Blood Glucose And Ketone Monitoring
Optimal diabetic control requires frequent self-monitoring of blood glucose levels as this allows for timely adjustments in insulin doses. People with type 1 diabetes learn how to self-monitor their blood glucose levels using a pocket-sized blood glucose meter and adjust their insulin doses accordingly. Depending on whether daily insulin injections or an insulin pump is used, blood glucose levels will likely need to be checked at least four times a day. Careful monitoring is the only way to ensure that blood glucose levels remain within the target range. Blood glucose testing involves using a lancing device to prick the skin to draw a drop of blood, which is placed on a test strip. The test strip is then inserted into a blood glucose meter, which provides a blood glucose level reading. Blood ketone meters, which measure blood ketone levels, and work in a similar way to blood glucose devices, are available to test for ketoacidosis.
Prevent Type 2 Diabetes
If your test results show you have prediabetes, ask your doctor or nurse if there is a lifestyle change program offered through the CDC-led National Diabetes Prevention Program in your community. You can also search for an online or in-person program. Having prediabetes puts you at greater risk for developing type 2 diabetes, but participating in the program can lower your risk by as much as 58% .
What Is Continuous Glucose Monitoring
Continuous glucose monitoring is another way to check your glucose levels. Most CGM systems use a tiny sensor that you insert under your skin. The sensor measures glucose levels in the fluids between your bodys cells every few minutes and can show changes in your glucose level throughout the day and night. If the CGM system shows that your glucose is too high or too low, you should check your glucose with a blood glucose meter before making any changes to your eating plan, physical activity, or medicines. A CGM system is especially useful for people who use insulin and have problems with low blood glucose.
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Factors That Contribute To Blood Sugar Range
The bodys level of blood glucose is controlled by , a hormone produced in the that helps your body absorb the sugar and use it in your cells. As your level of blood glucose rises, your pancreas produces more insulin to compensate. This helps keep your average blood glucose level within a safe range.
In diabetes, the body cant produce enough insulin or cant use the insulin properly . This means that your body cant compensate well for increases in blood glucose, which prevents your pancreas from stopping sharp spikes in blood glucose and increases the average blood glucose level over time.
Blood glucose spikes happen to everyone, especially after eating and drinking, but also after skipping breakfast, when youre dehydrated, and after you get a sunburn, among other triggers. They are especially dangerous for people with diabetes because their bodies cant , or even out, the spikes.
How Is Type 1 Diabetes Diagnosed
Type 1 diabetes can be diagnosed through any of the following tests:
An A1C test, also called a glycated hemoglobin test or HbA1c test. This blood test provides an estimate of a persons average blood sugar level from the past two or three months. An A1C of 6.5% or higher is considered diabetes.
A fasting plasma glucose test measures a persons blood glucose level after fasting for eight hours. An FPG of 126 mg/dl or higher indicates diabetes.
An oral glucose tolerance test measures the body’s blood glucose level two hours after consuming a sugary drink. An OGTT result at two hours of 200 mg/dl or higher indicates diabetes.
In someone with symptoms of high blood sugar , a random plasma glucose test can be used to check blood sugar levels. A random blood sugar level above 200 mg/dl indicates diabetes.
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Blood Sugar Chart: Summary
The fasting blood sugar, 2-hour post-meal blood sugar and HbA1C tests are important ways to diagnose prediabetes and diabetes, as well as indicate how well a persons diabetes is being managed. If you think you have diabetes, its important to not try and diagnose yourself by doing a fingerstick with a home blood glucose meter. There are strict standards and procedures that laboratories use for diagnosing diabetes therefore, you should get tested at your doctors office or at a laboratory.
Its also important to talk with your doctor to make sure you understand a) how often you should have certain tests, such as a fasting blood glucose or HbA1C test b) what your results mean and c) what your blood sugar and HbA1C targets are.
If you are diagnosed with diabetes, its recommended that you learn how to check your blood sugars with a meter so that you and your health-care team can determine how your treatment plan is working for you.
Now That Youre Checking Your Blood Glucose What Do The Numbers Mean
Depending on your diabetes treatment plan, your doctor or diabetes educator may advise you to check once a week, once a day or up to 10 times a day . But what does it mean when you see a 67, 101 or 350 on your meter? And what is a normal blood sugar, anyway? Great questions! After all, if you dont know what the numbers on your meter mean, its hard to know how youre doing.
The American Diabetes Association provides guidelines for blood glucose goals for people with diabetes, and the goals vary depending on when youre checking your glucose:
Fasting and before meals: 80130 mg/dl
Postprandial : Less than 180 mg/dl
By the way, these guidelines are for non-pregnant adults with diabetes. Children, adolescents and pregnant women may have different goals.
Your blood glucose goals may be different, however. If youre younger, have had diabetes for a shorter amount of time or are not taking any medicine for your diabetes, your glucose goals might be a little tighter, or lower. Likewise, your blood glucose goals may be higher than what ADA recommends if youre older, have diabetes complications, or dont get symptoms when your blood glucose is low.
Bottom line: talk with your health-care provider about the following:
When to check your blood glucose How often to check your blood glucose What your blood glucose goals are
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What Is The A1c Test
The A1C test is a simple blood test that measures your average blood sugar levels over the past 2 or 3 months. The test is done at a lab or your doctors office in addition tonot instead ofregular blood sugar testing you do yourself.
A1C testing is part of the ABCs of diabetesimportant steps you can take to prevent or delay health complications down the road:
- A: Get a regular A1C test.
- B: Try to keep your blood pressure below 140/90 mm Hg .
- C: Manage your cholesterol levels.
- s: Stop smoking or dont start.
The A1C goal for most adults with diabetes is between 7% and 8%, but your goal may be different depending on your age, other health conditions, medicines youre taking, and other factors. Work with your doctor to establish a personal A1C goal for you.
How Is Hyperglycemia Diagnosed
If you have diabetes and notice a sudden change in your blood sugar levels during your home monitoring, you should alert your doctor of your symptoms. The increase in blood sugar may affect your treatment plan.
Regardless of whether you have diabetes, if you begin experiencing any symptoms of hyperglycemia, you should speak to your doctor. Before going to your appointment, you should note what symptoms youre experiencing. You should also consider these questions:
- Has your diet changed?
- Have you had enough water to drink?
- Are you under a lot of stress?
- Were you just in the hospital for surgery?
- Were you involved in an accident?
Once at your doctors appointment, your doctor will discuss all of your concerns. Theyll perform a brief physical exam and discuss your family history. Your doctor will also discuss your target blood sugar level.
If youre age 59 or younger, a safe blood sugar range is generally between 80 and 120 milligrams per deciliter . This is also the projected range for people who dont have any underlying medical conditions.
People who are age 60 or older and those who have other medical conditions or concerns may have levels between 100 and 140 mg/dL.
Your doctor may conduct an A1C test to determine what your average blood sugar level has been in recent months. This is done by measuring the amount of blood sugar attached to the oxygen-carrying protein hemoglobin in your red blood cells.
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How To Test For Ketones
You can use a urine test strip or blood ketone meter and ketone test strip to test for ketones at home. Testing either urine or blood is important, but when possible, a blood test is preferred because it gives you and your care team more precise information about your ketone levels. Because urine may have been in the bladder for some time, the results from these tests may show levels that are either higher or lower than the ketone levels that are actually circulating in your body. It is also very important to know that urine test trips degrade over time, so if you are using this method, you need to look at expiration dates carefully.
Your diabetes care team can give you specific directions about when you should check for ketones, but in general, you should check for them when your blood glucose is 240 mg/dL or higher. You should also check for ketones if you notice any of the DKA symptoms listed above or if you are sick it is possible to have ketones while your blood glucose levels are within range .
At-home urine test strips will change color to show the level of ketones in the urine. They typically report results as negative, trace, small, moderate or large. Blood ketone meters will provide a number that indicates the ketone levels. The following ranges are generally used:
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How Can I Check My Blood Sugar
Use a blood sugar meter or a continuous glucose monitor to check your blood sugar. A blood sugar meter measures the amount of sugar in a small sample of blood, usually from your fingertip. A CGM uses a sensor inserted under the skin to measure your blood sugar every few minutes. If you use a CGM, youll still need to test daily with a blood sugar meter to make sure your CGM readings are accurate.
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What Is Type 1 Diabetes
Type 1 diabetes is an autoimmune disorder in which the immune system attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the pancreas produces little or no insulin. Type 1 diabetes is also characterized by the presence of certain autoantibodies against insulin or other components of the insulin-producing system such as glutamic acid decarboxylase , tyrosine phosphatase, and/or islet cells.
When the body does not have enough insulin to use the glucose that is in the bloodstream for fuel, it begins breaking down fat reserves for energy. However, the breakdown of fat creates acidic by-products called ketones, which accumulate in the blood. If enough ketones accumulate in the blood, they can cause a potentially life-threatening chemical imbalance known as ketoacidosis.
Type 1 diabetes often develops in children, although it can occur at any age. Symptoms include unusual thirst, a need to urinate frequently, unexplained weight loss, blurry vision, and a feeling of being tired constantly. Such symptoms tend to be acute.
Diabetes is diagnosed in one of three ways a fasting plasma glucose test, an oral glucose tolerance test, or a random plasma glucose test all of which involve drawing blood to measure the amount of glucose in it.
Causes Of Low Blood Sugar
There are many reasons why you may have low blood sugar, including:
- Taking too much insulin.
- Not eating enough carbs for how much insulin you take.
- Timing of when you take your insulin.
- The amount and timing of physical activity.
- Drinking alcohol.
- How much fat, protein, and fiber are in your meal.
- Hot and humid weather.
- Unexpected changes in your schedule.
- Spending time at a high altitude.
- Going through puberty.
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Can Type 1 Diabetes Be Controlled By Diet Alone
The simple answer is no. What you eat plays an important role in how well you manage your diabetes, but a healthy lifestyle also includes exercise, adequate sleep, and as little stress as possible. All of these factors need to be balanced with how much insulin you take. As someone with type 1 diabetes, you will have to consider insulin, diet, exercises, stress, and more for the rest of your life.
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How Does Blood Sugar Level Work
With a lack of nutrients and food that contain glucose, the blood sugar level will begin to decline. This is known as hypoglycemia.
After blood sugar becomes low, the pancreas releases a peptide hormone called glucagon. When this happens, the glucose that is stored in the body for energy is instructed to release due to the liver. This causes the glucose to turn into glycogen, known as the glycogenesis process. This is what can help a body to regain energy as the readily stored glycogen, in the liver and muscles, will release into the body.
On the other hand, the blood sugar can also rise and become too high which is known as hyperglycemia.
When the body does not produce enough of the insulin hormone, blood sugar levels begin to increase. This is because glucose relies on the insulin hormone to help it absorb into the bloodstream. Usually, this occurs when the body cannot produce enough insulin, known as type 1 diabetes, or does not respond to insulin correctly, known as type 2 diabetes.
Eating too many processed foods can also cause your blood sugar level to rise. If there is not enough insulin present in the body, too much bad food can cause your blood sugar level to build up.
For those with a normal blood sugar level, this will be due to eating the right foods and your body being able to produce and respond to insulin.
You may be wondering what exactly causes an imbalance in blood sugar levels, so here is a roundup:
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How Do I Take Care Of My Child Who Has Type 1 Diabetes
When your child is first diagnosed with Type 1 diabetes, it can be overwhelming. Theres a lot to learn, and youll need to get up to speed quickly on how to manage Type 1 diabetes and incorporate lifestyle changes at home. Caregivers often manage Type 1 diabetes for their children, especially if theyre young.
Some things youll need to do include:
- Learn to count carbohydrates, which may involve adapting your familys diet.
- Learn about how insulin works and how to give shots or use an insulin pump.
- Learn to check your childs blood sugar and interpret the results.
- Understand how different foods, exercise and illnesses affect blood sugar levels.
- Manage rivalries and feelings of jealousy between your children , which is common when theres a Type 1 diabetes diagnosis in a family.
- Support your childs mental and emotional health and reach out for professional help if needed. They may suddenly feel very overwhelmed with whats happening or feel that theyre different from their peers.
- Help your child learn how to listen to their body for symptoms of high and low blood sugar and how to manage Type 1 diabetes on their own .
- Educate friends, family, school administrators and others about Type 1 diabetes and your childs management needs and what they can do to help. Its important to reach out for help because while you can do a lot for your child, you cant do it all.
When To Contact A Medical Professional
- Chest pain or pressure, shortness of breath, or other signs of angina
- Loss of consciousness
- Sores or infections on your feet
- Frequent feelings of depression or anxiety
- Symptoms that your blood sugar is getting too low
- Symptoms that your blood sugar is too high
- Blood sugar readings that are below 70 mg/dL
You can treat early signs of hypoglycemia at home by drinking orange juice, eating sugar or candy, or by taking glucose tablets. If signs of hypoglycemia continue or your blood glucose level stays below 60 mg/dL , go to the emergency room.
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Type 1 Diabetes Symptoms
Signs are often subtle, but they can become severe. They include:
- Heavy, labored breathing
- Frequent infections of your skin, urinary tract, or
- Crankiness or mood changes
- Bedwetting in a child whoâs been dry at night
Signs of an emergency with type 1 diabetes include:
- Shaking and confusion
- Loss of consciousness
Type 1 Diabetes And The Keto Diet
There has been considerable interest in using the high-fat, very low-carb ketogenic diet to control diabetes, including type 1 diabetes. Normally, our bodies get energy from sugar, which comes from carbohydrate-rich foods. By restricting carbs and loading up on fat, the keto diet makes your body rely on ketones, which your liver produces from stored fat, according to Harvard Health.
The subject is a controversial one. This small study from 2018 in Diabetic Medicine found that adults with type 1 diabetes who followed a keto diet had well-controlled blood-sugar levels but that the diet may have increased cholesterol levels as well as episodes of low blood sugar, which can be serious. It is important to consult a specialist before making any major changes in your diet.
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