Maintaining Control: Blood Glucose Monitoring

One of the important goals of diabetes management is to maintain your blood glucose levels as close to normal as possible.

Blood glucose monitoring is one of the essential tools in the management of your diabetes. Testing your blood glucose lets you know how well your body is working and highlights the need for more medication or refining of lifestyle. If you notice any trends or consistent readings above your blood glucose targets that occur between your routine visits, contact your diabetes care team and/or GP as soon as possible for further advice to help you get back on track.

** (see section Self Blood Glucose Monitoring on p45 for important information regarding guidelines for testing and targets for blood glucose control)

Hypoglycaemia (hypo - rhymes with low)

Hypoglycaemia is defined as a blood glucose level (BGL) less than 4.0mmol/L with or without symptoms and must be treated immediately.

Anyone on insulin and certain diabetes tablets should always carry some fast acting glucose such as jelly beans, glucose tablets or gel, or a sweet drink such as lemonade to treat a hypo. Glucose based foods or drinks work the fastest as they are more quickly absorbed by the body. Sugar based foods and drinks may take longer to work but are a good standby.

If you or someone you know has diabetes and they have a fit or are unconscious get emergency help! Do not attempt to feel them glucose by mouth as they can choke.

• Call 000 or 112 on a mobile phone

** (for more detailed information about hypoglycaemia please see the section entitled hypoglycaemia

Hyperglycaemia (hyper - rhymes with higher)

Sometimes you may get a higher blood glucose reading than usual and you may not be able to figure out the reason. This is not necessarily a cause for concern. It is only when blood glucose levels are consistently higher than they ought to be over weeks or months that the damage-causing complications can occur.

If your blood glucose levels are consistently high (above 8mmol/L), consult a health professional.

When you are sick with a virus or ‘flu your blood glucose levels will nearly always go up and you may need to contact your doctor, (especially if ketones are present) for an increase in your medication – especially if you are treated with insulin.

HbA1c

An HbA1c test is another tool for helping you and your doctor assess how well you are managing your diabetes. This test measures the average blood glucose concentration over the past 2 to 3 months by measuring the amount of glucose attached to your red blood cells.

This measurement is expressed as a percent ( %) and is not the same as the tests that you do at home where blood glucose is measured in millimols per litre (mmol/L).

The goal for most people with diabetes is to have an HbA1C in the 6.5% to 7.0% range, however this may need to be adjusted for the older person, for children, or during pregnancy. Having a really low HbA1C does not necessarily mean you are managing your diabetes better. It may mean you are experiencing more low blood glucose levels (hypos). Looking at both the HbA1c and blood glucose readings and frequency of hypo and hyperglycaemic readings will help you and your diabetes team work out a management plan that matches your lifestyle with your diabetes targets.

Tablets for Diabetes

Tablets can help lower blood glucose levels and are only effective when the pancreas is still producing insulin. They are not able to be used in type 1 diabetes.

Diabetes tablets are NOT insulin.

Your doctor will choose your diabetes medications based on your general health, your blood glucose levels, your eating habits, lifestyle and your weight. Prior to your taking this medication it is very important the doctor explains its action and the effects it might have.

You should also discuss your medication (and any vitamin, mineral or other complementary therapy you may be using) with the health professionals involved in your care including your specialist, pharmacist, diabetes educator and dietitian.

Many people often forget that chronic illnesses can have important mental health consequences. Many of these mental health problems are can be treated in a number of ways, including psychological and behavioral therapies: social support; medication; and complementary and alternative therapies.

If you're not in good mental shape, you might not look after yourself as well or follow the sort of regimen that's required to keep the diabetes under control. Psychological therapies have been shown to improve mental well-being in people with diabetes.