Sugar Matters
November 11, 2014
How many numbers do you need?

Diabetes is in many ways about numbers: you can’t make the diagnosis without knowing actual blood sugars (according to guidelines); much of the target for your treatment is based on a number/set of numbers, and when you want to know how your diabetes is doing, it again comes down to numbers. Sure, there are “hard” evidence ways of seeing diabetes, but most of us don’t want those! Those kinds of evidence would be like sores that don’t heal, urinating all the time, losing weight, having legs cut off because of bad blood flow and dead limbs. Nope, we don’t want those if we can avoid them, right?{{more}}

The numbers in diabetes that are important will depend on who you are and your situation at the time. For almost everyone, the hemoglobin A1C is one of the most important numbers that will be checked. The A1C, as it is called sometimes, tells you and your medical team how your blood sugars have been doing on average over the past three months. We jokingly call it “the lie detector test,” because if someone says, “oh, my blood sugars run good all the time, perfect,” but their A1C is high, we know they are not telling the complete truth. The A1C is most often done by lab draw, where you get your blood taken. Sometimes a clinic will have special machines that can do it from a finger prick, like the machine we use on our mission trip every year.

Other numbers that are important in regard to sugar levels will depend on your situation, but all come down to you checking at home on your own meter. I know the strips are ridiculously expensive. It is a problem everybody faces. The trick is finding the best machine and strips at the lowest price and then figuring out the most economical way to keep a check on your sugars without running out of strips too fast. For some people, checking your blood sugars three times a week is fine. For pregnant women with diabetes, they should be checking their sugars before AND AFTER every meal, and at bedtime. If you are newly started on insulin, ideally you should be checking your sugars at least three times a day, if possible, and if not every day then a few days a week. This is something that should be discussed with your medical team, so that you know the best way to track your sugars.

There is no safe way to adjust your medications without knowing some of these numbers. Saying, “oh, I feel fine” or “I feel low” is not enough, unless something serious happens. If you are sweating and about to pass out, well then we know the medication, your food, your pattern or all of the above need to be adjusted. But we don’t want you to get to that state! It is best to be able to make those changes based on numbers instead of symptoms, which are not always reliable.

A last note: if you are being diligent and checking your sugars on your own, please bring a written logbook or your meter to your clinic appointments, so your medical team can look at them. A meter/logbook sitting on your kitchen table will not help your team make decisions with you.

Until next week, stay safe and healthy Vincies!

Anita Ramsetty, MD

Medical Director Endocrine Care Group

Tel: 843-798-4227