Monitoring blood sugar levels is crucial for individuals with diabetes. Although the exact cause of diabetes remains unclear and it cannot be entirely cured, the quality of blood sugar management significantly influences the development and prognosis of both acute and chronic complications. Effective blood sugar control can even prevent complications and may not affect life expectancy, making blood sugar monitoring an essential component of diabetes care.
Here are some commonly used blood sugar monitoring indicators:
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Glycated Hemoglobin (HbA1c): HbA1c is a key measure of long-term blood sugar control and is vital for guiding clinical treatment adjustments. It reflects the average blood sugar level over the past two to three months, with a normal reference range of 4-6% (this may vary slightly between laboratories due to different testing methods).
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Glycated Serum Protein: This indicator primarily reflects blood sugar control levels over the past two to three weeks.
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Fasting, Pre-meal, and 2-hour Post-meal Blood Sugar: These are common methods for self-monitoring blood sugar, typically using fingertip capillary blood. They provide an immediate blood sugar reading but should not be used as a diagnostic basis for diabetes.
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Urine Sugar: In areas with limited resources, urine sugar testing can offer insight into blood sugar control. However, it is affected by the renal glucose threshold and may not be useful for elderly individuals or pregnant women, who may have altered thresholds, and it does not help monitor for hypoglycemia.
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Monitoring Frequency: Those with poor blood sugar control or in critical conditions should monitor 4-7 times a day until stability is achieved. Once stable, monitoring can be reduced to 1-2 days a week, five times a day.
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Monitoring Times: Pre-meal blood sugar tests are crucial when levels are high, and for those at risk of hypoglycemia. 2-hour postprandial blood glucose monitoring is suitable for those with well-controlled fasting blood sugar but who still cannot meet treatment goals. Bedtime monitoring is recommended for insulin users, particularly those on medium to long-acting insulin. Nighttime monitoring is beneficial for those nearing treatment targets but still experiencing high fasting blood sugar.
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Symptom-Driven Monitoring: Blood sugar should be checked promptly when hypoglycemia symptoms occur. It is also advisable before and after intense exercise.
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Insulin Users' Monitoring: Those using basal insulin should monitor fasting blood sugar three days a week before blood sugar reaches the standard, with follow-up visits every two weeks. The day before the visit, a 5-point blood sugar profile (fasting, after three meals, and before bed) should be measured. Once insulin and blood sugar are stable, the 5-point profile can be monitored 1-2 times a week.
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Non-Insulin Therapy Monitoring: For those not on insulin, a low-intensity monitoring program can be followed, checking blood sugar before breakfast and bedtime three days a week to understand the impact of meals on blood sugar.
In reality, there are no rigid rules for blood sugar monitoring. The plan should be adjusted based on blood sugar control, diet, and exercise. Internationally, pre-meal blood sugar control is emphasized, while domestically, fasting and 2-hour post-meal blood sugar are more focused, possibly due to differing dietary structures. For significant blood sugar fluctuations, continuous glucose monitoring can provide a detailed blood sugar profile over 3-7 days, aiding in medication adjustments.
Keywords: Blood Sugar Monitoring, Diabetes Management, HbA1c, Glycated Serum Protein, Post-meal Blood Sugar, Insulin Therapy, Diabetes Complications, Blood Sugar Fluctuations.