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Diabetic blood glucose regimens

by Isabel Fawcett

Contrary to how it may be perceived by some, diabetes management is not just doing blood glucose math. Regular, accurate blood glucose readings are essential for diabetics and their caregivers. The mutual goal is to mitigate effects of too much glucose in the diabetic's blood. A blood glucose reading and tracking regimen is but one element of progressive diabetes management.

Blood Glucose Testing For Life

I learned blood glucose testing from the best. I'm not a diabetic. My learning occurred as if by osmosis. In the same manner I learned to style my mother's hair by first-hand observation and mental focus, I learned about blood glucose testing. In retrospect, I mentally processed more than I realized I'd absorbed.

Mom was diagnosed with adult-onset diabetes circa her late 50's. After getting over brief initial shock and what I perceived to be reasonable feelings of being downcast at the news, she was stoic about needing to follow a regimen for blood glucose monitoring. So began her long journey of diabetes management and self-care. She used little hard-copy glucose logs, no larger than a mid-sized pocket calendar, to annotate her glucose readings multiple times daily.

Finger Pricks and More: Just Say "Ouch!"

Each time Mom pricked one of her fingers to draw blood with her glucose testing equipment I cringed. Initially, I actually looked anywhere else to avoid seeing Mom's self-infliction of pain via sharp needles. At some point I must have stopped looking away. I started paying attention, including engaging in Mom dialogue to better understand what she was doing. Mom told me more than I ever wanted to know about why she needed to test her blood sugar with such regularity.

Now that she is 84, soon-to-be 85 years old, and I'm her full-time caregiver, I'm thankful I learned about blood glucose testing and fluctuations, including glucose levels in diabetics' urine tests.

I have not been Mom's caregiver for the entire 30+ year span since her diabetes diagnosis. I've just had the same 30 years to get used to the unending blood glucose regimen and *attempts to make sense of fluctuating blood sugar levels.

Good and *Bad News: Blood Glucose Math

The word "attempts" is one way to make clear that regardless of how blood glucose readings may trend for individual diabetics, there is no such thing as foolproof or perpetual mastery of glucose levels in the human body. The whys and wherefores of fluctuating blood glucose readings vary based on any number of factors.

1. Blood glucose testing is not an exercise in futility. Highly educated, experienced doctors prescribe blood glucose testing for patients with diabetes for good reason. The amount of glucose in an individual's blood matters in the short and long term of chronic disease management-- more so for diabetics. The ideal range for glucose levels is neither excessively high nor perilously low. Either extreme creates a no-win for diabetics, including undesirable long-term health complications. Currently there is no known cure for diabetes. The best strategy is to remain under skilled medical care for the duration.

2. Glucose levels will fluctuate regardless of how disciplined a diabetic may be and without regard to the diabetic's recurring stable glucose levels over short, or long periods of time. Diabetics and their caregivers need to be realistic about such fluctuations. With input from the doctor, remain alert without panicking at the slightest fluctuations or blood glucose trends. I view blood glucose readings and trends as health goals, not hourly marching orders.

3. Acquire a solid understanding of the ideal blood glucose range. If it's been awhile since the doctor stressed the importance of blood glucose management ask for a refresher.

4. Pre and post meal blood glucose readings, daily, weekly, bi-weekly and monthly trends should be reviewed and considered in context of historical lab reports as ordered (and previously discussed) by doctors with their diabetic patients and/or **those who help care for diabetics.

**Medical disclosures to caregivers are subject to patient consent.

5. Consistently healthy nutrition is not a panacea for avoiding blood glucose fluctuations without fail. Healthy nutrition remains a worthy goal for diabetics. Fad diets may be medically unsafe. For diabetics, healthy eating begins with regular meals. Skipping meals can contribute to blood glucose extremes, whether highs or lows.

6. Avoid obsessive or compulsive blood glucose testing. Glucose testing is a regimen,not an endurance test. Talk to the doctor if there's undue anxiety with glucose testing regimens.

ABC News: Blood Sugar Levels Explained by a Doctor

http://abcnews.go.com/Health/DiabetesScreening/story?id=3812946

Source for URL Video and Text Interview: ABC News, January 11, 2008, What is the Normal Range for Blood Sugar Levels...A True Emergency?;Video and Text Interview with Edward S. Horton, M.D., Section Head, Clinical Research, Joslin Diabetes Center; Professor of Medicine, Harvard Medical School.