It’s important to know how your insulin doses and treatment plan are affecting your blood glucose levels so that you can adjust your plan when necessary.
Testing and monitoring
It is possible to keep a very close track of your blood glucose levels by testing and monitoring your blood yourself. You can purchase a Glucometer from your local pharmacy or healthcare provider. Checking blood glucose levels requires obtaining a small drop of blood to place on a blood glucose strip. Talk to your diabetes educator, doctor or pharmacist about the various methods available and which one is right for you.
In South Africa, blood glucose levels are measured in millimoles per litre. Good management entails regular blood glucose monitoring – i.e. testing your blood glucose levels and adjusting your treatment accordingly. The normal range in people who do not have diabetes is considered to be between 4 and 6 mmol/l. You are considered to be diabetic if your blood glucose (blood test done before you have eaten breakfast) is over 7 mmol/l or over 11 mmol/l at any other time (non-fasting).
Your doctor will advise you what levels to aim for, but it is generally accepted that keeping the glucose levels between 4 and 8 mmol/l will greatly reduce the risk of diabetic complications.
Hypoglycemia or low blood sugar
Hypoglycemia occurs when Diabetics are over controlling their medication or not eating for extended periods of time.
Hypoglycaemia is a condition in which blood glucose levels drop too low (generally below 3.5mmol/l). Symptoms include irritability, numbness in the arms and hands, sweating, confusion, extreme hunger, shakiness or dizziness. It should be treated immediately by eating or drinking a simple sugar such as a glucose sweet, or sugary cold drink, followed by a sandwich or other form of carbohydrate. If left untreated, this condition can become severe and lead to unconsciousness.
Haemoglobin binds and transports oxygen in red blood cells. Depending on how high or low the blood glucose level is, more or less glucose is bound to its haemoglobin during the blood cell’s life span.
HbA1c is a measure of the per cent of the haemoglobin in the red blood cells that have glucose bound to it, providing an average measurement of the blood glucose levels during the last 2-3 months. If HbA1c is monitored at regular intervals, this will provide a good summary of how good your diabetic control has been during that time.
HbA1c should be checked regularly (every three to six months in all people with diabetes), as elevated HbA1C levels can provide early warning of potential future complications. If elevated levels occur, your doctor should recommend treatment measures appropriate to your situation to achieve better control. The doctor should then monitor your HbA1C levels more frequently (e.g. monthly) until better control is achieved.
Studies have shown that by maintaining controlled blood glucose levels, it is possible to delay or even prevent the potential long-term complications of diabetes.
It is generally accepted that you should maintain HbA1C below 8%. The following guidelines are suggested by the South African Diabetes Association:
4 – 6% Non-diabetic range.
< 7% Well-controlled diabetic 7% – 8% Acceptable diabetic control > 8% Poor diabetic control, needs attention.
Hypoglycemia or high blood glucose
High blood glucose can result when food, activity and insulin and/or other medication are not balanced. High blood glucose may happen when you are ill, pregnant or under stress. Symptoms include thirst and/or dry mouth, glucose in the urine, large urine volumes and more frequent urination, as well as weakness and lethargy, blurred vision, and weight loss.