Life with Diabetes-Checking your blood sugars

Ah, and now we come to one of the challenges in diabetes care-the checking of blood sugars. This is probably the number one thing patients tell me they cannot get themselves to do regularly. So for all of you out there dreading the finger prick, this one is for you.{{more}}

First, we all wish there was a better way to determine blood sugars without having to use blood, but right now there isn’t one. There have been devices on the market, including a watch, that can read your estimated blood sugar through your skin, BUT it lagged behind in time and was not always very accurate. So they were not quite useful overall aside from alerting you to very low sugars at night (which is what the watch was mainly being used for). There is some work being done on reading blood sugars through your tears etc, but until that is widely marketed and proven as reliable, we are left with our basic blood sugar testing.

Why do we need to do this? Why can’t we just wait until we have blood drawn by our lab and use that level anyway? Yes, while the lab value checked as a hemoglobinA1c is valuable in terms of an average over several months, it does not tell us one thing about how your sugars do on a daily basis. You could have blood sugars all in the 90’s, versus sugars bouncing between 130 and 50, and still have the same A1c. But as you can see, those patterns are quite different and the A1C would tell us none of those details. In situations where people cannot afford ANY supplies, then there are no other options. But every other person who is on any medication for diabetes should be checking his or her blood sugars regularly.

Another important reason is that symptoms are sometimes unreliable. I have had patients swear up and down that they feel low, but when we check their sugar level in clinic it is normal or even high. Now if you feel like you are about to pass out, PLEASE by all means grab some juice or icing quickly. But otherwise, you should always check your sugars if you feel “strange”, very tired, lacking in concentration or hungry. Do not assume that as long as you do not feel normal, your sugar must be low.

A story to get your attention, true story: during my training we received news of a patient who had been hospitalized. This nice lady never seemed to check her blood sugars at all, no matter how much we pleaded with her. One day she “felt low” so she kept eating to make herself feel better. Never once did she check her sugars during the few hours that she felt unwell. Eventually she felt really terrible and went to the hospital. Turns out that her blood sugars were now high (from all the sweets she was eating) but more importantly she was feeling unwell because she was having a heart attack. It was not the low blood sugars she assumed she was having. So please, unless you are on the verge of passing out-check them!

(Continued next week)

Anita Ramsetty, MD endodocs@endocrinehelp.com
Medical Director Endocrine Care Group
www.endocrinehelp.com
Tel: 843-798-4227