Blood sugar is the amount of sugar in your blood at a given time. It’s important to check your blood sugar level, because it will:
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We’re most interested in your bad cholesterol, called the LDL. Increased levels of LDL can clog up your arteries and increase your risk of heart disease. For most people living with diabetes, we target an LDL cholesterol of less than or equal to two mmol/L per litre. For people living with diabetes, it’s really important for them to understand that it’s a disease that will change with time. Your treatment will change the longer you have diabetes.
People with type 1 or type 2 diabetes who are using insulin to control their blood sugars, we suggest that they test their blood glucose levels as frequently as they’re taking insulin. Often, you need that information to be able to make an adjustment to your insulin dosage. So that’s really the easy one. Where it gets a bit more difficult is when you’re using oral medications to manage your diabetes.
Some of those medications put you at absolutely no risk for having a low blood sugar, but other medications can actually put you at risk of having a low blood sugar.
So for people who use oral medications to manage their diabetes, we really want to determine, should they be testing because they’re going to make some changes to their diet or their activity, or should they be testing their blood glucose levels because they’re at risk of hypoglycemia? And it’s important to understand that hypoglycemia is a risk for people living with diabetes. So anytime that you suspect that you may be having a low blood sugar, you should test your blood sugar to see what it is, or check your blood sugar. And also, any time that you’re at risk of having a low blood sugar, such as unusual activity, less food than usual, or a mistake in your medication, you should always be testing to make sure whether or not your blood sugar is too low.
The appropriate use of blood glucose monitoring is around the world a very important question. Many associations have addressed this in their guidelines for those caring for people with diabetes. What’s important to remember is that how you use self-monitoring of blood glucose should be individualized to your diabetes and what you’re trying to achieve.
And so, for example, for people whose blood sugars are out of control, you may be asked to monitor more frequently to be able to identify patterns of areas where your blood glucoses are not controlled. For people who are using insulin, you may feel the need to test more frequently to adjust; you might feel your highs and lows. So you may be testing more frequently than you’re taking insulin.
What’s important to know as well is that for some people, they may have episodes of overnight low blood sugars. So sometimes, we’re asking them to get up in the middle of the night and to test their blood sugar. Why would we do that?
Well, there are certain medications that can cause you to go low overnight, and the symptoms of being low overnight are very different than the symptoms of being low during the day. What are they? Often, if you’ve had a low blood sugar overnight, you’ll wake up with a headache. Often, if you’ve had a low blood sugar overnight, you might have had a nightmare, or perhaps you’re having night sweats. Seeing a Local Registered Dietitian can often help. And for women who are in the menopausal state, “Am I having night sweats because I’m menopausal or am I having a night sweat because I’m low?” So the way that we validate that information is by asking people to test in the middle of the night. Blood Glucose Local endocrinologist Monitoring Patient Communication Presenter: Lori Berard, Nurse, Winnipeg, MB
Maintaining glucose targets is very important for prevention of complications related to diabetes. There are two tests to know about. The first one is an A1C. That is an average of your blood sugars over three months. It’s measured by a blood test done in a lab. For most people living with diabetes, that number should be less than or equal to seven percent. The other tests that’s important in terms of understanding your glucose control is when you do self-monitoring of blood glucose. Your health care professional can help you pick out the meter that’s best for you, teach you when would be appropriate times to perform glucose monitoring, and set your targets. For most people living with diabetes, fasting and before meals is four to seven mmol/L per litre, and after meals is five to ten mmol/L per litre. Maintaining good blood pressure control is very important for people with diabetes to protect their vascular health. There are two numbers in the blood pressure measurement: systolic and diastolic.
Systolic is the top number, it’s the measurement when the heart is beating against the wall of the artery. Diastolic is the bottom number, which is when the heart relaxes and fills back up again. It’s recommended that you have your blood pressure checked at all your diabetes-related visits. For most people living with diabetes, your target blood pressure is less than 130 on 80.
For people living with diabetes, it’s very important that your cholesterol is checked, at least on an annual basis. Cholesterol is part of what can increase your risk for heart disease. People living with diabetes already have a higher risk than the general population for heart disease.
If you’re looking for more information on how to manage your diabetes, or for help with some of the educational tips, you should speak to your diabetes health care team. That can include a diabetes nurse educator, a dietitian educator, a pharmacist, a family doctor, or perhaps a specialist called an endocrinologist. Often seeing a Endocrinologist or local family physician in conjunction with a registered dietitian and athletic therapist is a great option to take control of this condition. Smart Food Now and exercise is also optominal for overall health
Presenter: Lori Berard, Nurse, Winnipeg, MB