Today, young people with diabetes have every chance of a long and satisfying life without serious complications of diabetes, provided they are actively involved in its treatment. Regularly assessing physical and mental development, controlling blood sugar levels and HbA1c, children and adolescents can have a normal childhood and education.
HbA1c is a blood test that reflects average blood sugar levels over the last 4-6 weeks. Low HbA1c indicates that blood sugar was constantly well controlled. Constantly well-controlled blood sugar prevents the development of late complications from the eyes, kidneys and nerves. HbA1c should be examined at least 4 times a year. The desired result is a level below 8.5% without episodes of low blood sugar. It is often necessary to establish individual allowable values of blood sugar, especially for the youngest children and adolescents who have entered puberty.
Blood sugar test
Blood sugar should be tested 2-4 times a day. One determination must be made at bedtime to avoid low blood sugar overnight. Blood sugar should be investigated more often in unusual situations, such as comorbidities, holidays, sporting events. It is necessary to record the values of blood sugar. The record provides an opportunity to evaluate blood sugar control and is the basis for the correction of insulin doses.
Blood sugar levels should range from 5 to 15 mmol / l. Corrections for individual differences can be made by diabetes specialists.
Many people with diabetes inject insulin two to four times a day. To achieve the best results, it is important to develop a treatment plan that is most suitable for a given patient. All people with diabetes should learn how to regulate insulin doses according to current blood sugar levels. They also need to know how to regulate insulin doses in order to cope with special situations, such as birthdays, “fast food” snacks, drinking alcohol and playing sports.
Training and follow-up visits to the clinic
Training and follow-up visits to a diabetes clinic are the basis of good blood sugar control. It is very important that people with diabetes do everything they can to keep their blood sugar levels high. Supporting the surrounding people for a child with diabetes is necessary.
In addition to good home control of diabetes, a person with diabetes is involved in the treatment of their disease:
- performing all the instructions of doctors
- being honest with a diabetes specialist
- asking questions and asking for advice when you need
- Benefiting from educational materials such as courses, books and posters
DIABETES AND GOOD CONTROL OF BLOOD SUGAR IN ADOLESCENTS
Modern adolescents with diabetes have every chance to live a full and satisfying life, provided that they are actively involved in the treatment of diabetes.
How can you help yourself?
- Measure blood sugar several times a day and always before bedtime.
- Measure blood sugar in any unusual situation, such as holidays, sports activities and eating out
- React accordingly to the results of blood sugar. If they are often very low or very high, adjust the daily dose of insulin. Diabetes specialists can help, if necessary, even between visits to the clinic. The need for insulin dose adjustment cannot wait until the next visit to the clinic.
- If blood sugar is high or you expect it to increase, act! Eat less, work out more physically or add extra short-acting insulin. Be careful when choosing exactly the jokes of an additional amount of insulin - this can lead to weight gain
- A team of diabetes specialists can give advice, help. Specialists can do it better when you are honest and tell them about your problems.
- The diabetic team will monitor your HbA1c to monitor your average blood sugar over the last 4-6 weeks. Low HbA1c levels are necessary to prevent late complications.
- Eyes: ophthalmologist or examines or photographs the fundus of the eye. If there are any signs of complications, blood sugar levels should be improved and regular eye examinations should be scheduled.
- Kidney: whether they are checked for albumin in the urine. If they miss, it is very important to improve blood sugar control and to regularly measure blood pressure.
- Nerves: Your ability to feel the vibration in your fingers and your feet will be tested. If sensitivity is reduced, blood sugar control should be improved.
These examinations are performed when a child turns 9 and 12 years old. After 12 years they must be held annually.
Urine protein test (microalbuminuria)
Over time, diabetes can damage the kidneys. When blood sugar and blood pressure are well controlled, the risk of developing diabetic kidney disease (nephropathy) is very small. In the early stages of kidney disease, a small amount of albumin enters the urine. This is called microalbuminuria. If albuminuria is diagnosed early, it can be cured by improving blood sugar control. Sometimes another treatment is prescribed.
If protein leakage into the urine exceeds 20 µg / min, blood sugar control, as assessed by HbA1c, should be improved over the next 6 months. If this does not help, blood pressure lowering medications are prescribed to prevent further kidney disease. Blood pressure should be measured regularly and kept within normal limits.
Microalbuminuria research requires urine collection. Researches are made by laboratory assistants. Urine is going over two nights. A portion of each night urine is sent to the laboratory, indicating the time of collection and the total amount of collected urine.
After several years of diabetes, diabetic eye disease (retinopathy) is often noted. Early changes in the fundus (retina) are asymptomatic, and vision does not deteriorate until it is too late to begin treatment. Therefore, it is important to conduct annual surveys from puberty. Early treatment can prevent the progression of vision loss.
The primary treatment for diabetic retinopathy in its early stages is good blood sugar control, assessed using HbA1c. If eye changes are a threat to vision, laser treatment should begin.
Eye examinations begin with a routine eye exam. Then eye drops are used to expand and fix the pupil. After 30 minutes, the doctor uses special tools to examine the fundus through the pupil. The doctor can still take a photo of the retina.
Vibration sensitivity study
Diabetic nerve disease (neuropathy) is common in adults with diabetes for several years. This complication is rare in children and adolescents, but early changes are sometimes found in this age group. When diabetic neuropathy is detected in a timely manner and its treatment is started early, its further development can be prevented. The primary treatment for early diabetic nerve damage is to improve blood sugar control as measured by HbA1c measurement.
The study of vibration sensitivity does not inconvenience. The device for the study is riveted to the index finger and the big toe. The doctor asks the child to tell him when he or she starts to feel the vibration. The time when a child begins to feel vibration is measured in "volts" and must be below a certain level, corresponding to the child's age.
People with diabetes have every chance of a long and happy life if they:
- actively participate in their treatment, learning everything they can about diabetes
- examine blood sugar and regulate insulin dose accordingly
- benefit from available tutorials in order to learn how to manage glycemia well
- annually examined to identify possible complications of the eyes, kidneys, nerves and blood vessels
- Find out what patients and family members understand as “well compensated diabetes”
- Find out the knowledge of patients and their families about late complications.
- Explain how high blood sugar affects the development of late complications.
- Emphasize the importance of keeping blood sugar within normal limits, as far as possible, without increasing the risk of developing severe hypoglycemia.
- Emphasize the importance of annual surveys, since early manifestations of late complications are usually asymptomatic and their timely treatment is simply necessary.
- Emphasize the need for support from family and friends.
- Point out the importance of blood sugar testing throughout the day to adjust insulin doses on a regular basis.
- Determine acceptable blood sugar levels
- Repeat the principles of changing the dose of insulin
- Explain HbA1c: definition, interpretation of results, valid values
- Tactfully inform children and adolescents about late complications, adapting the pace of learning to individual needs.
- Emphasize the ability to live a normal life, provided that blood sugar is maintained within acceptable limits.
- Explain each medical test applied at the first annual screening, including details of the results analysis
- Encourage continuing education with diabetes specialists
- Recommend the use of books, the Internet, educational materials and courses for more information on diabetes.
- Choose the form of treatment that is most suitable for the patient.
- Consider the child's age, mental development, level of motivation, and general family opportunities when planning treatment.
- Keep in mind that some teens may not cope with diabetes during puberty. Simplify information, try to support rather than criticize, and involve parents in it
- Clearly explain specific rules that should be followed in regulating blood sugar in very young children.
- Highlighting good predictions, make it clear that the patient is responsible for actively participating in the control of diabetes
- Be sure to make the parents of the youngest children realize the risk of developing hypoglycemia if diabetes control is very hard.
What is diabetes control?
If you are diagnosed with diabetes, then disease control should become your daily concern. Diabetes and Control are inseparable concepts. You need to measure blood sugar levels, blood pressure, count bread units and calories every day, follow a diet, walk a few kilometers. , as well as with a certain frequency to pass laboratory tests in the clinic or hospital.
- If a patient with diabetes succeeds in maintaining sugar normal (up to 7 mmol / l), then this condition is called compensated diabetes. In this case, the sugar is slightly elevated, a person must follow a diet, but complications develop very slowly.
- If sugar often exceeds the norm, rolls up to 10 mmol / l, then this condition is called uncompensated diabetes. In this case, for several years, a person has the first complications: the legs lose their sensitivity, vision deteriorates, non-healing wounds form, vascular diseases are formed.
To compensate for the disease and monitor blood sugar levels - the daily care of a diabetic. Measures to compensate for the disease are called control of diabetes.
Blood sugar control
- The normal blood sugar level of a healthy person is 3.3 - 5.5 mol / l (before meals) and 6.6 mol / l (after meals).
- For a patient with diabetes, these figures are increased - up to 6 mol before meals and up to 7.8 - 8.6 mmol / l after meals.
Maintaining the level of sugar in these norms is called compensation for diabetes and ensures minimal diabetic complications.
Sugar should be controlled before each meal and after it (using a glucometer or test strips). If sugar often exceeds the permissible norms, it is necessary to revise the diet and insulin dose.
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Control of hyper and hypoglycemia
The diabetic needs to control sugar to prevent it from being too high or too low. An increased amount of sugar is called hyperglycemia (more than 6.7 mmol / l). With an increase in the amount of sugar three times (16 mmol / l and above), a pre-comatose state is formed, and after a few hours or days a diabetic coma (loss of consciousness) occurs.
Low blood sugar is called hypoglycemia. Hypoglycemia occurs with a decrease in sugar of less than 3.3 mmol / l (with an overdose of insulin injection). Human sweating is increased, muscle tremors, the skin turns pale.
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Glycated hemoglobin control
Glycosylated hemoglobin - laboratory analysis, which must be taken in a medical institution every three months. It shows whether blood sugar has risen in the past three months. Why is it necessary to take this analysis?
The life of a red blood cell is 80-120 days. When the blood sugar level rises, a part of hemoglobin irreversibly binds to glucose, forming glycated hemoglobin.
The presence of glycated hemoglobin in the blood indicates an increase in sugar over the past three months.
The amount of glycohemoglobin gives an indirect assessment - how often sugar rose, how strong was the rise, and whether the person with diabetes watches for diet and nutrition. With a high level of glycohemoglobin, diabetic complications are formed.
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Urinary Sugar Control - glycosuria
The appearance of sugar in the urine indicates a significant increase in blood sugar levels (over 10 mmol / l). The body is trying to get rid of excess glucose through the organs of excretion - the urinary canal.
Urine sugar analysis is performed using test strips. Normally, sugar should be contained in negligible amounts (less than 0.02%) and should not be diagnosed.
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Control of acetone in urine
The appearance of acetone in the urine is associated with the breakdown of fat into glucose and acetone. This process occurs when glucose starvation of cells, when insulin is not enough and glucose can not get from the blood into the surrounding tissue.
The appearance of acetone odor from urine, sweat and respiration of a sick person indicates an insufficient dose of insulin injection or an incorrect diet (the complete absence of carbohydrates in the menu). Test strips show the presence of acetone in the urine.
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Cholesterol control is necessary to reduce the likelihood of vascular complications - atherosclerosis, angina pectoris, and heart attack.
Excess cholesterol is deposited on the walls of blood vessels, forming cholesterol plaques. At the same time, the lumen and vascular permeability is narrowed, the blood supply to the tissues is disturbed, congestive processes, inflammation and suppuration are formed.
A blood test for cholesterol and its fractions is performed in a medical laboratory. Wherein:
- total cholesterol should not exceed 4.5 mmol / l,
- low density lipoproteins (LDL) - should not be higher than 2.6 mmol / l (it is from these lipoproteins that cholesterol deposits form inside the vessels). In the presence of cardiovascular diseases show LDL limit to 1.8 mmol / l.
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Blood pressure control
Pressure control indirectly diagnoses the state of the vessels and the possibility of cardiovascular complications, seizures. The presence in the blood of an increased amount of sugar changes the blood vessels, making them inelastic, brittle. In addition, the thick "sweet" blood hardly moves through small vessels and capillaries. To push the blood through the vessels, the body increases blood pressure.
Too much pressure increase with poor elasticity of the blood vessels leads to rupture of them with subsequent internal hemorrhage (diabetic heart attack or stroke).
It is especially important to control the pressure in elderly patients. With age and the development of diabetes, the condition of the vessels worsens. Pressure control (at home - with a tonometer) makes it possible to take the drug in time for pressure reduction and undergo a vascular treatment.
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Weight Control - Body Mass Index
Weight control is important for patients with type 2 diabetes. This type of disease is often formed with too high-calorie food and is accompanied by obesity.
Body Mass Index - BMI - is calculated by the formula: weight (kg) / height (m).
The resulting index with a normal body weight is 20 (plus or minus 3 units) corresponds to normal body weight. Excess of the index shows excess weight, the index reading over 30 units - obesity.
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Diabetes control is the daily occupation of a sick person. Diabetic life expectancy depends on the diabetic's life expectancy and its quality - how long a person can walk, how much his vision and extremities will remain, how good his blood vessels will be after 10-20 years of diabetes.
Compensation of diabetes allows the patient to live with the disease up to 80 years. An uncompensated disease with frequent increases in blood sugar quickly forms complications and leads to early mortality.
They were identified in the mid-twentieth century, based on a survey of thousands of healthy people and people with diabetes. Official sugar standards for diabetics are much higher than for healthy ones. Medicine is not even trying to control sugar in diabetes so that it gets closer to normal levels. Below you will find out why this is happening and what alternative treatment methods are available.
A balanced diet recommended by doctors is overloaded with carbohydrates. Such nutrition is harmful for diabetics. Because carbohydrates cause jumps in blood sugar. Because of this, diabetics feel unwell and develop chronic complications. In patients with diabetes who are treated by traditional methods, sugar jumps from very high to low. It is eaten up by carbohydrates, and then reduced injections of large doses of insulin. At the same time there can be no question of bringing the sugar back to normal. Doctors and patients are satisfied with the fact that it is possible to avoid diabetic coma.
However, if you follow a low-carbohydrate diet, then with type 2 diabetes and even with severe type 1 diabetes, you can keep a stable normal sugar, like in healthy people. Patients who limit carbohydrate intake, control their diabetes without insulin at all, or do it at low doses. The risk of complications in the cardiovascular system, kidneys, legs, eyesight is reduced to zero. The site Diabet-Med.Com promotes a low-carbohydrate diet to control diabetes in Russian patients. Read more "Why in diabetes type 1 and type 2 you need to eat less carbohydrates." The following describes what the indicators of sugar in the blood of healthy people and how they differ from official norms.
|Indicator||For diabetics||Healthy people|
|Sugar in the morning on an empty stomach, mmol / l||5,0-7,2||3,9-5,0|
|Sugar after 1 and 2 hours after a meal, mmol / l||below 10.0||usually not higher than 5.5|
|Glycated hemoglobin HbA1C,%||below 6.5-7||4,6-5,4|
In healthy people, blood sugar is almost always within 3.9-5.3 mmol / l. Most often it turns out to be 4.2-4.6 mmol / l, on an empty stomach and after meals. If a person eats fast carbohydrates, the sugar can rise to 6.7-6.9 mmol / l for a few minutes. However, it is unlikely to be above 7.0 mmol / l. For patients with diabetes mellitus, the value of glucose in the blood of 7-8 mmol / l 1-2 hours after eating is considered excellent, and up to 10 mmol / l is acceptable. The doctor may not prescribe any treatment, but only give the patient a valuable indication - to monitor the sugar.
Why is it desirable for patients with diabetes to strive for indicators of sugar, like in healthy people? Because chronic complications develop already when blood sugar rises to 6.0 mmol / l. Although, of course, they do not develop as fast as at higher values. It is advisable to keep your glycated hemoglobin below 5.5%. If you can achieve this goal, then the risk of death from all causes - the lowest.
In 2001, the British medical journal published a sensational article on the relationship between glycated hemoglobin and mortality. It is called "Glycated haemoglobin, diabetes, and EPC-Norfolk". Authors - Kay-Tee Khaw, Nicholas Wareham and others. HbA1C was measured in 4662 men aged 45–79 years, and then they were observed for 4 years. Among the study participants, most were healthy people who did not suffer from diabetes.
It turned out that mortality from all causes, including from heart attack and stroke, is minimal among people who have glycated hemoglobin not higher than 5.0%. Every 1% increase in HbA1C means an increased risk of death of 28%. Thus, a person with HbA1C has a 7% risk of death 63% higher than that of a healthy person. But glycated hemoglobin 7% - it is believed that this is a good control of diabetes.
Official sugar standards are too high, because a “balanced” diet does not allow for good control of diabetes. Doctors are trying to facilitate their work at the cost of worsening results for patients. It is not beneficial for the state to engage in the treatment of diabetics. Because the worse people control their diabetes, the higher the budget savings on the payment of pensions and various benefits. Take responsibility for your treatment. Try a low-carbohydrate diet - and make sure that it gives results in 2-3 days. Blood sugar drops to normal, insulin dosages are reduced by 2-7 times, and well-being improves.
Sugar on an empty stomach and after meals - what is different
The minimum level of sugar in humans is on an empty stomach, on an empty stomach. When food is digested, nutrients enter the bloodstream. Therefore, the concentration of glucose after a meal increases. If carbohydrate metabolism is not disturbed, this increase is insignificant and does not last long. Because the pancreas quickly secretes extra insulin to lower the sugar after a meal.
If insulin is not enough (type 1 diabetes) or it is weak (type 2 diabetes), then the sugar after a meal rises every time for several hours. This is harmful, because complications develop in the kidneys, vision drops, the conductivity of the nervous system is disturbed. The most dangerous thing is that conditions are created for a sudden heart attack or stroke. Health problems that are caused by increased sugar after eating are often considered natural age-related changes. However, they need to be treated, otherwise the patient will not be able to live normally in middle and old age.
|Fasting blood sugar||This analysis is taken in the morning, after the person has not eaten anything since the evening for 8-12 hours.|
|Two hour glucose tolerance test||You need to drink an aqueous solution containing 75 grams of glucose, and then measure the sugar after 1 and 2 hours. This is the most accurate test for diagnosing diabetes and pre-diabetes. However, it is not convenient, because it is long.|
|Glycosylated hemoglobin||Shows what% of glucose is associated with red blood cells (erythrocytes). This is an important analysis to diagnose diabetes and monitor the effectiveness of its treatment in the last 2-3 months. Conveniently, it does not need to pass on an empty stomach, and the procedure is quick. However, not suitable for pregnant women.|
|Measurement of sugar 2 hours after meals||An important analysis to monitor the effectiveness of diabetes treatment. Usually, patients spend it on their own with a glucometer. Allows you to find out if you correctly selected the insulin dosage before meals.|
A fasting blood sugar test is a poor choice for diagnosing diabetes. Let's see why. When diabetes mellitus develops, glucose in the blood rises first after eating. The pancreas for various reasons can not cope in order to quickly reduce it to normal. Elevated sugar after eating gradually destroys blood vessels and causes complications. During the first few years of diabetes, fasting glucose levels may remain normal. However, at this time, complications are already underway. If the patient does not measure sugar after eating, then he is unaware of his illness until the symptoms appear.
To check if you have diabetes, take a blood test for glycated hemoglobin in the laboratory. If you have a home blood glucose meter, measure your sugar 1 and 2 hours after a meal. Do not be deceived if your fasting sugar indicators are normal. Women in the second and third trimesters of pregnancy must have a two-hour glucose tolerance test. Because if gestational diabetes has developed, the analysis of glycated hemoglobin will not allow detecting it in time.
Pre-diabetes and diabetes
As you know, 90% of cases of metabolic glucose is type 2 diabetes. It does not develop immediately, but usually prediabetes occurs first. This disease lasts for several years. If the patient is not treated, then the next stage begins - “full-fledged” diabetes.
Criteria for the diagnosis of prediabetes:
- Blood sugar on an empty stomach 5.5-7.0 mmol / l.
- Glycated hemoglobin 5,7-6,4%.
- Sugar after 1 or 2 hours after eating 7.8-11.0 mmol / l.
It is enough to fulfill one of the conditions indicated above so that you can make a diagnosis.
Prediabetes is a serious metabolic disorder. You have a high risk of type 2 diabetes. Deadly complications in the kidneys, legs, eyesight are already developing. If you do not go on a healthy lifestyle, then prediabetes goes into type 2 diabetes. Or you will have time to die from a heart attack or stroke. I do not want to scare you, but this is a real situation, without embellishment. How to be treated? Read the articles "Metabolic Syndrome" and "Insulin Resistance", and then follow the recommendations. Pre-diabetes can be easily controlled without insulin shots. No need to starve or undergo hard physical exertion.
Criteria for the diagnosis of type 2 diabetes:
- Sugar on an empty stomach is higher than 7.0 mmol / l according to the results of two analyzes in a row on different days.
- At some point, blood sugar was higher than 11.1 mmol / l, regardless of the meal.
- Glycated hemoglobin is 6.5% or higher.
- During the two-hour glucose tolerance test, the sugar was 11.1 mmol / L or higher.
As with prediabetes, one of the listed conditions is enough to be able to make a diagnosis. Common symptoms - fatigue, thirst, frequent urination. There may be an inexplicable weight loss. For more, read the article "Symptoms of diabetes." At the same time, many patients do not notice any symptoms. For them, the poor results of blood sugar tests turn out to be an unpleasant surprise.
The previous section describes in detail why official blood sugar standards are too high. It is necessary to sound the alarm already when sugar after food is 7.0 mmol / l and even more so if it is higher. Fasting sugar can remain normal for the first few years while diabetes destroys the body. This analysis is not advisable to pass for diagnosis. Use other criteria - glycated hemoglobin or blood sugar after a meal.
|Indicator||Prediabetes||Type 2 diabetes|
|Glucose in the blood on an empty stomach, mmol / l||5,5-7,0||above 7.0|
|Sugar after 1 and 2 hours after a meal, mmol / l||7,8-11,0||above 11.0|
|Glycated hemoglobin,%||5,7-6,4||above 6.4|
Risk factors for prediabetes and type 2 diabetes:
- Overweight - body mass index 25 kg / m2 and above.
- Blood pressure 140/90 mm RT. Art. and higher.
- Poor cholesterol blood test results.
- Women who had a baby weighing 4.5 kg or more, or were diagnosed with gestational diabetes during pregnancy.
- Polycystic ovary.
- Cases of diabetes mellitus type 1 or 2 in the family.
If you have at least one of these risk factors, then you need to check blood sugar every 3 years, starting at the age of 45 years. Medical supervision of children and adolescents who are overweight and there is at least one additional risk factor is also recommended. They need to regularly check the sugar from the age of 10 years. Because since the 1980s, type 2 diabetes has become “younger”. In Western countries, it manifests itself even in adolescents.
How the body regulates blood glucose
The body continuously adjusts the concentration of glucose in the blood, trying to keep it within 3.9-5.3 mmol / l. These are optimal values for normal vital activity. Diabetics are well aware that it is possible to live at higher values of sugar. However, even if there are no unpleasant symptoms, high sugar stimulates the development of diabetes complications.
Low sugar is called hypoglycemia. This is a real catastrophe for the body. The brain does not tolerate when the blood glucose is not enough. Therefore, hypoglycemia is quickly manifested by symptoms - irritability, nervousness, palpitations, severe hunger. If the sugar drops to 2.2 mmol / l, then a loss of consciousness and death may occur. Read more about the article "Hypoglycemia - prevention and relief of seizures."
Catabolic hormones and insulin are antagonists of each other, i.e. they have the opposite effect. Read the article "How insulin regulates blood sugar in normal and diabetes."
At every moment, very little glucose circulates in a person’s blood. For example, in an adult male weighing 75 kg, the blood volume in the body is about 5 liters. To achieve a blood sugar of 5.5 mmol / l, it is enough to dissolve in it only 5 grams of glucose. This is about 1 teaspoon of sugar with a slide.Every second microscopic doses of glucose and regulating hormones enter the blood to maintain balance. This complex process takes place 24 hours a day without interruption.
Increased sugar - symptoms and signs
Most often, a person has high blood sugar due to diabetes. But there may be other causes - drugs, acute stress, disorders in the adrenal glands or the pituitary gland, infectious diseases. Many medicines increase sugar. These are corticosteroids, beta-blockers, thiazide diuretics (diuretics), antidepressants. Bring in this article a complete list of them is not possible. Before a doctor prescribes you a new medicine, discuss how it affects your blood sugar.
Hyperglycemia often causes no symptoms, even when sugar is much higher than normal. In severe cases, the patient may lose consciousness. Hyperglycemic coma and ketoacidosis are life threatening complications of high sugar.
Less acute, but more common symptoms:
- strong thirst
- dry mouth
- frequent urination,
- skin is dry, itches,
- foggy eyesight
- fatigue, sleepiness,
- unexplained weight loss
- wounds, scratches poorly heal,
- discomfort in the legs - tingling, goosebumps,
- frequent infectious and fungal diseases that are difficult to treat.
Additional symptoms of ketoacidosis:
- quick and deep breathing
- the smell of acetone when breathing,
- unstable emotional state.
Why elevated blood sugar is harmful
If you do not treat high blood sugar, it causes acute and chronic complications of diabetes. Acute complications were listed above. These are hyperglycemic coma and diabetic ketoacidosis. They manifest as impaired consciousness, fainting, and require emergency medical care. However, acute complications cause the death of 5-10% of diabetics. All the others die from chronic complications of the kidneys, eyesight, legs, nervous system, and most of all - from heart attack and stroke.
Chronically elevated sugar damages the walls of blood vessels from the inside. They become abnormally hard and thick. Over the years, calcium is deposited on them, and the vessels resemble old rusty water pipes. This is called angiopathy - vascular damage. She, in turn, causes complications of diabetes. The main hazards are renal failure, blindness, amputation of the foot or foot, and cardiovascular diseases. The higher the blood sugar level, the faster the development and the more severe the complications become. Pay attention to the treatment and control of your diabetes!
Folk remedies that lower blood sugar are Jerusalem artichoke, cinnamon, as well as various herbal teas, decoctions, tinctures, prayers, plots, etc. That you have not received any real benefit. Folk remedies are designed for diabetics who are engaged in self-deception, instead of competently treated. Such people die early from complications.
Fans of folk remedies for diabetes are the main “clients” of doctors who deal with renal failure, amputation of the lower extremities, as well as ophthalmologists. Complications of diabetes in the kidneys, legs and eyesight provide several years of hard life before the patient kills a heart attack or stroke. Most manufacturers and sellers of quack drugs work carefully to avoid criminal liability. However, their activities violate moral norms.
|Jerusalem artichoke||Edible tubers. They contain significant amounts of carbohydrates, including fructose, which diabetics should avoid.|
|Cinnamon||Aromatic spice, which is often used in cooking. Diabetes efficacy data are inconsistent. May reduce sugar by 0.1-0.3 mmol / l. Avoid pre-blended cinnamon with powdered sugar.|
|Video Bazylhan Dyusupova "In the name of life"||No comments…|
|Method Zherlygin||Dangerous quack. He is trying to extort 45-90 thousand euros for a course of treatment of type 1 diabetes, without guarantees of success. In type 2 diabetes, physical activity lowers sugar — this has been known for a long time without Zherlygin. Read how to enjoy physical activity for free.|
Measure your blood sugar with a glucometer several times a day. If you see that the results do not improve or even worsen, stop using the useless remedy.
Check with your doctor before taking any remedies for diabetes. Especially if you have already developed kidney complications or have liver disease. The supplements listed above do not replace treatment with diet, insulin injections and physical activity. After you start taking alpha lipoic acid, you may need to lower your insulin dosage to avoid hypoglycemia.
Blood Glucose Meter - Home Sugar Measuring Instrument
If you have found prediabetes or diabetes, then you need to quickly buy a device for home blood sugar measurement. This device is called a blood glucose meter. Without it, it is impossible to control diabetes well. Sugar should be measured at least 2-3 times a day, and preferably more often. Home blood glucose meters appeared in the 1970s. Until they became widely used, diabetics had to go to the laboratory each time to measure sugar, and even to stay in the hospital for weeks.
Modern glucometers are light and comfortable. They measure blood sugar almost painlessly and immediately show the result. The only problem is that test strips are not cheap. Each measurement of sugar costs about $ 0.5. In the month accumulates a round amount. However, these are inevitable costs. Save on test strips - go broke on treating diabetes complications.
At one time, doctors desperately resisted entering the home blood glucose meter market. Because they were threatened with the loss of large sources of income from laboratory blood tests for sugar. Medical organizations have managed to delay the promotion of home blood glucose meters for 3-5 years. Nevertheless, when these devices nevertheless appeared on sale, they immediately gained popularity. You can find out more about this in Dr. Bernstein’s autobiography. Now official medicine also inhibits the promotion of a low-carbohydrate diet - the only suitable diet for patients with type 1 and 2 diabetes.
Measuring sugar with a glucometer: step by step instructions
Patients with diabetes need to measure their sugar with a glucometer at least 2-3 times a day, and preferably more often. This is a simple and virtually painless procedure. In the lancets that pierce the finger, the needles are incredibly thin. Feelings - no more painful than a mosquito bite. It can be difficult to measure blood sugar for the first time, and then you get it. It is advisable that someone first show how to use the meter. But if an experienced person is not around - you can handle it yourself. Use the step-by-step instructions below.
- Wash your hands and dry well.
- Washing with soap is desirable, but not necessary, if there are no conditions for it. Do not wipe with alcohol!
- You can shake your hand so that blood rushes to your fingers. Even better - hold under a stream of warm water.
- Important! The puncture site should be dry. Do not allow water to dilute a drop of blood.
- Insert the test strip into the meter. Make sure that the message “OK” appears on the screen, you can measure.
- Pierce a finger with a lancet.
- Massage your finger to squeeze a drop of blood.
- It is advisable not to use the first drop, but remove it with dry cotton or a napkin. This is not an official recommendation. But try doing so - and make sure that the accuracy of the measurement improves.
- Squeeze the second drop of blood and apply it on the test strip.
- The measurement result will appear on the meter screen - write it in your diabetes monitoring diary, along with related information.
It is advisable to continuously keep a diabetes control diary. Write in it:
- date and time of sugar measurement,
- the result obtained
- that ate,
- what pills were taken
- how much and what insulin was injected,
- what was the physical activity, stress and other factors.
After a few days you will see that this is valuable information. Analyze it alone or with your doctor. Understand how different foods, medicines, insulin shots and other factors affect your sugar. Read more in the article “What affects blood sugar. How to prevent it from jumping and keeping steadily normal. "
How to get accurate results by measuring sugar with a glucometer:
- Carefully read the instructions for your device.
- Check the meter for accuracy as described here. If it turns out that the device is lying - do not use it, replace it with another one.
- As a rule, blood glucose meters, which have cheap test strips, are not accurate. They reduce diabetics to the grave.
- According to the instructions figure out how to put a drop of blood on the test strip.
- Strictly follow the rules for storing test strips. Carefully seal the bottle to prevent excess air from entering it. Otherwise, the test strips will deteriorate.
- Do not use test strips that have expired.
- When you go to the doctor, take a blood glucose meter with you. Show the doctor how you measure sugar. Perhaps an experienced doctor will indicate that you are doing wrong.
How many times a day do you need to measure sugar
To control diabetes well, you need to know how your blood sugar behaves during the day. In most diabetics, the main problem is increased sugar in the morning on an empty stomach, and then after breakfast. In many patients, glucose also rises strongly after lunch or in the evening. Your situation is special, not the same as everyone else. Therefore, we need an individual plan - a diet, insulin injections, taking pills and other activities. The only way to gather important information to control diabetes is to check your sugar often with a glucometer. It is described below how many times a day it is necessary to measure it.
Total blood sugar control is when you measure it:
- in the morning - as soon as we woke up
- then again - before you start breakfast,
- 5 hours after each injection of fast-acting insulin,
- before each meal or snack,
- after each meal or snack - in two hours,
- before bedtime,
- before and after physical education, stressful situations, stormy troubles at work,
- as soon as you feel hungry, or you suspect that your sugar is lower or higher than normal,
- before you get behind the wheel of a car or start a dangerous job, and then again every hour until you finish,
- in the middle of the night - for the prevention of night hypoglycemia.
Every time after measuring the sugar, the results should be recorded in a diary. Also indicate the time and related circumstances:
- what they ate - what products, how many grams,
- what insulin was pricked and what dose
- what diabetes pills have been taken
- what did you do,
- physical activity,
- freaked out
Write it all down, come in handy. The memory cells of the meter do not allow to fix the accompanying circumstances. Therefore, to keep a diary, you need to use a paper notebook, or better, a special program in your mobile phone. The results of total glucose self-control can be analyzed independently or together with your doctor. The goal is to find out at what periods of the day and for what reasons your sugar is outside the normal range. And then, respectively, to take action - to make an individual program for the treatment of diabetes.
Total sugar self-control allows you to assess how effective your diet, medications, physical activity and insulin shots are. Without careful monitoring, diabetes is “treated” only by charlatans, from whom there is a direct route to the surgeon for amputation of the foot and / or to the nephrologist for dialysis. Few people with diabetes are ready to live every day in the mode described above. Because the cost of test strips for the meter may be too heavy. Nevertheless, spend total blood sugar self-control at least one day every week.
If you notice that your sugar began to fluctuate unusually, then spend a few days in total control mode until you find and eliminate the cause. It is useful to study the article “What affects blood sugar. How to eliminate his jumps and keep steadily normal. ” The more money you spend on test strips for your meter, the more you will save on treating diabetes complications. The ultimate goal is to enjoy good health, to survive the majority of peers and not to become decrepit in old age. To keep all the time in the blood sugar is not higher than 5.2-6.0 mmol / l - this is real.
Frequently asked questions and answers
If you have lived for several years with high sugar, 12 mmol / l and higher, then it is really not advisable to quickly reduce it to 4-6 mmol / l, like in healthy people. Because unpleasant and dangerous symptoms of hypoglycemia can appear. In particular, the complications of diabetes on vision may increase. It is recommended that such people first lower sugar to 7–8 mmol / l and allow the body to get used within 1-2 months. And then move to the indicators of healthy people. For more, read the article “The goals of diabetes care. What sugar to strive for. ” It has a section “When you need to specifically keep high sugar”.
You do not measure your sugar often with a glucometer. Otherwise, they would have noticed that bread, cereal and potatoes enhance it just like sweets. You may have prediabetes or an initial stage of type 2 diabetes. To clarify the diagnosis you need to provide more information. How to treat - described in detail above in the article. The main tool is a low-carbohydrate diet.
Sugar in the morning on an empty stomach rises due to the fact that in the hours before dawn, the liver actively removes insulin from the blood. This is called the phenomenon of dawn. It manifests itself in most patients with type 1 and type 2 diabetes. Read more on how to normalize sugar in the morning on an empty stomach. This is not an easy task, but doable. You will need discipline. After 3 weeks a steady habit will be formed, and it will become easy to adhere to the regime.
It is important to measure sugar every morning on an empty stomach. If you prick insulin before a meal, then you need to measure the sugar before each injection, and then again 2 hours after meals. This is obtained 7 times a day - in the morning on an empty stomach and another 2 times for each meal. If you have type 2 diabetes and control it with a low-carb diet without fast insulin shots, measure sugar 2 hours after a meal.
There are devices that are called continuous blood glucose monitoring systems. However, they have too high an error, compared with conventional glucometers. To date, Dr. Bernstein does not recommend using them. Especially since their price is high.
Sometimes try to pierce with a lancet not your fingers, but other areas of the skin - the back of your hand, forearm, etc. The above article describes how to do it correctly. In any case, alternate the fingers of both hands. Do not call the same finger all the time.
The only real way to quickly reduce sugar is the injection of short or ultrashort insulin. A low-carbohydrate diet lowers sugar, but not immediately, but within 1-3 days. Some pills for type 2 diabetes are fast. But if you take them in the wrong dosage, the sugar may drop excessively, and the person will lose consciousness. Folk remedies are nonsense, they do not help at all. Diabetes mellitus - a disease that requires systemic treatment, accuracy, accuracy. If you try to do something quickly, in a hurry, you can only do harm.
You probably have type 1 diabetes. A detailed answer to the question is given in the article “Physical Education in Diabetes”.In any case, the benefits of physical activity, you get more than the hassle. Do not give up physical education. After several attempts, you will figure out how to keep normal sugar before, during and after physical activity.
In fact, proteins also increase sugar, but slowly and not as much as carbohydrates. The reason - part of the protein eaten in the body turns into glucose. Read more about the article “Proteins, fats, carbohydrates and dietary fiber for diabetes.” If you follow a low-carb diet to control diabetes, then you need to consider how many grams of protein you eat to calculate insulin dosages. Diabetics that feed on a “balanced” diet overloaded with carbohydrates are not taken into account by proteins. But they have other problems ...
- How to measure sugar with a glucometer, how many times a day you need to do it.
- How and why to keep a diabetes self-management diary
- Blood sugar standards - why they differ from healthy people.
- What to do if sugar is high. How to reduce it and keep steadily normal.
- Features of treatment of severe and advanced diabetes.
The material presented in the article is the foundation of your successful diabetes control program. Keeping stable normal sugar, like in healthy people, is an achievable goal even with severe type 1 diabetes and even more so with type 2 diabetes. Most of the complications can be not only slowed down, but also completely cured. You do not need to starve, to suffer in physical education classes or to prick large doses of insulin. However, you need to develop discipline in order to comply with the regime.