How many times a day should you check your blood sugar?

Once diagnosed with diabetes, monitoring blood sugar is essential. Some patients don’t know how many times a day they need to check their blood sugar, and what is the difference between fasting and postprandial blood sugar. Let us give you a detailed introduction to several indicators for monitoring blood sugar and some issues that need attention. How to monitor blood sugar at home? The blood glucose meter is a standard configuration and essential tool for diabetic patients.

 

In addition to examinations in the hospital, diabetic patients need to monitor their blood sugar levels at home with a rapid blood glucose meter. In outpatient clinics, there are still a few patients who never monitor their blood sugar and always rely on feeling. Today I feel a little dizzy, my mouth is obviously dry, and I urinate a lot. I think my blood sugar may be high, so I should eat less. This is very unscientific and undesirable, and can easily delay the condition.

 

It is very important for patients with diabetes to monitor blood sugar. Although the pathogenesis of diabetes is not very clear at present and it cannot be completely cured, the quality of blood sugar control has an important impact on the occurrence and prognosis of acute and chronic complications. Patients with good blood sugar control , it can be the same as normal people, and life expectancy will not be affected.

 

1. Commonly used monitoring indicators (1) Fasting, pre-meal and 2-hour post-meal blood sugar: This is the routine point for patients to self-monitor blood sugar, generally using fingertip capillary blood sugar. This is the immediate blood sugar at that time, but it should be noted that this result alone cannot be used as a basis for diagnosing diabetes. (2) Urine sugar: In places where conditions are unavailable or conditions are limited, testing urine sugar is also a way to understand self-blood sugar control. However, because urine sugar will be affected by the renal glucose threshold, for the elderly with an increased renal glucose threshold or patients with gestational diabetes with a lowered renal glucose threshold, urine glucose is meaningless and may even mislead treatment. It is also not helpful in detecting hypoglycemia. So there are certain restrictions.

 

2. Frequency of blood sugar monitoring. Patients with poor blood sugar control or those in critical condition should monitor 4 to 7 times a day (including fasting, before meals, 2 hours after meals, before bed, and some also need to monitor at 12 midnight and 3 am. blood sugar, etc.) until blood sugar control is stable. When the condition is stable, diet is controlled, activity is regular, and blood sugar reaches the standard, monitoring can be done 1 to 2 days a week, 5 times a day.

 

3. Blood sugar monitoring time (1) Pre-meal blood sugar: When blood sugar levels are high, fasting blood sugar levels are the first thing to pay attention to. People who are at risk of hypoglycemia (elderly people with better blood sugar control) should also measure blood sugar before meals; (2) 2-hour post-meal blood sugar: suitable for people whose fasting blood sugar has been well controlled but still cannot reach the treatment goal; (3) ) Bedtime blood sugar: suitable for patients who inject insulin, especially those who inject medium and long-acting insulin; (4) Nighttime blood sugar: suitable for patients whose insulin treatment is close to the treatment target, but fasting blood sugar is still high; (5) hypoglycemia occurs Symptoms: Blood sugar should be monitored in time; symptoms of hypoglycemia include: confusion, dizziness, unsteady standing, very hungry, headache, irritability, rapid heartbeat, pale face, sweating, trembling, weakness, anxiety, etc. (6) Before and after strenuous exercise: It is advisable to monitor blood sugar.

 

4. Blood glucose monitoring plan (1) Patients using basal insulin: Before blood glucose reaches the target, monitor fasting blood glucose 3 times a week, and review once every 2 weeks; additionally measure 5 points the day before the review (fasting, after three meals, and before bed). ) Blood glucose spectrum; after the blood glucose reaches the target, monitor the 5-point blood glucose spectrum 1 to 2 times a week. The day before going to the hospital for a follow-up visit, take an additional 5-point blood glucose test. (2) Patients using premixed insulin: Before the blood glucose reaches the target, monitor the 5-point blood glucose spectrum 3 days a week; after the blood glucose reaches the target, monitor the 5-point blood glucose spectrum 1 to 2 times a week. There will be a follow-up visit once a month and a 5-point blood glucose spectrum test the day before the follow-up visit. (3) Intensive blood glucose monitoring program for those not taking insulin therapy: 3 days a week, 5 to 7 o'clock blood glucose monitoring every day, mainly used during drug adjustment. What does blood glucose monitoring include?

 

In the hospital, some other indicators need to be checked to reflect the condition or treatment of diabetes.

 

1. Glycated hemoglobin, namely HbA1c and glycated serum protein HbA1c, are the most important evaluation indicators for long-term blood sugar control and are also one of the important basis for guiding the adjustment of clinical treatment plans. It reflects the average blood sugar control level in the past three months. The normal reference range is 4% to 6%. Each hospital may have slight differences due to different detection methods. Current domestic and foreign guidelines recommend that this indicator should be controlled below 6.5% to 7%, but there will be some individual differences. Some hospitals can also check glycated serum protein, which mainly reflects the level of blood sugar control in the past 2 to 3 weeks. Both of these reflect average blood sugar levels and cannot reflect blood sugar fluctuations.

 

2. Venous serum blood glucose includes fasting and 2-hour postprandial blood glucose. It is mainly used for screening for diabetes. Not used as a common indicator for blood glucose monitoring. If the two indicators of fasting blood glucose and glycated hemoglobin (HbA1c) can be used together, people at high risk of diabetes can be better screened. Therefore, the current routine physical examination only checks fasting blood glucose, which still has a certain rate of missed diagnosis. If conditions permit, glycated hemoglobin can be checked at the same time.

 

3. Dynamic blood glucose monitoring Dynamic blood glucose monitoring system uses special instruments to continuously and dynamically monitor changes in blood sugar. It can automatically record blood glucose data every 3 to 5 minutes, and can record continuously for 3 days to observe dynamic blood glucose changes within 72 hours. It can draw a daily blood sugar change curve, and can mark meals, exercise, major events, etc. on the curve. For patients with large and irregular blood sugar fluctuations, this chart can observe many conditions that cannot be discovered by conventional monitoring, and infer whether they are related to events such as meals and exercise, providing important clues for clinical diagnosis and treatment. This kind of equipment is relatively expensive and is generally found in larger hospitals. More advanced equipment also combines blood glucose monitoring with an insulin pump. This is the so-called "artificial pancreas."

 

Insulin is given quantitatively based on real-time blood glucose detection. In fact, there are no fixed requirements for blood sugar monitoring. The plan is mainly adjusted based on blood sugar control, diet, and exercise. Foreign countries place more emphasis on pre-meal blood sugar control, while my country pays more attention to fasting and 2-hour post-meal blood sugar, which may be related to the different dietary structures at home and abroad.

 

Personally, I prefer to follow a regular diet and exercise. If you need to adjust medications, you should understand the blood sugar situation throughout the day, that is, fasting, after three meals, and before bed blood sugar. If the blood sugar of patients taking insulin fluctuates greatly, it is best to know the blood sugar before three meals. For patients with particularly large blood sugar fluctuations and irregular occurrences of hyperglycemia and hypoglycemia, dynamic blood glucose monitoring can be performed to provide a basis for doctors to adjust medications.