Click here to download the 'Importance of Glucose Control' information
In order to keep well and healthy, some changes to your way of life may be needed. It is important that you work closely with your care team as they will work with you to set up a care plan specifically designed for you.You will gain essential understanding of your own diabetes, enabling you to be in control of your condition.
Going for a walk, eating out or having a drink with friends are normally taken for granted, but these activities can affect your glucose (sugar) levels, so your care plan should give you information on the following:
One of the best ways to be sure that your care plan is working is by monitoring your glucose levels.This should be done by yourself and through regular health check reviews with your care team.
Your diabetes care team will give you a range to keep your blood glucose levels.A normal glucose level is around 4.0 - 7.0mmol/l. Keeping your levels as close to this range as possible, most of the time, greatly reduces the risk of problems and complications.
Before the availability of blood glucose (sugar) testing, urine testing was traditionally used, when people with diabetes needed to check for glucose. It has now, in the main, been superseded by blood glucose self-testing also known as finger pricking.
Blood glucose self-testing is preferred as it gives more in-depth information on day-to-day glucose patterns & control; also most people find it more convenient. However urine testing may still occasionally be used and you may be asked to perform it if:
Although recognised as being less accurate and off-putting to perform, urine testing is low cost and less invasive than blood glucose self-testing. If you are asked to urine test you will have to:
The level at which glucose may be present in urine varies with each individual, as our kidneys have their own tolerance to glucose; this is known as “The Renal Threshold” so urine glucose tests can be difficult to interpret. Many factors affect the suitability of using urine testing and you should discuss these with your care team. Factors for discussion include:
This is the best method of being in control of your diabetes, as it enables you to see how well your body is responding to your medicine, diet and activities.Your glucose level can be seen the moment you perform the finger-prick test and use your blood glucose meter.
By providing “up to the minute” information on your blood glucose levels you can check that they are within range, or if you are at risk of a hypo (low blood glucose) or hyper (high blood glucose).You can then make immediate or day-to-day adjustments to your diabetes management with confidence.
Self-testing is simple to do and with the right techniques and technology it’s virtually pain-free.To self-test you will need a blood glucose meter, test strips and a finger pricker.You simply wash your hands first, prick the side of your fingertip and place the drop of blood to the end of the test strip.Then wait a few seconds for the meter to show you the result.
The more you test, the more you will know about your glucose control, so the test should be performed several times a day, normally before meals.Testing should be more frequent:
If you think that your fingers will get sore, don’t worry. Some of the new meter systems available let you take blood samples from other areas on your body, this is called “Alternative Site Testing” (AST).
Please ask your healthcare team about AST, when it is best for you to test and which meter system is best for you.
Remember, record your test results and discuss them with your diabetes care team.
In addition to self-testing, you will need regular HBA1c tests.The HBA1c test is different to self-testing as it measures how well your glucose level is being controlled over time, providing a picture to your care team of your long-term glucose control.
HbA1c is formed when glucose (sugar) in your bloodstream attaches to the Haemoglobin in red blood cells. HbA1c stays attached for the life of the red blood cells (about 120 days). HbA1c testing measures the percentage of Haemoglobin (Hb) molecules in red blood cells that have glucose attached to them.
As the test is directly proportional to the amount of glucose in your blood over a 3-month period, the higher your average glucose has been in the last 8-10 weeks, the higher the level of HbA1c will be.
HbA1c is normal if it is 6%
HbA1c provides an indication of time-averaged glucose control but does not provide information about day-to-day fluctuations.You can have blood glucose levels varying from 2 - 12mmols/l and yet have an HbA1c of 7%.Therefore, it should be used in conjunction with, rather than instead of blood glucose monitoring.
Sometimes, things just don't go to plan and no matter how hard you try, your glucose levels seem to be all over the place. This can result in:
These episodes are unpleasant and worrying, especially if you are not aware of your symptoms and thus do not treat them in time. Hypoglycaemia is the most frequent side effect of insulin treatment, it is not uncommon and it can occur at night.
If you find, regardless of the amount of self-testing you are doing, that this is happening, your diabetes team may want to discuss continuous glucose monitoring with you.
Continuous glucose monitoring is achieved by using a specially designed monitor. Simply set-up by your diabetes specialist nurse, you will wear it for 2 days. It checks your glucose level every second throughout the 2 days and a full report is then downloaded to a computer for analysis.
This system lets your diabetes team see your full glucose pattern and the true picture of your changing glucose levels, meaning fluctuations during the day, and particularly during the night can be detected.
This information is extremely useful to your team, helping them make changes to your treatment plan which will help to improve your overall control and reduce your risk of long-term complications.
In summary:
All information contained on this page has been approved by a Consultant Diabetologist.
The content of this site is for informational purposes only. Images and other information are not to be used as reasons to change any health, dietary, exercise, or medical regimen. Always seek advice from your health care professional before making any changes to medications, diet, or exercise regimens.
