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Blood glucose control

Blood glucose control

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Blood glucose control -

Type 1 diabetes — For people with type 1 diabetes, frequent glucose testing is the only way to safely and effectively manage blood glucose levels.

People with type 1 diabetes may use blood glucose monitoring BGM with fingersticks and a glucose meter, or continuous glucose monitoring CGM. In people with type 1 diabetes, CGM is generally used if available and affordable. See 'Methods of glucose monitoring' above and 'Continuous glucose monitoring' below and "Patient education: Type 1 diabetes: Overview Beyond the Basics ".

Most people with type 1 diabetes who use BGM alone need to check their blood glucose level at least four times every day. If you use an insulin pump, give yourself three or more insulin injections per day, or are currently pregnant, you may need to test as many as 10 times a day or more.

See "Patient education: Care during pregnancy for patients with type 1 or 2 diabetes Beyond the Basics ". This way you will be able to access your testing equipment wherever you are, making it easier to manage your blood glucose.

Glucose monitoring is useful for people with type 2 diabetes who take insulin or certain medications that can cause hypoglycemia. It is generally unnecessary in people who manage their diabetes with diet alone or who take medications that do not cause hypoglycemia, especially if they have reached their glucose goals.

Your health care provider can help you determine how frequently to check your glucose based on your situation. Most people with type 2 diabetes who perform glucose monitoring use BGM.

For people taking insulin, CGM may be used if available and affordable. See 'Who should use CGM? How to check your blood glucose — The following steps include general guidelines for testing blood glucose levels.

However, because the instructions can vary between devices, it's best to check the package insert for your glucose meter or talk with your health care provider. It's important to never share monitoring equipment or fingerstick devices, as this could lead to infection.

Lancets that are used more than once are not as sharp as a new lancet and can cause more pain and injury to the skin. Alternate sites are often less painful than the fingertip. However, results from alternate sites are not as accurate as fingertip samples. This should not be a problem if you always use the same site.

However, when your blood glucose is rising rapidly eg, immediately after eating or falling rapidly in response to insulin or exercise , it's more accurate to use the fingertip, as testing at alternate sites may give significantly different results in these situations.

If you have difficulty getting a good drop of blood from your fingertip, try rinsing your fingers with warm water and shaking your hand below your waist. This can help get the blood flowing. The results will be displayed on the meter after several seconds.

Blood glucose meters — There is no single blood glucose meter that is better than others. Your health care provider or pharmacist can help you choose a meter based on your preferences as well as other factors like cost, ease of use, and accuracy; it should be one that is approved by either the International Organization for Standardization or the US Food and Drug Administration FDA.

Medicare also covers costs of BGM. Accuracy of home BGM — Blood glucose meters are reasonably accurate. However, there can be some variability between meters, so it is always wise to use caution and common sense.

If you get a result that does not fit with how you feel for example, if it says your blood glucose is very low but you don't have any symptoms , take a second reading or use an alternate method for testing your blood glucose such as a different meter.

Blood glucose meters are least accurate during episodes of low blood glucose. See "Patient education: Hypoglycemia low blood glucose in people with diabetes Beyond the Basics ". The accuracy of BGM can be affected by several factors, including the type of blood glucose strip and meter.

Inaccurate readings can be caused by the use of expired strips, improper storage of strips exposure to high temperature and humidity , inadequate cleansing of your skin, and ingestion of vitamin C and acetaminophen. It's a good idea to check the accuracy of your blood glucose meter occasionally by bringing it with you when you have an appointment to get blood testing.

This way, you use your home monitor to check your blood glucose at the same time that blood is drawn and compare the results. If the results differ by more than 15 percent, there may be a problem with your meter or other equipment; your provider can help you figure out what's going on and how to correct the problem.

Help for people with vision impairment — People with vision impairment a common complication of diabetes sometimes have difficulty using glucose meters. Meters with large screens and "talking" meters are available. If you have impaired vision, you can get help from the American Association of Diabetes Care and Education Specialists ADCES at Continuous glucose monitoring CGM is a way to monitor your glucose levels every 5 to 15 minutes, 24 hours a day.

Because of reliability issues, warm-up periods, and the need to calibrate some of the devices, CGM does not eliminate the need for at least occasional fingersticks.

CGM systems are described in detail above see 'Continuous glucose monitoring' above. Who should use CGM? CGM systems are most often used by people with type 1 diabetes. Periodic use of CGM can also help you and your health care provider determine when your glucose is low or high and how to adjust your medication doses or food intake to prevent these fluctuations.

Devices that combine an insulin pump with a CGM system are also available. See "Patient education: Type 1 diabetes: Insulin treatment Beyond the Basics ". Advantages — There is evidence that people with type 1 diabetes who use a CGM system consistently and reliably rather than blood glucose monitoring [BGM] have modestly better managed blood glucose levels.

The "real-time" CGM devices automatically display your glucose level every five minutes, using numbers, graphics, and arrows so you can easily tell if your level is increasing, decreasing, or stable figure 3. The receiver recording device can also be set to trigger an alarm if your glucose level gets above or below a preset level, which can be especially helpful for people who cannot feel when they have low blood glucose also known as "impaired awareness of hypoglycemia".

Most CGM systems permit real-time "sharing" of your CGM readings with others eg, family members or caregivers. Some, but not all, of these intermittently scanning CGM devices are able to alert you of low or high glucose readings.

You can download glucose results from the CGM system to your computer, tablet, or smartphone, allowing you to see glucose trends over time. If you take insulin, your health care provider can help you figure out how to use this information to adjust your insulin dose if needed. Drawbacks — CGM systems may show lower glucose values than blood glucose meters, especially when blood glucose levels are rapidly rising.

In addition, the costs associated with CGM are greater than those of traditional glucose meters. Not all continuous glucose meters and supplies are covered by commercial health insurance companies. Glucose testing — The results of glucose testing with blood glucose monitoring BGM or continuous glucose monitoring CGM tell you how well your diabetes treatments are working.

Glucose results can be affected by different things, including your level of physical activity, what you eat, stress, and medications including insulin, non-insulin injectable medications, and oral diabetes medications.

To fully understand what your glucose levels mean, it is important to consider all of these factors. When keeping track of your results, you should include the time and date, glucose result, and the medication and dose you are taking.

Additional notes about what you ate, whether you exercised, and any difficulties with illness or stress can also be helpful but are not generally required every day. You should review this information regularly with your health care provider to understand what your results mean and whether you need to make any changes to better manage your glucose levels.

Need for urine testing — If you have type 1 diabetes, your health care provider will talk to you about checking your urine for ketones. Ketones are acids that are formed when the body does not have enough insulin to get glucose into the cells, causing the body to break down fat for energy.

Ketones can also develop during illness, if an inadequate amount of glucose is available due to skipped meals or vomiting. Ketoacidosis is a condition that occurs when high levels of ketones are present in the body; it can lead to serious complications such as diabetic coma.

Urine ketone testing is done with a dipstick, available in pharmacies without a prescription. If you have moderate to large ketones, you should call your health care provider immediately to determine the best treatment. You may need to take an additional dose of insulin, or your provider may instruct you to go to the nearest emergency room.

Meters that measure ketone levels in the blood are also available, but due to their cost, urine testing is more widely used. ADJUSTING TREATMENT. Checking your glucose either with blood glucose monitoring [BGM] or continuous glucose monitoring [CGM] provides useful information and is an important part of managing your diabetes.

If you use insulin, your glucose results will help guide you in choosing the appropriate doses from meal to meal. When you first start treatment for diabetes, you will need to work with your health care provider as you learn to make adjustments in treatment.

However, with time and experience, most people learn how to make many of these adjustments on their own. Your health care provider is the best source of information for questions and concerns related to your medical problem. This article will be updated as needed on our website www.

Related topics for patients, as well as selected articles written for health care professionals, are also available. Some of the most relevant are listed below. Patient level information — UpToDate offers two types of patient education materials.

The Basics — The Basics patient education pieces answer the four or five key questions a patient might have about a given condition. These articles are best for patients who want a general overview and who prefer short, easy-to-read materials.

Patient education: Type 2 diabetes The Basics Patient education: Using insulin The Basics Patient education: Treatment for type 2 diabetes The Basics Patient education: Low blood sugar in people with diabetes The Basics Patient education: Care during pregnancy for people with type 1 or type 2 diabetes The Basics Patient education: My child has diabetes: How will we manage?

You program an insulin pump to dispense specific amounts of insulin. It can be adjusted to give out more or less insulin depending on meals, activity level and blood sugar level.

A closed loop system is a device implanted in the body that links a continuous glucose monitor to an insulin pump. The monitor checks blood sugar levels regularly. The device automatically delivers the right amount of insulin when the monitor shows that it's needed.

The Food and Drug Administration has approved several hybrid closed loop systems for type 1 diabetes. They are called "hybrid" because these systems require some input from the user.

For example, you may have to tell the device how many carbohydrates are eaten, or confirm blood sugar levels from time to time.

A closed loop system that doesn't need any user input isn't available yet. But more of these systems currently are in clinical trials. Sometimes your provider may prescribe other oral or injected drugs as well.

Some diabetes drugs help your pancreas to release more insulin. Others prevent the production and release of glucose from your liver, which means you need less insulin to move sugar into your cells. Still others block the action of stomach or intestinal enzymes that break down carbohydrates, slowing their absorption, or make your tissues more sensitive to insulin.

Metformin Glumetza, Fortamet, others is generally the first drug prescribed for type 2 diabetes. Another class of medication called SGLT2 inhibitors may be used.

They work by preventing the kidneys from reabsorbing filtered sugar into the blood. Instead, the sugar is eliminated in the urine. In some people who have type 1 diabetes, a pancreas transplant may be an option. Islet transplants are being studied as well. With a successful pancreas transplant, you would no longer need insulin therapy.

But transplants aren't always successful. And these procedures pose serious risks. You need a lifetime of immune-suppressing drugs to prevent organ rejection.

These drugs can have serious side effects. Because of this, transplants are usually reserved for people whose diabetes can't be controlled or those who also need a kidney transplant.

Some people with type 2 diabetes who are obese and have a body mass index higher than 35 may be helped by some types of bariatric surgery. People who've had gastric bypass have seen major improvements in their blood sugar levels.

But this procedure's long-term risks and benefits for type 2 diabetes aren't yet known. Controlling your blood sugar level is essential to keeping your baby healthy.

It can also keep you from having complications during delivery. In addition to having a healthy diet and exercising regularly, your treatment plan for gestational diabetes may include monitoring your blood sugar.

In some cases, you may also use insulin or oral drugs. Your provider will monitor your blood sugar level during labor. If your blood sugar rises, your baby may release high levels of insulin.

This can lead to low blood sugar right after birth. Treatment for prediabetes usually involves healthy lifestyle choices. These habits can help bring your blood sugar level back to normal. Or it could keep it from rising toward the levels seen in type 2 diabetes. Keeping a healthy weight through exercise and healthy eating can help.

Drugs — such as metformin, statins and high blood pressure medications — may be an option for some people with prediabetes and other conditions such as heart disease. Many factors can affect your blood sugar. Problems may sometimes come up that need care right away. High blood sugar hyperglycemia in diabetes can occur for many reasons, including eating too much, being sick or not taking enough glucose-lowering medication.

Check your blood sugar level as directed by your provider. And watch for symptoms of high blood sugar, including:. Diabetic ketoacidosis is a serious complication of diabetes. If your cells are starved for energy, your body may begin to break down fat.

This makes toxic acids known as ketones, which can build up in the blood. Watch for the following symptoms:. You can check your urine for excess ketones with a ketones test kit that you can get without a prescription. If you have excess ketones in your urine, talk with your provider right away or seek emergency care.

This condition is more common in people with type 1 diabetes. This condition is seen in people with type 2 diabetes. It often happens after an illness. Call your provider or seek medical care right away if you have symptoms of this condition.

If your blood sugar level drops below your target range, it's known as low blood sugar diabetic hypoglycemia. If you're taking drugs that lower your blood sugar, including insulin, your blood sugar level can drop for many reasons.

These include skipping a meal and getting more physical activity than normal. Low blood sugar also occurs if you take too much insulin or too much of a glucose-lowering medication that causes the pancreas to hold insulin. Low blood sugar is best treated with carbohydrates that your body can absorb quickly, such as fruit juice or glucose tablets.

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Diabetes is a serious disease. Following your diabetes treatment plan takes total commitment. Careful management of diabetes can lower your risk of serious or life-threatening complications. Make physical activity part of your daily routine. Regular physical activity can help prevent prediabetes and type 2 diabetes.

It can also help those who already have diabetes to maintain better blood sugar control. A minimum of 30 minutes of moderate physical activity — such as brisk walking — most days of the week is recommended.

Aim for at least minutes of moderate aerobic physical activity a week. Getting regular aerobic exercise along with getting at least two days a week of strength training exercises can help control blood sugar more effectively than does either type of exercise alone.

Aerobic exercises can include walking, biking or dancing. Resistance training can include weight training and body weight exercises. Also try to spend less time sitting still.

Try to get up and move around for a few minutes at least every 30 minutes or so when you're awake. Keep your vaccinations up to date. High blood sugar can weaken your immune system.

Get a flu shot every year. Your provider may recommend the pneumonia and COVID vaccines, as well. The Centers for Disease Control and Prevention CDC also currently recommends hepatitis B vaccination if you haven't previously had it and you're an adult ages 19 to 59 with type 1 or type 2 diabetes.

The most recent CDC guidelines suggest vaccination as soon as possible after diagnosis with type 1 or type 2 diabetes. If you are age 60 or older, have been diagnosed with diabetes, and haven't previously received the vaccine, talk to your provider about whether it's right for you. If you drink alcohol, do so responsibly.

Alcohol can cause either high or low blood sugar. This depends on how much you drink and if you eat at the same time.

If you choose to drink, do so only in moderation — one drink a day for women and up to two drinks a day for men — and always with food. Remember to include the carbohydrates from any alcohol you drink in your daily carbohydrate count. And check your blood sugar levels before going to bed.

Many substances have been shown to improve the body's ability to process insulin in some studies. Other studies fail to find any benefit for blood sugar control or in lowering A1C levels. Because of the conflicting findings, there aren't any alternative therapies that are currently recommended to help everyone to manage blood sugar.

If you decide to try any type of alternative therapy, don't stop taking the drugs that your provider has prescribed. Be sure to discuss the use of any of these therapies with your provider. Make sure that they won't cause bad reactions or interact with your current therapy. Also, no treatments — alternative or conventional — can cure diabetes.

If you're using insulin therapy for diabetes, never stop using insulin unless directed to do so by your provider. Living with diabetes can be difficult and frustrating. Sometimes, even when you've done everything right, your blood sugar levels may rise. But stick with your diabetes management plan and you'll likely see a positive difference in your A1C when you visit your provider.

Good diabetes management can take a great deal of time and feel overwhelming. Some people find that it helps to talk to someone. Your provider can probably recommend a mental health professional for you to speak with. Or you may want to try a support group.

Sharing your frustrations and triumphs with people who understand what you're going through can be very helpful. And you may find that others have great tips to share about diabetes management.

Your provider may know of a local support group. You can also call the American Diabetes Association at DIABETES or the Juvenile Diabetes Research Foundation at CURE You're likely to start by seeing your health care provider if you're having diabetes symptoms.

If your child is having diabetes symptoms, you might see your child's health care provider. If blood sugar levels are very high, you'll likely be sent to the emergency room.

If blood sugar levels aren't high enough to put you or your child immediately at risk, you may be referred to a provider trained in diagnosing and treating diabetes endocrinologist.

Soon after diagnosis, you'll also likely meet with a diabetes educator and a registered dietitian to get more information on managing your diabetes. Preparing a list of questions can help you make the most of your time with your provider.

For diabetes, some questions to ask include:. Diabetes care at Mayo Clinic. Mayo Clinic does not endorse companies or products.

Advertising revenue supports our not-for-profit mission. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. This content does not have an English version. This content does not have an Arabic version. Diagnosis Type 1 diabetes FAQs Endocrinologist Yogish Kudva, M.

Care at Mayo Clinic Our caring team of Mayo Clinic experts can help you with your diabetes-related health concerns Start Here. Enlarge image Close. Continuous glucose monitor and insulin pump A continuous glucose monitor, on the left, is a device that measures your blood sugar every few minutes using a sensor inserted under the skin.

Request an appointment. Thank you for subscribing! Sorry something went wrong with your subscription Please, try again in a couple of minutes Retry. By Mayo Clinic Staff. Show references Ferri FF.

Diabetes mellitus. In: Ferri's Clinical Advisor Elsevier; Accessed May 7, Classification and diagnosis of diabetes: Standards of medical care in diabetes — Diabetes Care. Papadakis MA, et al. McGraw Hill; Accessed May 4, Diabetes risk factors. Centers for Disease Control and Prevention.

Accessed June 2, Cunningham FG, et al. In: Williams Obstetrics. McGraw-Hill Education; Diabetes and DKA ketoacidosis. American Diabetes Association. Diabetes Canada Clinical Practice Guidelines Expert Committee. Complementary and alternative medicine for diabetes.

Canadian Journal of Diabetes. Nimmagadda R. Allscripts EPSi. Mayo Clinic. June 16, Jameson JL, et al. Diabetes mellitus: Diagnosis, classification and pathophysiology.

High blood sugar, also known Cognitive function alertness hyperglycemia, gluccose associated with diabetes, Oats and diabetes management disease that Conteol cause heart attack, heart failure, stroke, glucse kidney failure. High blood sugar occurs when your body fails to produce enough insulin or use insulin efficiently. You can help to control your blood sugar levels with a few natural adjustments to your lifestyle and diet. Of course, you should discuss changes with your health provider first. If you need a primary care physician, book your appointment online at gradyhealth. orguse MyChartor call

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Your Blood Sugar Reading is False! Here is Why. Mayo Blood glucose control gludose appointments in Arizona, Florida Blood glucose control Minnesota and at Mayo Bllod Health System locations. Diabetes management takes ccontrol. Know what makes your fontrol sugar level Fat metabolism supplements and fall — and how to control these day-to-day factors. When you have diabetes, it's important to keep your blood sugar levels within the range recommended by your healthcare professional. But many things can make your blood sugar levels change, sometimes quickly. Find out some of the factors that can affect blood sugar. Blood glucose control

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