How to monitor blood sugar

Monitoring blood sugar in patients with diabetes is very important. 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. Good blood sugar control can even It does not affect its life expectancy, and an important part of it is blood sugar monitoring.

 

The following are some commonly used monitoring indicators: Glycated hemoglobin (HbA1c): HbA1c is the most important evaluation indicator for long-term blood sugar control, and is 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 4-6%, (each hospital may have slight differences due to different detection methods).

 

Glycated serum protein: mainly reflects the level of blood sugar control in the past 2-3 weeks. Fasting, pre-meal and 2-hour post-meal blood sugar: This is a common method for patients to self-monitor blood sugar. Generally, fingertip capillary blood sugar is used. It reflects the immediate blood sugar at that time, but it should be noted that this test cannot be used as a basis for diagnosis of diabetes. .

 

Urine sugar: In places where conditions are unavailable or conditions are limited, the detection of urine sugar is also a method to understand self-blood sugar control, but it is affected by the renal glucose threshold. For the elderly with increased renal glucose threshold or pregnant women with lowered renal glucose threshold, For patients, urine glucose monitoring is meaningless and may even mislead treatment, and it is not helpful for hypoglycemia monitoring.

 

Frequency of blood sugar monitoring: Patients with poor blood sugar control or those in critical condition should monitor 4-7 times a day (including fasting, before meals, 2 hours after meals, before going to bed, and some also add 0am, 3am, etc.) until blood sugar is controlled. Stablize. When the condition is stable and the diet, activity patterns, and blood sugar levels are up to standard, monitoring can be done 1-2 days a week, 5 times a day.

 

Blood sugar monitoring time: Pre-meal blood sugar test: When blood sugar levels are very high, fasting blood sugar levels are the first thing to pay attention to. People at risk of hypoglycemia (elderly people, those with better blood sugar control) should also measure blood sugar before meals.

 

2-hour postprandial blood glucose monitoring: suitable for people whose fasting blood sugar has been well controlled but still cannot achieve treatment goals.

 

Bedtime blood glucose monitoring: suitable for patients who inject insulin, especially those who inject medium and long-acting insulin. Nighttime blood glucose monitoring: It is suitable for those whose insulin treatment is close to the treatment target but fasting blood glucose is still high.

 

When symptoms of hypoglycemia occur: Blood glucose should be monitored promptly. Before and after strenuous exercise: It is advisable to monitor blood sugar. Patients who use basal insulin in the blood glucose monitoring plan should monitor fasting blood sugar 3 days a week before the blood glucose reaches the standard, and have a follow-up visit every 2 weeks. The day before the follow-up visit, an additional 5-point (fasting, after three meals, and before bed) blood sugar spectrum should be measured the day before the follow-up visit; Then monitor the 5-point blood glucose spectrum 1-2 times a week. A 5-point blood glucose spectrum test was performed one day before the follow-up visit. Those who use premixed insulin should monitor the 5-point blood glucose spectrum 3 days a week before the blood glucose reaches the target; after the blood sugar reaches the target, monitor the 5-point blood glucose spectrum 1-2 times a week and have a follow-up visit once a month, and measure the 5-point blood glucose spectrum once a day before the follow-up visit. . Intensive blood glucose monitoring program for people not taking insulin therapy: blood glucose monitoring from 5 to 7 o'clock 3 days a week, mainly used during drug adjustment. Low-intensity blood sugar monitoring program without insulin treatment: Monitor blood sugar before breakfast and bedtime three days a week, so as to not only grasp the blood sugar control trend but also understand the impact of meals on blood sugar. If asymptomatic hypoglycemia is suspected, focus on monitoring meals. Preglycemic.

 

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. This 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 know the blood sugar situation throughout the day (fasting, after three meals, and before bed blood sugar). If you take insulin and the blood sugar fluctuates greatly, it is best to also know the three meals. Preglycemic. For blood sugar fluctuations that are particularly large, and hyperglycemia and hypoglycemia appear irregularly, dynamic blood sugar monitoring can be performed. With special instruments, we can understand the blood sugar level for 3-7 days through continuous blood sugar monitoring, which provides us with a basis for adjusting medications.