Understanding Blood Glucose levels
So you are newly diagnosed as a diabetic and you know that you have to monitor your blood sugar levels, and you know this because the Doctor told you that.
But what you don’t know is what it actually means. This should help.
Blood sugar concentration, (or in reality glucose level), refers to the amount of glucose present in your blood. Normally the blood glucose level is maintained at a reference range between about 3.6 and 5.8 mM (mmol/l). It is tightly regulated as a part of metabolic homeostasis.
WTF? Exactly what does that mean?
metabolic homeostasis basically means keeping (or regulating) the internal systems so as to keep a stable condition.
Mmol/L is the standard unit of measurement and refers to micro moles per litre and you don’t need to understand the chemistry but in case you want to know:
SCIENCE BIT:
Average normal blood glucose levels in humans are about 5mM (mmol/l) this is because the molecular weight of glucose, C6H12O6, is about 180 g/mol). The total amount of glucose normally in circulating human blood is about 3.3 to 7g – because an average human contains about 5 litres of blood. (That is just over a gallon in old money). Glucose levels vary a little during the day, rising after meals for an hour or two by a few grams and are usually lowest in the morning, before the first meal of the day (unless you are a secret midnight snacker).
So, what is this GLUCOSE stuff? Well it is carried by the bloodstream from the intestines or liver to body cells, it is the primary source of energy for body's cells, fats and oils (ie, lipids) being primarily a compact energy store, kind of like a battery. It really doesn’t mean that you should stop eating sugar, it means that you need to better control the type of food that you eat. But that is a separate story.
Failure to maintain blood glucose in the normal range leads to conditions of persistently high (hyperglycemia) or low (hypoglycemia) blood sugar. And that means that your body is not maintaining metabolic homeostasis.
A diabetic fails to maintain metabolic homeostasis and normally is hyperglycaemic and has very high glucose levels and this is often characterised by a constant thirst, with the resultant frequent trips to the loo.
Earlier on in treatment, a diabetic may also start to suffer hypoglycaemic attacks. This is often because the medication has not returned the body to stability and may well be over compensating.
So, at first, you really need to monitor your blood glucose levels, and map it against the food that you eat. That way you can see the effects of what you eat and the medication that you take.
As Alexandr would say ‘Simples’
Showing posts with label blood Sugar. Show all posts
Showing posts with label blood Sugar. Show all posts
Sunday
From Diabetes Health
Q & A: How To Lower Your Blood Sugar When It's Over 200 mg/dl
Nov 21, 2009
Q: How do I lower my blood sugar when it goes over 200 mg/dl? I have type 2 diabetes.
A: An excellent question, but a complicated one to answer. Your doctor or nurse educator should be contacted whenever your blood sugar runs consistently higher than 250 mg/dl for more than two days. When a person with type 2 diabetes encounters a high blood sugar, the strategy used to bring it down will vary from individual to individual. This is because of differences in treatment involving diet, exercise, and medication. It will also depend upon the guidelines for glucose control that you and your doctor have mutually agreed upon.
When high blood sugars do occur, there are a number of strategies that can be employed to lower the glucose level back down to a normal range. These might include:
1) Eating less food at the next meal, eliminating a snack, and/or eating foods with a lower glycemic index.
A general rule of thumb to follow is to eliminate 15 grams of carbohydrate (the amount in one starch exchange, one fruit exchange, or one cup of skim milk exchange), which will lower blood glucose by 30 mg/dl. If you test your blood sugar at 182 mg/dl before a meal or snack, then eliminate one starch and one cup of milk at the next meal to bring the glucose value close to 120 mg/dl as a baseline. Although people with diabetes will respond differently to this adjustment, it provides a basic guideline to start with.
For persons with type 2 diabetes who are overweight, the loss of only five to 10 percent of total weight can dramatically improve blood glucose values. Consequently, just cutting calories moderately can achieve better blood glucose control.
Lastly, choosing foods with a lower glycemic index, that is, foods that do not raise blood sugar as quickly or dramatically, can help to bring blood glucose back into a normal range. Some examples of foods with a low glycemic index are dried beans and lentils.
To test the glycemic effect of a food on your system, you will need to do more frequent monitoring. For example, you may want to compare the effect of brown rice versus baked potato by eating equivalent carbohydrate amounts of these foods at dinner and comparing your blood glucose response two hours later. The exact effect will vary from person to person.
2) Increasing activity or incorporating more exercise.
Persons with type 2 diabetes generally respond to increased exercise with a lowered blood glucose value. Simple exercise, such as walking 20 minutes or more per day, can effectively improve glucose tolerance and induce weight loss. Proper exercise can actually be effective enough to lower or completely eliminate the need for medication altogether.
3) Increasing medications, changing medications, and/or administering them more frequently.
Although this is certainly an option, it makes more sense to first address the problem of elevated blood glucose by exercise and cutting back on food. These measures are less costly and have fewer side effects. If they aren't effective, however, a medication change may be indicated. If you are on the minimal dose of oral agents, your doctor might raise the dose or split it into morning and evening doses.
This could also be true for those using insulin. Taking more shots per day does not mean that your diabetes is worse. It may even bring more flexibility into your lifestyle. In fact, a rule of thumb for those on insulin (check with your doctor first before making these adjustments) is to take one unit of regular insulin to lower blood glucose 30 mg/dl. If your blood sugar is 191 mg/dl before a meal, an extra three units of insulin will bring the glucose down about 100 mg/dl.
It is important to note that this rule may change for people who exercise regularly because it will take less insulin to achieve the desired effect. It may also change for those who become ill because they are more insulin-resistant and may need more insulin to achieve the desired effect. The effectiveness of insulin is also dramatically decreased by high blood sugar levels.
4) Using relaxation techniques and behavioral management.
Relaxation exercises, including deep breathing and audio tapes that guide you through deep muscle relaxation, can reduce stress and help you deal more effectively with it. Tapes are available specifically designed to create images of healthiness in diabetic individuals and encourage visualization of improved glucose control. Behavioral management techniques also increase one's overall sense of control over life and self-efficacy, so that diabetes becomes a state of "wellness in the midst of illness." When you are relaxed and in control, your blood glucose values can improve.
5) Treating identified illness and/or infections.
Illness and infection causes a rise in adrenergic hormones, which increase the production of glucose in the body. This extra surge of glucose is part of the healing process, but can upset glucose control. Thus, continuing to take medications despite poor appetite is vital. You may temporarily require more medication during periods of extended illness. Ask your doctor for instructions on dealing with illness.
6) Monitoring on a more frequent basis and/or monitoring other parameters.
When your blood glucose values exceed the target ranges established by you and your doctor, monitoring should be done every two hours until your blood glucose returns to normal. This gives you an opportunity to treat and adjust blood glucose as soon as possible, rather than waiting until your next doctor visit or next meal (which might be four or five hours later). It also tells you whether or not what you are doing is helping to bring the blood glucose down. Another step to take if your blood sugar is over 250 mg/dl would be ketone checks (done by urine dip stick or via a fingerstick to measure betahydroxybutyrate, an acid). Testing ketones hourly until they disappear is recommended.
7) Increasing consumption of sugar-free fluids.
Often, poor hydration accounts for the concentration of sugar in the blood. All people (with diabetes or not) should drink two to three quarts of sugar-free fluids per day. When glucose is elevated, drinking helps to dilute it. Also, drinking fluids is filling, decreasing the possibility of overeating.
People with heart disease who take diuretics and those with renal (kidney) complications may need to be on restricted fluids. Check with your doctor and/or dietitian if you fall into these special categories.
To combat high blood sugars, the most important strategy is prevention. Prevention of high blood sugars is usually possible with frequent and consistent monitoring. If you have awareness of your usual glucose response patterns to foods and exercise, it will be easier to plan out your day and prevent fluctuations in your blood sugar.
Tuesday
I was sent this news report today. I am not sure of the web source, if I can find it I will append it and reference it properly. I can say that I am totally at one with this, I have so struggled with memory loss since I became diabetic, and I can assert that when I was unregulated, my blood sugar I mean, my memory was terrible and contributed to my eventually losing the job I loved. My memory is better now, but nowhere near as good as it used to be. I am trying to keep my brain exercised - but it is so tiring.
Blood sugar control linked to memory decline, study says
Spikes in blood sugar can take a toll on memory by affecting the dentate gyrus, an area of the brain within the hippocampus that helps form memories, a new study reports.
Researchers said the effects can be seen even when levels of blood sugar, or glucose, are only moderately elevated, a finding that may help explain normal age-related cognitive decline, since glucose regulation worsens with age.
The study, by researchers at Columbia University Medical Center and funded in part by the National Institute on Aging, was published in the December issue of Annals of Neurology.
"If we conclude this is underlying normal age-related cognitive decline, then it affects all of us," said lead investigator Dr. Scott Small, associate professor of nememory lossurology at Columbia University Medical Center. The ability to regulate glucose starts deteriorating by the third or fourth decade of life, he added.
Since glucose regulation is improved with physical activity, Small said, "We have a behavioral recommendation — physical exercise."
In the study, researchers used high-resolution functional magnetic resonance imaging to map brain regions in 240 elderly subjects. They found a correlation between elevated blood glucose levels and reduced cerebral blood volume, or blood flow, in the dentate gyrus, an indication of reduced metabolic activity and function in that region of the brain.
By manipulating blood sugar levels in mice and monkeys, researchers said, they tried to confirm a cause-and-effect relationship between the glucose spikes and the reduced blood volume, Small said.
Bruce McEwen, who heads the neuroendocrinology lab at Rockefeller University in New York and was not involved in the research, said the study's findings were "compelling," with important implications not just for the elderly but for the growing number of overweight children and teens at risk of Type 2 diabetes.
"When we think about diabetes, we think about heart disease and all the consequences for the rest of the body, but we usually don't think about the brain," he said. "This is something we've got to be really worried about. We need to think about their ultimate risks not only for cardiovascular disease and metabolic disorders, but also about their cognitive skills, and whether they will be able to keep up with the demands of education and a fast-paced complex society. That's the part that scares the heck out of me."
Previous observational studies have shown that physical activity reduces the risk of cognitive decline, and studies have also found that diabetes increases the risk of dementia. Earlier studies had also found a link between Type 2 diabetes and dysfunction in the dentate gyrus.
Sheri Colberg-Ochs, an associate professor of exercise science at Old Dominion University in Norfolk, Virginia, said her research has found that regular exercise, even light physical activity, can offset the potentially negative effects of Type 2 diabetes on cognitive function. It is not clear what the mechanism is, she said, but may have something to do with the effect of insulin.
"This new study is interesting in that it allows for a greater understanding of which region of the hippocampus is likely most affected by poorly controlled diabetes," she said.
But the elevations in blood glucose seen in the new study are more subtle and would not be considered a disease state, Small said.
"It's part of the normal process of aging, much like wrinkling of skin," he said. "It happens to all of us inexorably, and it worsens progressively across the life span."
Blood sugar control linked to memory decline, study says
Spikes in blood sugar can take a toll on memory by affecting the dentate gyrus, an area of the brain within the hippocampus that helps form memories, a new study reports.
Researchers said the effects can be seen even when levels of blood sugar, or glucose, are only moderately elevated, a finding that may help explain normal age-related cognitive decline, since glucose regulation worsens with age.
The study, by researchers at Columbia University Medical Center and funded in part by the National Institute on Aging, was published in the December issue of Annals of Neurology.
"If we conclude this is underlying normal age-related cognitive decline, then it affects all of us," said lead investigator Dr. Scott Small, associate professor of nememory lossurology at Columbia University Medical Center. The ability to regulate glucose starts deteriorating by the third or fourth decade of life, he added.
Since glucose regulation is improved with physical activity, Small said, "We have a behavioral recommendation — physical exercise."
In the study, researchers used high-resolution functional magnetic resonance imaging to map brain regions in 240 elderly subjects. They found a correlation between elevated blood glucose levels and reduced cerebral blood volume, or blood flow, in the dentate gyrus, an indication of reduced metabolic activity and function in that region of the brain.
By manipulating blood sugar levels in mice and monkeys, researchers said, they tried to confirm a cause-and-effect relationship between the glucose spikes and the reduced blood volume, Small said.
Bruce McEwen, who heads the neuroendocrinology lab at Rockefeller University in New York and was not involved in the research, said the study's findings were "compelling," with important implications not just for the elderly but for the growing number of overweight children and teens at risk of Type 2 diabetes.
"When we think about diabetes, we think about heart disease and all the consequences for the rest of the body, but we usually don't think about the brain," he said. "This is something we've got to be really worried about. We need to think about their ultimate risks not only for cardiovascular disease and metabolic disorders, but also about their cognitive skills, and whether they will be able to keep up with the demands of education and a fast-paced complex society. That's the part that scares the heck out of me."
Previous observational studies have shown that physical activity reduces the risk of cognitive decline, and studies have also found that diabetes increases the risk of dementia. Earlier studies had also found a link between Type 2 diabetes and dysfunction in the dentate gyrus.
Sheri Colberg-Ochs, an associate professor of exercise science at Old Dominion University in Norfolk, Virginia, said her research has found that regular exercise, even light physical activity, can offset the potentially negative effects of Type 2 diabetes on cognitive function. It is not clear what the mechanism is, she said, but may have something to do with the effect of insulin.
"This new study is interesting in that it allows for a greater understanding of which region of the hippocampus is likely most affected by poorly controlled diabetes," she said.
But the elevations in blood glucose seen in the new study are more subtle and would not be considered a disease state, Small said.
"It's part of the normal process of aging, much like wrinkling of skin," he said. "It happens to all of us inexorably, and it worsens progressively across the life span."
Wednesday
I think I am in heaven. We are at a place called the Al Maha Desert Resort and Spa. When we told people that we were going to stay in the desert in Dubai in July, they told us that we were mad. We almost kind of believed them too. But then we got here and wow. Look at the view from our bed. We have Arabian Oryx wandering past and a huge array of birds, many of which come and drink from our own personal not overlooked ( except by occasional oryx) pool. We even have room valets who put towels on the sun beds for us! The temerature in the shade at midday is 48C or thereabouts, but after the humididty in Dubai city, it is absolutely great. It is a much drier heat and we have no problem spending all morning on the sun deck and in and out of the pool. Me? I stay in the shade and write on the laptop, Yvonne lies in the full sun, fully factored up and then we get together in the pool for a cool.
The food here is superb, fully the equal of michelin starred restaurants that I have eaten in. Let me give you a for example, tonights dinner menu was:
Amuse Bouche: Marinated Lobster with a rouille sauce
Starter : Asian Crab cake with Mustard aoilli, fennel salad and caramelized kumquats
Salad: Baby beetroot salad with karkadeh
Sorbet: Summer raspberry
Main: Fillet of Hammour with a spiced crab crust on a saffron potatoe puree with steamed baby asparagus and a light apricot and ginger sauce
Desert: Lavendar & Rhubard panna cotta with pistachio syrup & candied almonds.
Six courses of absolutely stunning prepared food, that tasted divine, and if you don't want what is on the menu, then, they will do you something that you like, you just work it out with the chef (madame chef!) in advance, no hassle, no fuss. My blood sugar is around 6.2 two hours after eating, and so no problems at all with my diabetes, and even if there were, then chef would work with me to sort it out. Not many places where you can say that and get haute cuisine.
Lunch today for me was sushi and a selection of fruit, breakfast was a full English (yes with pork sausage and pork bacon) with toast and marmalade. I have truly never eaten so well on holiday, and that does include staying at the Burj Al Arab.
We have stayed at the Burj three times now, and to be honest, I don't think that we will go back again. We will probably do two nights in a city centre hotel such as the Le Meridien so that we can get a full day of city shopping - Al Karama Souk is the best place for designer bargains on the Ralph Lauren etc style, and then we will head out to the desert for our main chilled out holiday in the summer desert. Yvonne will no doubt use the Timeless Spa again, and me, I will just write and swim and eat. Heaven - oh yes!
An update on the meds. After 4 weeks on the Avandamet I had gained over a stone in weight, pushing me over the sixteen stone and adding over 2 inches to my waist. Apart from the fact that trousers don't fit and shirts are tight, the biggest threat to my health is, according to my diabetic specialist nurse, the extra weight around my abdomen. It is this weight in particular that seems to affect the ability of the body to produce sufficient insulin and to deal with the sugars in the system. It seems strange to me that the very drug that is supposed to resolve my diabetes problem is actually exacerbating it.
My GP has prescribed Xenical (120mg orlistat) alongside the avandamet to help me lose weight. After taking it for two weeks, I haven't lost weight, but I have seemingly stopped putting it on. I have stablised at 16s 2ib and a 39" waist. That is over a stone heavier than I want to be, and 2 inches more around my waist than is healthy or advisable.
What at first I put down to the xenical, i.e. an absolute need to be no more than 3 paces from a toilet, I now suspect was food poisoning. Two days after starting the xenical I was suffering greatly from the gallops (actually, more of a slow knees together shuffle, in a quick sort of way), and I strongly debated whether I would be able to cope with xenical, but that only lasted around 48 hours, and now I am back as I would normally be. With the violent lower gut / stomach pains I had as well, I am now more inclined to put that down to a gut infection of some sort.
Ongoing I have blood sugars averaging at 6.9 around 3 hours after food. My BP is averaging 150/90 and I have no energy, absolutely no energy to do anything. It is a struggle of willpower to get up and go to work. By midday, I am absolutely wasted, and I am in trouble if this is the long term future for me. Right now, I don't even have the energy to write, hence the authoring has slowed down to a virtual stop. My mind is still active, I just really can't be bothered to type much.
So it seems that I shall need to review my meds once more when next I see my GP.
My GP has prescribed Xenical (120mg orlistat) alongside the avandamet to help me lose weight. After taking it for two weeks, I haven't lost weight, but I have seemingly stopped putting it on. I have stablised at 16s 2ib and a 39" waist. That is over a stone heavier than I want to be, and 2 inches more around my waist than is healthy or advisable.
What at first I put down to the xenical, i.e. an absolute need to be no more than 3 paces from a toilet, I now suspect was food poisoning. Two days after starting the xenical I was suffering greatly from the gallops (actually, more of a slow knees together shuffle, in a quick sort of way), and I strongly debated whether I would be able to cope with xenical, but that only lasted around 48 hours, and now I am back as I would normally be. With the violent lower gut / stomach pains I had as well, I am now more inclined to put that down to a gut infection of some sort.
Ongoing I have blood sugars averaging at 6.9 around 3 hours after food. My BP is averaging 150/90 and I have no energy, absolutely no energy to do anything. It is a struggle of willpower to get up and go to work. By midday, I am absolutely wasted, and I am in trouble if this is the long term future for me. Right now, I don't even have the energy to write, hence the authoring has slowed down to a virtual stop. My mind is still active, I just really can't be bothered to type much.
So it seems that I shall need to review my meds once more when next I see my GP.
Thursday
Couple of different subject matters for todays post. Wry Interest and Health. First the wry interest:
Well, I thought that nothing much would take me by surprise, in a pleasant way. This standard from the British Standards Institute BS 6008 proved me wrong. ISO 3103 would appear to be the same standard but regulated by the International Organization for Standardization. I suppose if I stop and think about it logically it shouldn't really suprise me, but I always supposed that 'Standards' would be more for things like bricks, or glass or other tangible objects and measures. I suspect that this is my failing and not that of the standards organisations. In reality anything that could be made in a repetitive process should have a standard methodology, it just never occurred to me that a cup of tea was any such thing.
ISO 6668 then gives us a standard for preparing coffee, and I should imagine that any number of odd things that we do day in and day out can also fall under the auspices of the standards bodies.
Okay, off to check ISO6668, I'm a tad thirsty.
Now the Health:
Just come back from the GP. Good news and bad. The blood sugars have stabilised at between 7 and 8 prior to eating and he is happy about that (as I am !), BP still a little high at an average of 150/90, and I am suffering weight gain (1 stone added in 4 weeks)as a side effect of the Avandamet. A bit of fine tuning and so an Update on my daily meds.
Avandamet (4mg rosiglatazone, 1000mg metformin) twice daily
xenical (120mg orlistat) thrice daily (New for me!)
aspirin 75mg mornings
perindopril 4mg mornings
amlopidine 5mg mornings
doxazosin 4mg night
simvastatin 20mg night
oxycodone 5mg twice daily (pain killers at last!!!!!! :-) )
Net result of all the meds is a general feeling of queasyness, an 'upset tummy' most of the time, some cracking headaches and let's just describe me as 'loose'. But the upside is that the Blood Sugars are under control and the BP is down from where it was, ( i was getting 200+ over 100+), that has to be good for my long term health. It'll be interesting to see how things go with the fine tuning that the new meds will bring. My GP also managed to get my opthalmic appointment bought forward at the local hospital, and now I have an appoinment tomorrow. Now that is what I call service.
Well, I thought that nothing much would take me by surprise, in a pleasant way. This standard from the British Standards Institute BS 6008 proved me wrong. ISO 3103 would appear to be the same standard but regulated by the International Organization for Standardization. I suppose if I stop and think about it logically it shouldn't really suprise me, but I always supposed that 'Standards' would be more for things like bricks, or glass or other tangible objects and measures. I suspect that this is my failing and not that of the standards organisations. In reality anything that could be made in a repetitive process should have a standard methodology, it just never occurred to me that a cup of tea was any such thing.
ISO 6668 then gives us a standard for preparing coffee, and I should imagine that any number of odd things that we do day in and day out can also fall under the auspices of the standards bodies.
Okay, off to check ISO6668, I'm a tad thirsty.
Now the Health:
Just come back from the GP. Good news and bad. The blood sugars have stabilised at between 7 and 8 prior to eating and he is happy about that (as I am !), BP still a little high at an average of 150/90, and I am suffering weight gain (1 stone added in 4 weeks)as a side effect of the Avandamet. A bit of fine tuning and so an Update on my daily meds.
Net result of all the meds is a general feeling of queasyness, an 'upset tummy' most of the time, some cracking headaches and let's just describe me as 'loose'. But the upside is that the Blood Sugars are under control and the BP is down from where it was, ( i was getting 200+ over 100+), that has to be good for my long term health. It'll be interesting to see how things go with the fine tuning that the new meds will bring. My GP also managed to get my opthalmic appointment bought forward at the local hospital, and now I have an appoinment tomorrow. Now that is what I call service.
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