Indeed, for certain categories of diabetes patients, measuring fasting blood sugar at the hospital might not be the most suitable method, particularly when considering the timing of their insulin doses and the potential impact on their blood sugar levels.
First Category: Patients Using Premixed Insulin Patients who are on a regimen of premixed insulin injections, where the insulin blend includes both short-acting and intermediate-acting components, usually take these injections before meals to cover both immediate and longer-lasting glucose control. If their last evening dose wears off around 6 or 7 am, and they arrive at the hospital later for a fasting blood test, they could experience prolonged fasting with subsequent hypoglycemia. This would not accurately reflect their typical fasting blood glucose levels.
Second Category: Patients with Low Endogenous Insulin Secretion and Morning Hyperglycemia In patients with reduced natural insulin production and a tendency towards elevated blood sugar in the early morning (dawn phenomenon), delaying breakfast and insulin due to a hospital visit can disrupt their daily routine and lead to abnormal blood sugar readings. Testing fasting blood sugar under these circumstances might not provide a clear picture of their usual pre-meal blood glucose control.
As a solution, these patients are advised to:
- Measure fasting blood glucose at home under their standard routine.
- When visiting the hospital, opt for a postprandial blood glucose test 2 hours after having a meal. This approach ensures that the test results better represent their body's response to food intake and current medication dosage.
By adhering to their normal schedule before heading to the hospital and getting their post-meal blood glucose checked, these patients can receive a more accurate assessment of their blood sugar control without the confounding effects of altered eating habits or delayed insulin administration due to clinical procedures. This information can then guide healthcare providers in refining their treatment plans accordingly.