BLOOD SUGAR TESTING:WHY,WHEN AND HOW

If you have diabetes,self testing your blood sugar ( blood glucose ) can be an important tools in managing your diabetes and preventing complications.

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You can test your blood sugar at home with a portable electronic device called a bloodsugar meter using a small drop of your blood. You can also use a device called a continuous glucose monitor ( CGM).

Many types of glucose tests exist and they can be used to estimate blood sugar levels at a given time or, over a longer period of time, to obtain average levels.

In healthy people these levels quickly return to normal via increased cellular glucose uptake which is primarily mediated by increase in blood insulin level.

Glucose tests can reveal temporary/long term hyperglycemia or hypoglycemia. These conditions may not have obvious symptoms and can damage organs in the long tern. Glucose tests are thus often used to diagnose such conditions.

Tests that can be performed at home are used in blood glucose monitoring for illness that have already been diagnosed medically so that these illnesses can be maintained via medication and meal timing.

Some of the home testing methods include :-

  • Finger prick type of glucose meter need to prick self finger 8-12 times a day.
  • Continuous glucose monitor – The CGM monitors the glucose levels every 5 minutes approximately.

Laboratory tests are often used to diagnose illnesses and such method include :

  • Fasting blood sugar (FBS), Fasting plasma glucose(FBG) 10-16 hours after eating.
  • Glucose tolerance test continuous testing
  • Postprandial glucose test(PC) 2 hours after eating.
  • Random glucose test.

Blood sugar levels can be affected by some and prior to some glucose tests these medications should be temporarily given up or their dosages should be decreased. Such drugs may include salicylates ( Aspirin ), birth control pills, corticosteroids, tricyclic antidepressants, lithium, diureties and phenytoin.

Some foods contain caffeine ( coffee, tea, colas, energy drinks ) Blood sugar levels of healthy people are generally not significantly changed by caffeine, but in diabetes caffiene intake may elevate these levels.

A level below 5.6mm ol/L(100mg/dl) 10-16 hours without eating is normal 5.6-6mm ol/l(100-109 mg/dl) may indicate prediabetes.

6.1-6.9 mm ol/l(110-125 mg/dl ) means OGTT ( oral glucose tolerance test ) should be done even if other indicators of diabetes are not present 7mm ol/l ( 126 mg/dl ) and above indicates diabetes and the fasting test should be repeated.

For a 2 hour GTT with 755 gram intake, a glucose level below 7.8mm ol/l(140 mg/dl ) is normal. Blood plasma glucose between 7.8 mmol/l ( 140mg.dl) indicate “impaired glucose tolerance ” and levels at or above 11.1 mmol/l at 2 hours confirm a diagnosis of diabetes.

For gestational diabetes, the American college of obstetricians and Gynecologist (ACOG) recommends a procedure, most pregnant women have a glucose screening test between 24 and 28 weeks of pregnancy.The test may be done earlier if you have a high glucose levels in your urine during your routine prenatal visits.

A glucose tolerance test is a common type of testing for potential gestational diabetes. Glucose challenges screening is a preliminary screening test performed between 26-28 weeks. If a women tests positive during this screening test, the second test, called the glucose tolerance test may be performed.

The glucose challenge screening is now considered to be a standard test performed during the early part of the third trimester of pregnancy. No preparation is required prior to the test. During the test, the mother is asked to drink a sweet liquid ( glucose ) and then will have blood drawn one hour from having the drink, as blood glucose levels normally pick within one hour. No fasting is required prior to this test. A high level in your blood may indicate your body is not processing sugar effectively ( positive test ).

Prior to the taking the glucose tolerance test, your doctor will ask you to make sure and eat at least 150mg of carbohydrates for three days prior to the time you will be asked to fast. you will not be permitted to eat or drink anything but sips of water for 14 hours prior to the test, so it is best to schedule the test for first thing in the morning.

The following are the values that the American Diabetes Association considers to be abnormal during the Glucose Tolerance Test :

  • FASTING – 95MG/DL OR HIGHER
  • ONE HOUR – 180MG/DL OR HIGHER
  • TWO HOURS – 155 MG/DL OR HIGHER
  • THREE HOURS – 140 MG/DL OR HIGHER

If only one of your readings comes back abnormal, your doctor may suggest some changes to your diet and/or test you again later in the pregnancy. If two or more of your readings come back abnormal, you will be diagnosed with gestational diabetes and your doctor will talk to you about a treatment plan. Treating diabetes during pregnancy is extremely important to protect the health of both mother and baby.

The blood sugar level, blood sugar concentration, or blood glucose level is the concentration of glucose present in the blood of humans and other animals.

Glucose is a simple sugar and approximately 04 grams of glucose are present in the blood of a 70-kilogram ( 150 lb ) human at all times. Blood glucose is maintained at a constant level at the expense of glycogen stores in the liver and skeletal muscles.

Glucose levels are usually lowest in the morning, before the first meal of the day, and rise after meals for an hour or two by a few millimoles. A glucose persistently high level is referred to as hyperglycemia, low levels are referred to as hypoglycemia. The intake of alcohol causes an initial surge in blood sugar, and later tends to cause levels to fall.

Normal value ranges may vary slightly between laboratories. Blood sugar level to a narrow range of about 4.4 to 6.1mmol/l( 79 to 110mg/dl) as measured by a fasting blood glucose test. American Diabetes Associations should be 5.0 – 7.2mmol/l(90-130mg/dl) before meals and less than 10mmol/l)18-mg/dl) two hours after meal (as measued by a blood glucose monitor).

For people with diabetes maintaining ‘tight diabetes control’the American Diabetes Association recommends a post meal glucose level of less than 10mmol/l ( 180mg/dl) and a fasting plasma Glucose of 3.9 to 7.2mmol/l( 70-130 mg/dl).

If blood sugar levels remain too high the body suppresses appetite over the short term . long term hyperglycemia causes many health problems, including heart diseases, cancer, eye , kidneys and nerve damage.

If blood sugar levels drop too low a potentially fatal condition called hypoglycemia develops symptoms may include impaired mental functioning, irritability,shaking, twitching, weakness in arm and leg muscles, sweating and loss of consciousness.

Blood glucose monitoring is far preferable, both clinically and for home monitoring by patients.

Stay Tuned !

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