Sugar Matters
October 14, 2014
Beyond sugar numbers in diabetes

We have talked alot about monitoring blood sugar levels themselves, both with your own glucose meter as well as with the A1C lab you get drawn every thee months.

Those readings will all guide your medical team towards changing/starting/stopping diabetes medications that affect your blood sugars. Without any of those pieces of information, NO ONE can make an educated decision regarding adjusting your medications.{{more}}

Symptoms are not adequate, so your coming into clinic and saying, “my blood sugars feel high/low” or “I feel fine all the time” tells me absolutely nothing about where your blood sugars actually fall along the range of 40-400.

Symptoms of low sugars do exist, of course, but are sometimes not as reliable as you think; I have had patients swear in clinic they have a falling blood sugar and when we checked they were normal or even high, and same when we rechecked them a few minutes later. The lesson is that you need the numbers to make informed decisions about treatments.

Now, there are other numbers that your doctor/nurse will be looking at also, which is why every few months/year you need to have blood drawn. Yes, it is a pain to go to the lab. Yes, no one likes having a big needle stick in the arm. And yes, sometimes it costs money. IT IS WORTH all the trouble people; it is worth it.

As a reminder, these are a few other laboratory tests that your doctor/nurse NEEDS at some point to ensure that not only are you staying healthy, but that your medications are not having negative side effects, that your diabetes is not affecting other organs, and that there isn’t another explanation for some of your symptoms.

Liver tests: diabetes can make your liver abnormal, believe it or not, and it is important to know this up front. In addition, there are medication side effects that can damage the liver, as well as a result of infections and other conditions. Your medications may need to change if your liver is not working as well as it should or shows some damage.

Kidney functions tests, blood and urine: Your medical team will likely ask you to give urine once or twice a year (outside of checking for infection), as well as a blood test. Both will look for damage to the kidneys, which comes from diabetes. It is ESSENTIAL to catch kidney damage early and work to prevent it, through blood sugar control and blood pressure control. Remember: diabetes is one of the leading causes of kidney failure, next to high blood pressure.

Other tests your doctor may ask for include a blood count (to look for anemia, infections etc), vitamin levels, and reproductive hormone levels. All of these can be abnormal for various reasons in people who have diabetes. So, get thee to the lab! Your doctor is not asking for those tests just for fun, or random reasons.

Those tests are important to tracking your health, so please have them done when asked. Until next week, stay safe and healthy Vincies!

Anita Ramsetty, MD

Medical Director Endocrine Care Group

Tel: 843-798-4227