What are the ways of monitoring blood sugars in a Diabetic for Optimal Blood sugar Control?
Anyone with Diabetes would know that the Blood Sugars have to be periodically monitored.The way Blood Sugars are monitored has undergone changes over the years.Here I will list methods which are available in Indian markets.
The more frequently the blood sugars are monitored the better, provided that the information is used in a proper manner to modify the Dietary pattern, Exercise schedules and medications in order to achieve near normal blood sugar values.
The normal blood sugar range is
Fasting Blood Sugar(FBS)-70 to 100 gms/dl
Post Lunch/Prandial BloodÂ Sugar(PPBS) should be less than 140
HBA1cÂ between 4 -5.6 is non Diabetic rangeÂ Between 5.7 -6.4 indicates high chances of becoming Diabetic and above 6.4Â indicates Diabetes.
In general we must attempt to keep the blood sugars between 100 -150 gms/dl in a Diabetic or hba1c less than 7.
In elderly patients the control is little more lenient that is between 100 to 180 or hba1c less than 7.5
Just over 15 years agoÂ Doctors would advise doing FBS and PPBS testing in a standardised pathology laboratory.
This would have to be repeated as per the control of blood sugars.This involved repeated needle pricks with at least 2 ml blood withdrawn each time for checking.
Then came Glucometers.And the concept changed to Self Monitoring Of Blood Glucose(SMBG).Patients areÂ encouraged to periodically check blood sugars at home with a pin prick blood sample with their own Glucometers.Inaccuracies due to technical issues, moisture,difficulty in learning SMBG in elderly etc were the few problems.Newer Glucometers are fairly accurate and can be relied on to modify therapy. However,since Glucometer checks capillary blood some errors are expected.But it is used widely as repeated blood collection of the pathology laboratory is avoided.
Of late we have a new technique called Ambulatory glucose Monitoring(AGM) or also called Continuous Glucose Monitoring(CGM).
A small coin shaped instrument is stuck to the left arm with a polythene filament penetrating the skin.The filament inside the skin comes in contact with the capillary blood and the instrument records a blood sugar reading every 5 to 15 minutes depending on the instrument used.This record can be transferred via bluetooth to a reader and can be uploaded in a computer.it records around 90 readings in a day and close to 1500 readings in 14 days.
The patient is asked to follow up every 2 to 4 days and doses are adjusted. In most cases within 15 days a reasonably good 24 hrs blood sugar control is achieved.
Depending upon the initial blood sugar levels and the overall health status your doctor will advise you one of the above methods to monitor yourÂ blood sugar in order to achieve Optimal control.
DR JACOB THOMAS
ADVANCED DIABETES CENTER.