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Glucose monitoring

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Current ADA guidelines call for:

While the ADA guidelines remain important, many experts believe that one size does not fit all, that blood sugar goals should be adjusted according to the needs of individual patients. In general, an HbA1C target of 7.0% to 7.5%, which corresponds to an average blood sugar level of about 150 to 170 mg/dL, seems reasonable for many patients with type 2 diabetes.

Please note the the accuracy of glucometer is approximatly +-10%, so we can talk only about a range. For example 150 means between 135 and 165.

Goals for glycemic control for people with diabetes are:

[1B] To increase lean body mass, resistance training should be incorporated into the activity plan 3-4 days per week, and include upper, core and lower body strengthening exercises using free weights, resistance machines or resistance bands.

Guidelines for healthy adults:

What are the dangerously high blood sugar levels?

Dangerous Blood Sugar Levels - High & Low Glucose Level Readings

Normally, in a diabetic, blood sugar levels will always stay high. During stress, more “sugar” is added to your blood, which then, turn to “become” dangerous.

This is because your body will find it hard to bring them normal again. Furthermore, persistent high blood glucose level will cause many problems to all your body cells.

 

Types of test Dangerous sugar levels
Simple blood sugar level test
>200 mg/dl
Fasting blood sugar level test
>150 mg/dl
Oral-glucose-tolerance-test
>250 mg/dl
A1C Test
>9%
Click here to learn how to convert mg/dl to mmol/l.

 

Prediabetes - Wikipedia, the free encyclopedia

WHO criteria for impaired fasting glucose differs from the (American Diabetes Association) ADA criteria, because the normal range of glucose is defined differently. Fasting glucose levels 100 mg/dL and higher have been shown to increase complication rates significantly. However, WHO opted to keep its upper limit of normal at under 110 mg/dL for fear of causing too many people to be diagnosed as having impaired fasting glucose, whereas the ADA lowered the upper limit of normal to a fasting glucose under 100 mg/dL.

Levels above these limits would be a diagnosis for diabetes.

What To Do When Blood Suger Rises Above 300

You need immediately switch to fasting and drink a lot of water.

What To Do When Blood Suger Rises Above 300

Every diabetic should have a game plan when blood sugar rises above 300. Almost all diabetics will get some wild blood sugar fluctuations on occasion. Infections, poor eating, stress from the environment, stress from activity, stress from psychological aspects, and many other situations may result in wild blood sugar fluctuations.

Therefore a diabetic needs to preplan what to do for dangerously high blood sugar levels. The first idea to keep in mind is blood sugar levels over 300 are dangerous. The reason there is danger are the stresses within the body are multiplied as you get into these higher ranges. This is explained in the article on this web site called "Understanding Diabetic Blood Sugar Fluctuations When Sick." The key point in the article is when the body is under a high degree of stress, cortisol is continuously produced to combat this state of emergency in the body. Blood sugar is poured out into the bloodstream along with cortisol. At first the body attempts to localize problems. If the problems continue this overworks the body. Eventually the entire body, all the organs and systems become involved. This leads to more cortisol and blood sugar being pumped into the body. Finally breakdowns can begin unless this downward spiral of events is stopped. Even when this spiral has stopped you still have many problems in recovery. For example, the adrenals can be swollen, the immune system depressed, there can be shrinkage of the thymus, shrinkage of the spleen, and shrinkage of the lymph nodes and many other problems that occur in recovery.

The point is 300 blood sugar levels involve the entire body and endanger all the organs and systems. The first thing a diabetic can consider is activity. There should probably be none and instead the diabetic might consider relaxing and resting. Activity, going to work, going outside in all kinds of weather, eating poorly, and so on, are all additional stresses to the body. A diabetic above 300 blood sugar levels cannot afford additional stress. This may lead to more cortisol being pumped into the bloodstream and continuing the cycle of more blood sugar released along with the cortisol. This can overwork the organs and systems in the body. So rest and relax and do not risk your health. Call the doctor immediately. There should be a plan for this occurrence of dangerously high blood sugar levels.

... ... ...

There are a few ideas that a diabetic may consider with his doctor. This web site contains an article called "Semi emergency treatment" in the section called "Diabetic Tips." Basically one thing you can do as described in this article is to drink lots of water to pass blood sugar right out of the body.

... ... ...

 Remember, the longer you stay above 300, the greater is the damage to the body and the greater is the chance of irreversible damage. So you need a doctor who knows what to do when blood sugar is over 300. If your doctor does not know then look and find one who does know. The time may come when your blood sugar level rises above 300 and the chances of grave damage are greater the longer these high levels remain. If you cannot find a doctor who knows what to do when blood sugar is above 300 then look for an orthomolecular doctor. The web site www.restoreunity.org  has a list of orthomolecular doctors or use the Internet search engines. The orthomolecular doctors should be able to help you on the glucose treatment.

 


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[May 20, 2012] Type 2 Diabetes - Symptoms, Diagnosis, Treatment of Type 2 Diabetes -

NY Times Health Information

Diabetes blood tests:

Diabetes screening is recommended for:

You should see your health care provider every 3 months. At these visits, you can expect your health care provider to:

You should see your health care provider every 3 months. At these visits, you can expect your health care provider to:

The following tests will help you and your doctor monitor your diabetes and prevent problems:

[Apr 22, 2012] When To Test? A New Study Pinpoints Timing

March 1, 2012 | Diabetes Update

One of the most common questions people email me is when exactly they should start measuring the "hour after eating" at which I suggest they should test their blood sugar. Does that hour start after the first bite or at the end of the meal?

Luckily for us, an obscure paper published last year give us a definitive answer. Luckily for me, that answer is identical to the advice I've been giving people who have asked me this question for the last five years. (I based my answer on a previous study and the reports of people posting about when they tested on online discussion groups.)

The study used used data collected from people with both Type 1 and Type 2 Diabetes, using insulin, who were wearing continuous glucose monitors. You can read it here:

Peak-time determination of post-meal glucose excursions in insulin-treated diabetic patients. Daenen S, et al. Diabetes Metab. 2010 Apr;36(2):165-9. Epub 2010 Mar 11.

For insight into why this study is so useful you have to keep in mind that the whole point of testing at one hour is to find the highest blood sugar reading after the meal.

This study found that the average blood sugar peak after breakfast was found at 72 minutes after the start of the meal, with most people's values falling between 49 minutes and 95 minutes.

However, one person in five saw a peak after 90 minutes from the start of the meal. The researchers observe that "Peak time correlated with the amplitude of postprandial excursions, but not with the peak glucose value." I.e. A rise of 100 mg/dl to 170 mg/dl from a starting value of 70 mg/dl would take longer than a rise of 30 mg/dl from 140 g/dl to that same 170 mg/dl, which makes sense.

Since many of us spend about 15 minutes eating a meal, this explains why many people will do just fine if they test hour after finishing their meal.

But not everyone gulps down their meals, so how fast we eat along with several other factors, including how fast our digestion works and what kinds of foods we eat, will also influence when that blood sugar peak occurs.

For example, some people find that meals heavy in fat digest more slowly than those that are made up mostly of starches and sugars. Large meals of any composition may produce a slightly delayed spike. And meals heavy in protein may, under some conditions, produce a rise in blood sugar at the next meal because dietary protein can be converted into blood glucose over a period of six hours.

So what we can take from this is that, as is so often true with anything to do with blood sugar, the only way we can know for certain when our own blood sugar is likely to peak is by testing at various times after eating the exact same meal and discovering when we see the highest reading for that meal.

If you always see the peak a lot earlier or later than the average person would, adjust your testing schedule. But don't make yourself crazy about it. A rough approximation of an hour after the end of the meal or an hour and fifteen minutes after the first bite will give you a reading that for most people will be informative enough.

Given the poor accuracy of meters, a reading in the middle 100 mg/dl range could easily be 15 mg/dl higher or lower strictly due to meter variation so once you've determined that your highest readings aren't occurring significantly later than average--two hours after you start your meal, for example, don't fret about exact timing.

The other important piece of information we look for when we test after eating is how fast our blood sugar is coming down after that peak because the longer blood sugars stay over 140 mg/dl, the more damage they do. (Details on what researchers have found about wht blood sugar levels cause damage can be found HERE.)

When you take a second reading is up to you and depends on how many strips you have and what previous tests have taught you about how your blood sugar works. Most of us will find it informative to test an hour after the peak occurs to see how fast our blood sugar is dropping from its peak.

In this particular study people's blood sugar dropped on average 0.82 mg/dL per minute or 49.2 mg/dl per hour. But the actual range of how fast their blood sugar dropped was very large, with the range in which most readings clustered extending from 7 mg/dl per hour to 91 mg/dl per hour and some outliers dropping not at all or even faster.

If you see only a very small drop in your own blood sugar an hour after its peak, or a rise, you should check in another hour. If the usual pattern you see is for your blood sugar to stay high for two hours or more after peaking, it's time to cut back on the carbohydrate in your meals, since carbohydrates are what raise blood sugar.

If cutting carbohydrates doesn't get your blood sugars rising less and dropping faster, it's time for a visit to the doctor to discuss adding a safe medication would be advisable. (Metformin and insulin are by far the safest choices. You can read about all the drugs doctors prescribe to drop blood sugar HERE.)

If you start using insulin at meal times you should also test your blood sugar towards the end of the insulin's period of activity. How long the insulin stays active varies both with the kind of insulin you use and the dose.

Regular Human Insulin (R insulin) which is sold as Humulin or Novolin, is active for a period that can extend as long as 6 hours, so testing at 4 or 5 hours can warn you if you are in danger of a hypo.

For Humalog, Novolog (Novorapid), and Apidra, which have shorter times of duration, testing at 3 or 4 hours is wise until you determine you aren't in danger of a hypo.

If you see a low value at any time when your insulin still has more time left to work, take some glucose to raise your blood sugar and adjust your dose the next time you eat that meal or a one with similar amount of carbohydrate.

If your doctor hasn't taught you how to adjust your dose of fast acting insulin to match your carbohydrate intake, ask for that kind of training. If you can't get it, educate yourself by reading John Walsh's book, Using Insulin or Dr. Bernstein's Diabetes Solution by Dr. Richard K. Bernstein.

Dangerous Blood Sugar Levels - High & Low Glucose Level Readings

Normally, in a diabetic, blood sugar levels will always stay high. During stress, more “sugar” is added to your blood, which then, turn to “become” dangerous.

This is because your body will find it hard to bring them normal again. Furthermore, persistent high blood glucose level will cause many problems to all your body cells.

Types of test Dangerous sugar levels
Simple blood sugar level test
>200 mg/dl
Fasting blood sugar level test
>150 mg/dl
Oral-glucose-tolerance-test
>250 mg/dl
A1C Test
>9%
Click here to learn how to convert mg/dl to mmol/l.
How to recognize and distinguish these dangerous blood sugar levels?

All you need to do is to regularly check your sugar level.

  • In case you find your blood sugar level more than 200 mg/dl, persisting for more than two days, then this is considered as dangerous level.

    Then if you check your blood sugar, and have results higher than 300 mg/dl, together with urine incontinence, dry and cracked tongue, all these figures show you the danger of your situation too.

  • Blood Glucose Levels Testing and Normal Range

  • The normal values listed here-called a reference range-are just a guide. These ranges vary from lab to lab, and your lab may have a different range for what’s normal. Your lab report should contain the range your lab uses. Also, your doctor will evaluate your results based on your health and other factors. This means that a value that falls outside the normal values listed here may still be normal for you or your lab.
    Blood glucose
    Fasting blood glucose: 70-99 milligrams per deciliter (3.9-5.5 mmol/L)
    2 hours after eating (postprandial): 70-145 mg/dL (3.9-8.1 mmol/L)
    Random (casual): 70-125 mg/dL (3.9-6.9 mmol/L)

    Many conditions can change your blood glucose levels. Your doctor will discuss any significant abnormal results with you in relation to your symptoms and past health.

    • The American Diabetes Association (ADA) criteria for diagnosing diabetes are met when any of the following results have been repeated on at least two different days:
      • A fasting blood glucose level is 126 mg/dL (7.0 mmol/L) or higher.
      • A 2-hour oral glucose tolerance test result is 200 mg/dL (11.1 mmol/L) or higher. For more information, see the medical test Oral Glucose Tolerance Test.
      • Symptoms of diabetes are present and a random blood glucose test is 200 mg/dL (11.1 mmol/L) or higher. Symptoms of diabetes include increased thirst and frequent urination (especially at night), unexplained increase in appetite, unexplained weight loss, fatigue, erection problems, blurred vision, and tingling or numbness in the hands or feet.
    • If your fasting blood glucose level measures in the range of 100 mg/dL (5.6 mmol/L) to 125 mg/dL (6.9 mmol/L), you are considered to have prediabetes (impaired fasting glucose), and you have an increased chance of getting diabetes.
    • Other conditions that can cause high blood glucose levels include severe stress, heart attack, stroke, Cushing's syndrome, medicines such as corticosteroids, or excess production of growth hormone (acromegaly).

    Low values

    A fasting glucose level below 40 mg/dL (2.2 mmol/L) in women or below 50 mg/dL (2.8 mmol/L) in men that is accompanied by symptoms of hypoglycemia may mean you have an insulinoma, a tumor that produces abnormally high amounts of insulin.

    Low glucose levels also may be caused by:

    Use blood glucose numbers to better manage diabetes - By Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N

    March 6, 2010 | MayoClinic.com

    You may wonder why it's so important to test your blood sugar every day. Many people don't know how to interpret high readings or what to do about it. Sometimes you may think that the doctor is more focused on the hemoglobin A1C and isn't as interested in the daily blood sugar results. You also might not be motivated to check your blood glucose if you don't understand how you can benefit from the information.

    You may become frustrated or obsessed if you don't have the "right numbers" or feel like a failure if your blood glucose numbers are high. Blood glucose monitoring may seem hard to do at first, but as you learn to use the results to understand your body better and manage your treatment, it will become easier. Here are some general tips:

    The blood glucose number is a reminder, if used correctly, and will help you take control of your diabetes and not allow your diabetes to take control of you. Monitoring and controlling your blood glucose delays the development of long-term complications.

    How do you feel emotionally when your blood glucose results are in range? Out of range? Does this affect how you manage your diabetes? What are some of your ideas for ways to handle these times?

    Peggy

    Controlling Blood Sugar in Diabetes How Low Should You Go - Harvard Health Publications

    The sweet spot

    Research has modified some long-held assumptions about the treatment of diabetes, and new studies are likely to further refine our standards and goals. Still, some principles seem clear:

    1. Diet, exercise, and weight control should be the cornerstone of management for all diabetics. In fact, a healthful lifestyle can prevent many, if not most, cases of type 2 diabetes, and it can lower blood sugar levels and improve the outcome for all patients with the disease.

    2. Good blood sugar control is important for all diabetics. Tight control reduces the risk of microvascular complications (kidney disease, nerve damage, and eye disease) in type 1 diabetes. It also helps protect type 1 patients from macrovascular complications (heart attack, stroke, and cardiovascular death); it may have similar benefits for patients with newly diagnosed type 2 diabetes and healthy blood vessels, but is unlikely to help patients with longstanding type 2 diabetes and cardiovascular disease.

    Patients who can achieve near-normal blood sugar levels with lifestyle therapy and simple drug programs should do so. Current ADA guidelines call for:

    3. Patients who take insulin and others who aim for tight blood sugar control should monitor their own blood sugar levels. They should also learn to recognize symptoms of hypoglycemia, including anxiety, racing heart, sweating, tremors, and confusion, and they should know how to raise excessively low sugar levels and how to get help in emergencies.

    While the ADA guidelines remain important, many experts believe that one size does not fit all, that blood sugar goals should be adjusted according to the needs of individual patients. In general, an HbA1C target of 7.0% to 7.5%, which corresponds to an average blood sugar level of about 150 to 170 mg/dL, seems reasonable for many patients with type 2 diabetes.

    4. Because diabetes is a major cause of cardiovascular disease and premature death, patients should carefully control other risk factors. Current guidelines set targets for diabetics below targets for otherwise healthy individuals;

    5. Because special medications can slow the progression of diabetic kidney disease, patients should have regular urine tests for microalbuminuria; blood tests of kidney function may also help.

    Regular screening for eye disease (diabetic retinopathy) will also lead to helpful preventive treatment. Foot care is important, too.

    Diabetes is a chronic condition, and it is a serious illness. Lifelong attention to lifestyle, medication, and monitoring is the key to a good outcome. It's a challenge for patients, their families, and their doctors — but new emphasis on flexibility and moderation promises to make life easier and better. How sweet it is.

    Goals for glycemic control for people with diabetes are:

    The frequency of SMBG is highly individualized and should be based on such factors as glucose goals, medication changes and patient motivation. Most patients with type 1diabetes should monitor 4-6 times per day.

    Some patients may need to monitor even more frequently.

    For patients with type 2 diabetes, the frequency of monitoring is dependent upon such factors as mode of treatment and level of glycemic control. [1C]

    To obtain meaningful data for treatment decisions, it is helpful for the patient to monitor for several consecutive days (e.g., 2-4 days)

    In addition to obtaining fasting and preprandial glucose levels, consider obtaining glucose readings 2-3 hours postprandially, as postprandial hyperglycemia has been implicated as an additional cardiovascular risk factor. [1C]

    Postprandial monitoring is particularly recommended for patients who:

    Guidelines for healthy adults:

    [1B] To increase lean body mass, resistance training should be incorporated into the activity plan 3-4 days per week, and include upper, core and lower body strengthening exercises using free weights, resistance machines or resistance bands.

    • Stretching exercises should be done when muscles are warm or at the end of the activity plan to loosen muscles and prevent soreness. [1B]

    FEET

    *Foot care training:

    Foot care training should address: