American Diabetes Association Complete Guide to Diabetes. American Diabetes Association

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СКАЧАТЬ However, to be safe, talk over your blood glucose readings and exercise program with your health care team before you make changes to your diet, insulin, or other medications. Read more about managing your diabetes and physical activity in chapter 11.

      High Blood Glucose and Exercise

      It sounds strange, but people with type 1 diabetes will also need to check their blood glucose to make sure that it isn’t too high during exercise. If your blood glucose level is over 250 mg/dl, exercise may cause your blood glucose level to go up rather than down.

      Hard exercise with too little insulin can make the liver release stored glucose. Someone with type 1 diabetes whose blood glucose is greater than 250 mg/dl should test for ketones (read about how to test for ketones in chapter 7). Do not exercise if ketones are present. Use caution if your blood glucose is greater than 300 mg/dl, even if no ketones are present.

      Extra Checks for New Medications or Insulin

      If you have type 2 diabetes and take oral medication, finding the best dose can be tricky. You will need to monitor frequently when you are starting a new medication or trying to find the best dose of medication. Check your blood glucose once or twice a day (before breakfast and one other time during the day) to avoid low blood glucose. Occasionally you may want to check 2 hours after meals to see how well the medication works with your meal plan. Your monitoring records will help you and your health care provider decide what changes, if any, are needed.

      Starting or changing an insulin plan will also mean more blood glucose monitoring. Read up on the specifics of insulin in chapter 13.

      Other Times for Extra Checks

      • Before you drive (if you take insulin)

      • When you are more physically active than usual

      • When you have lost or gained weight

      • If you start taking a medication for another condition that affects blood glucose levels or your ability to recognize low blood glucose warning signs

      • If you have hypoglycemia at night or wake up with high blood glucose levels

      • When your levels have been outside your target range more often than in your range

      • If you don’t feel well. Checking helps you determine whether your glucose level needs attention

      • If you’re pregnant

      Extra Checks during Stress

      Everyone seems a little stressed out these days—and living with diabetes can add even more stress to your life. Stress can produce hormones that raise blood glucose levels. Stress can also be a hidden contributor to unexpected swings in blood glucose levels.

      Therefore, you’ll want to check your blood glucose more often when you’re experiencing stress. The effects of stress on your blood glucose can’t be measured as easily as units of insulin or calories burned during exercise. However, stressful situations could be throwing your blood glucose out of range (for example, if you have a bad day at work), so make sure to check your blood glucose when you feel stressed.

      When you can’t figure out why your blood glucose level is so high despite “doing everything right,” think about the stresses in your life and how you respond to them. Do you eat when you are under stress? These extra calories, plus stress hormones, could raise your blood glucose.

      Extra Checks during Illness

      Being sick is another kind of stress on your body that can raise blood glucose. Your body releases hormones to fight the illness, but these hormones also counteract the effect of insulin and raise blood glucose. Sickness can cause your diabetes to go out of control. Extremely high blood glucose levels caused by illness can also lead to diabetes emergencies, including coma and death.

      Blood glucose monitoring is especially important during any illness. Even if you have type 2 diabetes and only monitor once a day, you may want to check more often during times of illness. In general, you’ll want to check your blood glucose every 3–4 hours. Read more about handling sickness under the “Illness” section in chapter 8.

      Tips on Using Results of Self-Monitoring

      Throughout the book, you’ll find more advice about using the results of self-monitoring. Your results will help you develop your diabetes management plan, including your goals for meals, physical activity, and treatment.

      Sometimes, you’ll need to take immediate action based on a blood glucose reading, while many other times you’ll use the information to interpret a pattern and make future adjustments. This is particularly true for people who are not taking multiple, daily injections of insulin.

      Self-monitoring is also important for identifying blood glucose emergencies. Chapter 8 will describe some common blood glucose emergencies and how to handle them.

CHAPTER 7

      Self-Monitoring Tools

      • Lancets

      • Test Strips

      • Blood Glucose Meters

      • Continuous Glucose Monitors

      • Logbooks

      • Ketone Tests

      • Where to Buy Supplies

      Now that you’ve read about the importance of monitoring your blood glucose, you probably want to know exactly how to measure your blood glucose. There are a handful of tools that will help you accurately and easily measure your blood glucose every day. These tools are now smaller and more sophisticated than anyone would have dreamt of 30 years ago.

      New products are always being developed, so keep in mind that this chapter just covers the most essential tools. Every year the American Diabetes Association’s magazine Diabetes Forecast publishes a Consumer Guide for patients that describes the latest devices, as well as most devices currently on the market. The Consumer Guide is published in print and online, and it is a patient’s best resource for researching blood glucose monitoring tools (http://forecast.diabetes.org/consumerguide).

      Essential Tools

      Lancet: A device that pricks the skin with a small needle to obtain a blood sample.

      Test Strip: A strip (with a blood sample) that is inserted into a blood glucose meter.

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