——Mr. Xu Rongrong’s Sugar Friends Class (27)
Professor Xu Rongrong, 306 Hospital of the People’s Liberation Army, expert of experts, chief physician of the Diabetes Center of the whole army
Editor Zuo Tianyu of Brand Quality Management Office
Q:My mother It is a type 1 diabetes patient with a history of more than 30 years. Currently, insulin is injected twice a day, and the “instantaneous” blood glucose meter is worn for two weeks in a few days. Currently, there is a large amount of blood glucose monitoring data. In this case, can you give advice on adjusting the treatment based on these blood glucose results?
A: “Instantaneous Blood Glucose Monitor” is very suitable for type 1 diabetes to facilitate the timely detection of hyperglycemia and hypoglycemia, prevent excessive blood sugar fluctuations and timely adjust insulin therapy. Very good blood sugar monitoring equipment. Of course, patients with type 2 diabetes, especially those with poor glycemic control, high blood sugar fluctuations, and multiple insulin treatments, also benefit from wearing a “instantaneous” blood glucose meter. Since the blood glucose monitoring does not require blood to be taken from the finger, it is only necessary to scan the sensor on the arm with a blood glucose detector to obtain the blood sugar level. This blood glucose monitor automatically records the value, records the blood glucose value every 15 minutes, and records the blood glucose value 96 times a day. After 14 days, the sensor is removed and all blood glucose values are displayed. Therefore, on the one hand, through immediate scanning, we can know the blood sugar at that time; on the other hand, through a retrospective analysis of two weeks of blood glucose data, we can better understand the scope and causes of blood sugar fluctuations, and provide more scientific, objective and comprehensive for further adjustment of treatment. in accordance with. Therefore, a large number of studies have confirmed that after wearing the “instantaneous” blood glucose monitor, the patient’s hyperglycemia control is satisfactorily controlled, hypoglycemia is avoided, and the insulin dosage is significantly reduced, and the patient’s quality of life is significantly improved.
Although there are a large number of blood glucose values, these values must be scientifically analyzed to be valuable. The basis of scientific analysis is the correct, timely and comprehensive data collection. Accuracy of blood glucose values can be achieved by multiple blood glucose tests. Timely and comprehensively, patients need to be recorded while wearing the blood glucose self-monitoring device. For example, the type and amount of mealtime and meal, the time, manner and duration of exercise, insulin injection time, dose and type, whether there are special activities or events and their special feelings (such as chest pain, fatigue, fever, etc.). With these comprehensive data, especially knowing the patient’s daily activity patterns and medications, combined with specific blood glucose monitoring values and the timing of hyperglycemia, hypoglycemia, and the relationship with diet, exercise, and medication, doctors can give Opinions that are consistent with the patient’s actual scientific guidance treatment. If you only provide the data printed by the “instantaneous” blood glucose monitor, we can only tell you how many times of hypoglycemia, hyperglycemia or blood sugar fluctuations based on this series of data, and can not help you further adjust the treatment. In this way, it is somewhat regrettable that the data brought about by the “instantaneous” blood glucose monitoring is not fully utilized.
Q: I am 68 years old and have 10 Male patients with a history of type 2 diabetes over the years have not had any serious diabetic complications after hospital examination. However, my fasting blood glucose has recently increased from 5.8 to 6.5 mmol/L to 7 to 8 mmol/L. Most postprandial blood glucose is below 8 mmol/L, and some will reach 10 mmol/L. Is my diabetes serious? Does high fasting blood sugar mean that my condition is getting worse? What should I do?
A:(1) You have a history of diabetes for more than 10 years, long-term glycemic control is satisfactory and there are no obvious complications of diabetes. Combined with your age, your diabetes is very well controlled. it is good. No need to worry. (2) The recent increase in fasting blood glucose may mean that your diabetes control is not as good as it used to be, but this blood sugar level is acceptable for you with a history of more than 10 years of diabetes and 68 years of age. However, it is recommended that you go to the hospital to determine glycated hemoglobin in order to understand whether the blood sugar control during this time is truly up to standard. If the glycated hemoglobin is less than 7%, this means that your blood sugar level is well controlled; if it is less than 7.5%, the problem is not big, no Need to adjust the treatment. Secondly, it is best to do blood glucose monitoring several times a day, such as fasting plus three meals, plus 2 to 3 o’clock before and after bedtime, if the blood glucose is between 6 and 11 mmol/L. Then there is no problem. If there is less than 4 mmol /L of blood sugar, you need to pay attention to, adjust the medication under the guidance of a doctor. Of course, severe hyperglycemia also requires a doctor. But I think, as you said, you are unlikely to have severe hyperglycemia (such as random blood sugar above 15 mmol /L). (3) After you have checked the glycated hemoglobin and completed the blood glucose monitoring, contact again if necessary. However, when you contact, you are advised to provide you with the exact medication, diet, and exercise to give you more appropriate advice.