Just how accurate is the glucose meter?

Just how accurate is the glucose meter?

Testing one’s blood glucose with meters has been a great boon to managing diabetes.  The glucose testing meters are fairly accurate and they let us know what is going on.  But they are by no means perfect (See Research GDM 25th Mar 2011) and if you are a stickler for detail they can drive you to distraction.

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When does the clock start ticking- just at what time should I check my blood sugars if I have gestational diabetes?

When does the clock start ticking-  just at what time should I check my blood sugars if I have gestational diabetes?

Gestational diabetes is typically a milder diabetes so does not have much in the way of symptoms or complaints.  Most of what people feel that may be symptoms of diabetes, going to the bathroom frequently, tiredness, feeling warm or hungry relate much more to the pregnancy itself and not the diabetes.  Because of this we have to check the blood sugar as how one feels does not give an accurate sense of how high the blood sugar may be.  Some people may feel their sugar is high or low but it does not answer how high or how low.  So we need real numbers as it is on these absolute values a decision on whether more treatment needs to be started is based.  However, a question we face in the clinic is to decide when should one test the blood sugar and if we do suggest one or two hours after a meal just when does the clock start ticking?

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What is A1c and is it an accurate reflection of blood sugar in pregnancy?

What is A1c and is it an accurate reflection of blood sugar in pregnancy?

In diabetes a lot of attention is paid to the A1c. What is it and is it good at reflecting over sugar levels?
Simple average blood sugars are not that great at telling how the blood sugar control is really like.  Consider Mr Smith who has sugars ranging from 2 to 20 mmol/l (36 – 360 mgs/dl) and Mrs Dixon with sugars of 10 to 12 mmol/l (180 – 216 mgs/dl).  Both have the same average of 11 mmol/l (198 mgs/dl) but the control of sugar in Mr Smith sounds much worse.  The A1c is a much more stable reflection of overall sugar control.

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Just how low can a normal blood sugar go in pregnancy?

Just how low can a normal blood sugar go in pregnancy?

Recently in the clinic I was asked “Is 3.8 mmol/l (68 mgs/dl) two hours after my lunch too low? The blood sugar normally varies though out the day:  lower before breakfast, peaking just over an hour after a meal and coming back down by two hours.  Firstly, sugars at this level do not harm the baby but let us look at what normal sugars in people without GDM are and then we can look at the situation in gestational diabetes and for those with pre-existing diabetes, either Type 1 or Type 2 diabetes.

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Why the fuss about the A1c in early pregnancy?

Why the fuss about the A1c in early pregnancy?

When someone with Type 1 or Type 2 diabetes becomes pregnant the main things to think about are: the mom’s own situation with regards to diabetes complications, her blood sugars and the baby.  The big issues for the baby are that he or she might have a congenital malformation, be too large at birth or have low blood sugars just after birth.  Of these the congenital malformation is by far the most important.  A large baby can be delivered by Caesarian section, a low sugar in the baby is readily treated but if the heart, kidney or spine are not formed correctly we can’t turn back the clock.

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Morning sugar rise

Morning sugar rise

 

My sugar rises in the early morning even if I don’t eat!

A puzzling and frustrating issue for many with diabetes and pregnancy is that the blood sugar may rise coming into breakfast time even though no food was taken.  The usual scenario is the woman checks  her sugar when going to the bathroom at five or six in the morning,  takes nothing, goes back to bed and then at eight AM the sugar is higher by 1 mmol/lI (18 mgs/dl). Just what is going on?

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