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A Refresher is Always Good


This past week, two events led me to thinking that we should do a quick refresher. First, one of my in-laws was diagnosed with diabetes. He is in his 30’s and had lost about 30 pounds over the past two years, was always tired and thirsty, eating but not gaining any weight. He was afraid to go to his doctor because he thought he had something else worrisome, but he finally went, and turns out he has diabetes.{{more}} Second, I taught a diabetes class at my local church, and even though many people had diabetes for years, they still had many questions about some foundation issues. So let’s remind everyone about the basics.

1) How often should I be checking my blood sugars?

Overall, those taking pills only should check blood sugars 2-3 times daily when first starting on medications, and perhaps less frequently later on when blood glucose levels are stable. If you cannot check three times a day every day, then pick three days of the week when you can. Monday, Wednesday, Friday is an easy way to go.

If you are taking insulin treatments, you should be checking your blood glucose anywhere from 3-8 times per day.

If you are diet-controlled, you should check your fasting blood sugars at the very least, and ideally choose 3 days a week when you check blood sugars 2-3 times a day.

Yes, that is a lot of finger pricking, but there is no other way to know your daily pattern. The hemoglobin A1C gives us a general idea of how things are going, but it does not let us know anything about your day-to-day glucose patterns.

2) What should my blood sugar targets be?

Fasting <100mg/dL (5.5 mMol/dL) is ideal, but less than 120mg/dL(6.6mMol/dL) is a good safe target. Post-meal/random less than 140mg/dL(7.7mMol/dL) is ideal, but less than 180mg/dL(10 mMol/dL) is a safe target. 3) When should I contact my doctor between appointments (THIS IS SPECIFICALLY RELATED TO BLOOD SUGARS ONLY-there are a million other reasons you should contact your doctor)? Continued high blood sugars readings of over 300mg/dL (16.6 mMol/L) Repeated or severe low blood sugars of less 60mg/dL (3.3 mMol/dL) You have run out of medications You are vomiting and can’t keep anything down You are sweating a lot while you sleep or having many nightmares. This can be a sign of low blood sugars while sleeping. You had any episode of confusion or passing out. 5) How should I treat a low blood sugar? First, if you can, check it to be sure-symptoms of low blood sugars are not always specific. Shaking and sweating are good signs, but even they are not always related to blood sugars. I have seen them related instead to heart attacks, gallbladder attacks, strokes and all kinds of other problems. Use Liquids or gels first: juice, glucose gel, regular soda Follow with solid Carbohydrates mixed with some protein, for example half a cheese sandwich, 6 crackers and cheese, peanut butter. DO NOT over shoot. All you need is about half glass of juice, 6 crackers, two small sweets, quarter glass of soda etc to raise your blood sugars enough for you to feel and do fine. Two rotis or the whole pack of cookies is too much. Remember these starting points. They form the very basic foundation of what you need to get out on the right foot for your diabetes. Until next week, stay safe and healthy Vincies! Anita Ramsetty, MD
Medical Director Endocrine Care Group
Tel: 843-798-4227