Once diagnosed with diabetes, monitoring blood sugar is essential. Some patients do not know how many times a day to check blood sugar, and whether there is a difference between fasting and postprandial blood sugar in what.
Let’s give you a detailed introduction to several indicators for monitoring blood sugar and some problems that need attention.
Glucose monitoring at home in how?
Glucose meter is a standard configuration and necessary tool for diabetics. In addition to doing examinations in hospitals, Diabetes patients need to monitor their blood sugar level at home through a rapid blood glucose meter. In the outpatient department, There are still a few patients who never monitor their blood sugar, Always by feeling. Today, my head is a little dizzy, my mouth is obviously dry, and I urinate a lot. I think it may be high blood sugar, Eat less. This is very unscientific and undesirable. It is easy to delay the illness. It is very important for diabetics to monitor blood sugar. Although the pathogenesis of diabetes is not very clear at present, It cannot be completely cured, But the blood sugar control is good or bad, It has an important influence on the occurrence and prognosis of acute and chronic complications, Patients with well-controlled blood sugar, Just like normal people, Life expectancy will not be affected either. 1. Common monitoring indicators (1) Fasting, pre-meal and 2-hour postprandial blood sugar: This is the routine point for patients to self-monitor their blood glucose, Fingertip capillary blood sugar is usually used. This is the immediate blood sugar at that time. However, it should be noted that this result alone cannot be used as the basis for diagnosing diabetes. (2) Urine sugar: Where conditions are limited or unconditional, Testing urine sugar is also a way to understand self-control of blood sugar. But because urine sugar is affected by kidney sugar threshold, For the elderly with increased renal glucose threshold or patients with gestational diabetes mellitus with decreased renal glucose threshold, There is no point in urinating sugar, There is even the possibility of misleading treatment. It is not helpful to detect hypoglycemia. Therefore, there are certain restrictions. 2. Frequency of blood sugar monitoring. Patients with poor blood sugar control or critically ill patients should be monitored 4-7 times a day (including fasting, before meals, 2 hours after meals, before going to bed, Some also need to measure blood sugar at 12: 00 midnight and 3: 00 a.m.), Until the blood sugar control is stable. When the disease condition is stable, the diet is controlled, the activity rule is regular, and the blood sugar reaches the standard, the blood sugar can be monitored 1-2 days a week, 5 times a day. 3. Blood sugar monitoring time (1) Pre-meal blood sugar: when the blood sugar level is very high, fasting blood sugar level is the first concern. People with hypoglycemia risk (the elderly, those with better blood sugar control) should also measure pre-meal blood sugar. (2) 2-hour postprandial blood glucose: suitable for those whose fasting blood glucose has been well controlled but still cannot reach the treatment target; (3) Bedtime blood sugar: suitable for patients injected with insulin, especially patients injected with medium and long-acting insulin; (4) Night blood sugar: suitable for insulin therapy is close to the treatment target, but fasting blood sugar is still high; (5) When hypoglycemia symptoms occur: blood sugar should be monitored in time; Symptoms of hypoglycemia include: mental disorder, dizziness, unstable standing, very hungry, headache, irritability, accelerated heartbeat, bloodless face, sweating, shaking, weakness, anxiety, etc. (6) Before and after strenuous exercise: blood sugar should be monitored. 4. Blood sugar monitoring scheme (1) Patients using basic insulin: before blood sugar reaches the standard, fasting blood sugar should be monitored 3 days a week, and follow-up visits should be made once every 2 weeks; The blood glucose spectrum at 5 o’clock (fasting, after three meals and before going to bed) was measured the day before the follow-up visit. After the blood sugar reached the standard, the 5-point blood sugar spectrum was monitored 1-2 times a week. The 5-point blood sugar spectrum was additionally measured one day before going to the hospital for follow-up. (2) Patients using premixed insulin were monitored for 3 days a week before the blood sugar reached the standard. After the blood sugar reaches the standard, monitor the 5-point blood sugar spectrum 1-2 times a week. Follow-up visit once a month, and add 5-point blood sugar spectrum once a day before follow-up visit. (3) Intensive blood sugar monitoring scheme for patients who do not use insulin therapy: blood sugar monitoring at 5-7 points a day 3 days a week, mainly during drug adjustment. What aspects does blood sugar monitoring include? In the hospital, Some other indicators need to be examined to reflect the condition or treatment of diabetes. 1. Glycosylated hemoglobin, That is, HbA1c and glycosylated serum protein HbA1c are the most important evaluation indexes for long-term blood sugar control. It is also one of the important bases to guide the adjustment of clinical treatment plan. It reflects the average blood sugar control level in the past three months. The normal reference range is 4% ~ 6%, Different hospitals may have slight differences due to different detection methods. At present, domestic and foreign guidelines suggest that this index should be controlled below 6.5% ~ 7%, But there will be some individualized differences. Some hospitals can also check glycosylated serum proteins. It mainly reflects the level of blood glucose control in the past 2 ~ 3 weeks. Both of these reflect the average blood glucose level. It does not reflect the fluctuation of blood glucose. 2. Venous blood glucose includes fasting and 2-hour postprandial blood glucose. It is mainly used for screening diabetes mellitus. It is not a common indicator for blood glucose monitoring. If fasting blood glucose and glycosylated hemoglobin (HbA1c) can be combined, Can better screen people at high risk of diabetes. Therefore, At present, routine physical examination only checks fasting blood glucose, There is still a certain missed diagnosis rate, The dynamic blood glucose monitoring system continuously and dynamically monitors the changes of blood glucose through special instruments. It can automatically record blood glucose data every 3 ~ 5 minutes. It can be recorded continuously for 3 days, To observe the dynamic blood sugar changes within 72 hours. It can draw the daily blood sugar change curve. In addition, meals, exercises, major events, etc. can be marked on the curve. For patients with large and irregular blood sugar fluctuations, From this chart, we can observe many situations that cannot be found by routine monitoring. And infer whether it is related to eating, exercise and other events, It provides important clues for clinical diagnosis and treatment. This kind of instrument is relatively expensive, It is usually available in larger hospitals. More advanced instruments also combine blood sugar monitoring with insulin pumps. This is the so-called “artificial pancreas”. Insulin is given quantitatively according to the blood sugar detected in real time. In fact, there is no fixed requirement for blood sugar monitoring. Mainly according to the control of blood sugar, combined with diet and exercise to adjust the plan. Foreign countries place more emphasis on the control of blood sugar before meals. However, China pays more attention to fasting and 2-hour postprandial blood sugar, It may be related to the different diet structures at home and abroad. Personally, I prefer to eat and exercise regularly. If you need to adjust drugs, you should know the blood sugar situation throughout the day, that is, fasting, after three meals and before going to bed. If the blood sugar fluctuation of patients with insulin is large, it is better to know the blood sugar before three meals. For blood sugar fluctuation is especially large, hyperglycemia and hypoglycemia appear irregularly, dynamic blood sugar monitoring can be performed to provide basis for doctors to adjust drugs.