet Fasting and before meals: 80 to 130 mg/dL

zzGLOBbullet Approximately 2 hours after meals (~2 hours): less than 180 mg/dL

zzGLOBbullet A1c (test result is given as %): Less than 7%, which correlates to an average of BG 155 mg/dl.,

Here's an example of how the two different ways of measuring BG relate to each other: If BG is only being tested at home in the morning and is under 130 mg/dL but A1c is 7.3% (or about an average of 163 mg/dL) —then it is very likely that BG is much higher at other times of the day than in the morning. Creatively checking BG and working with healthcare providers and a diabetes educator can help a person with diabetes interpret BG results and learn how to adjust meals to improve BG control.

So a person with diabetes reading this might be wondering, "How many times a day should I be testing?" and thinking "I don't want to become a pin cushion!" The answer really depends on:

zzGLOBbullet 111616ManageCHARTDiabetes medication regimen.

zzGLOBbullet Amount of test strips covered by insurance.

zzGLOBbullet Level of BG control

zzGLOBbullet Testing plan recommended by the healthcare provider.

For example, someone who takes only one type of diabetes medication or none at all, may only need to test once a day or twice every other day. Someone who is on two diabetes medications and one insulin shot a day may need to test three times a day or more. Then there are some people who test six or more times a day—those are usually people who need multiple injections of insulin and the insulin dose depends on what the BG value is. Also, insurance coverage for test strips may depend on the type of medication regimen—some people may only receive enough test strips to test 30 times in one month..

 

111616DiabetesINSTAs indicated by the information above, diabetes can be quite complicated as if it's a different language. Diabetes education services can help interpret that language; however, not everyone is aware of these services. Therefore, if you or someone you know has diabetes and is getting discouraged or confused, you can ask a healthcare provider for a referral for this education. At UF Health it can be obtained by referral to the UF Health Shands Diabetes Education Program. Many insurance plans cover these services—contact your insurance carrier to find out what you are eligible for, talk with your health care provider,  and come see us!

In the meantime, check out the organizational web links below for more information and remember that knowledge is power in fighting diabetes!

American Diabetes Association

My Food Advisor (ADA)

Centers for Disease Control and Prevention

International Diabetes Federation

    • UF Health Diabetes Institute

 

FOLLOW THE GLOB WEB LINKS BELOW for more information about the new epidemic of Type 2 Diabetes:

zzGLOBbullet AMY APONICK HAS WRITTEN AN ARTICLE discussing diabetes and the resources available for persons with diabetes.

zzGLOBbullet THE GLOB MASTER RECREATES HIS DIABETES ADVENTURE from being hospitalized with diabetes through a recovery period of succesful outcomes, and disappointing consequences. 

zzGLOBbullet AMY APONICK EXPLAINS THE ROLE of meaningful blood glucose testing and diabetes self-management.


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