Date: 04/05/2017

In an ideal world, diabetics measure their blood sugar levels at least 6-7 times a day, but this is not possible due to limited time and resources, says Om Ganda, senior physician at the Joslin Diabetes Center in Boston.

For people who are well compensated, Dr. Ganda recommends monitoring blood glucose levels 2 times a day. For those who have a limited number of test strips, it is recommended that glucose monitoring be carried out in different days, at different times.

A recent study did not find of great importance glucose monitoring in people with type 2 diabetes who do not take . During the study, all participants were divided into three groups. The control group measured HbA1C once every three months and never used it . The second group was asked to record glycemic levels 3 times a day: 1 time on an empty stomach, and the other two times two hours after meals or before meals. Another group monitored blood glucose levels at home. After two months, the group that carried out the measurements Sahara in the blood at home a slight decrease in the level was noted .

Fasting blood sugar level

Fasting blood glucose levels provide a baseline for the day and a way to determine how blood glucose levels change at night. The American College of Endocrinology recommends keeping fasting blood glucose levels below 6.1 mmol/ l. Glycemic levels above this level may indicate the presence of Samoji syndrome or the “dawn phenomenon”.

The morning dawn phenomenon is the release of hormones in the early morning, which increases insulin resistance, which in turn leads to an increase in glycemic levels. This phenomenon occurs in all people, regardless of whether they have diabetes or not. However, in people without diabetes, extra insulin is released, so the increase in blood sugar is minimal. Ordinary preventive measures Treatments for patients with the “dawn phenomenon” include: physical exercise and adding glucose-lowering drugs such as metformin to the diabetes control regimen.

Samoji syndrome is a condition that most often occurs in people who take insulin. Short blood glucose levelduring the night leads to an increase in hormone levels, which leads to high glycemic levels in the morning.

Many people tend to increase their nightly insulin dose to combat high blood glucose levels in the morning. However,insulin administrationin smaller quantities or more high performance Overnight glucose monitoring may be more effective in preventing morning glucose rises.

Sugar measurements before meals

Like fasting readings, premeal glucose monitoring gives basic indicators glycemia. Some diabetes experts call them pre-indications.

If your preliminary readings are in the recommended range and your glycated hemoglobin level is also normal, then measuring your blood glucose levels after meals is not necessary. If your blood sugar is between 4.4 and 7.8 mmol/ l, then its jumps may exceed these indicators.

Sugar measurements after meals

Testing your blood glucose levels after meals is helpful if your HbA1C exceeds the norm. These measurements are also important for assessing the effectiveness of treatment. The results give an idea of ​​how much glycemic levels increase for certain foods.

The amount of sugar in the blood can be measured in several units. Knowledge of the measurement system is necessary for a diabetic to know in order to prevent the development of complications.

There is a certain amount of glucose in the blood of anyone, no matter healthy or diabetic. Scientists have established, and subsequently clinically proven, a certain range of sugar content at which a person is considered healthy. Deviations in one direction or another are a signal about the presence of pathology in the body. Glucose is main carbohydrate, present in blood plasma. Being the most valuable nutrient for most cells, in particular for the brain, it is also the main source of energy for all body functions. How to measure sugar, and what units of measurement are used now?

• hyperglycemia (excess glucose);
• hypoglycemia (its deficiency).

There are several ways to find out the sugar content:

1. In the laboratory:

• in pure blood;
• in plasma;
• in serum.

1. On one's own. Special devices - glucometers.

Sugar in healthy people

Despite the fact that there are certain standards for glucose levels, even in healthy people this indicator can go beyond the established limits.

For example, hyperglycemia is possible in such conditions.

1. If a person has eaten a lot of sweets and the pancreas is simply not able to quickly secrete a sufficient amount of insulin.
2. When under stress.
3. With increased secretion of adrenaline.

Such increases in blood sugar concentrations are called physiological and do not require medical intervention.

But there are conditions when glucose measurements are required even in healthy person. For example, pregnancy (possible development of gestational diabetes).

Sugar control in children is also important. If there is a metabolic disorder in the developing body, such serious complications are possible as:

• deterioration protective forces body.
• increased fatigue.
• failure of fat metabolism and so on.

Precisely in order to avoid serious consequences and increase the chance early diagnosis diabetes, it is important to check glucose concentrations even in healthy people.

Blood glucose units

Units for measuring sugar is a question that people with diabetes often ask. In world practice, there are two ways to determine the concentration of glucose in the blood:

• weight;
• by molecular weight.

Millimoles per liter (mmol/l) is a universal value that is a global standard. This is exactly what is spelled out in the SI system.

The following countries use mmol/l values: Russia, Finland, Australia, China, Czech Republic, Canada, Denmark, Great Britain, Ukraine, Kazakhstan and many others.

However, there are countries that prefer a different way of indicating glucose concentration. Milligram per deciliter (mg/dl) is a traditional weight measurement. Also earlier, for example, in Russia, milligram percentages (mg%) were still used.

Despite the fact that many scientific journals confidently move to the molar method for determining concentration, the gravimetric method continues to exist and is popular in many Western countries. Many scientists, medical professionals, and even patients continue to adhere to the mg/dL measurement because it is a familiar and familiar way of presenting information to them.

The weight method is accepted in the following countries: USA, Japan, Austria, Belgium, Egypt, France, Georgia, India, Israel and others.

Since there is no unity in the global environment, it is most reasonable to use those units of measurement that are accepted in a given area. For goods or texts of international use, it is recommended to use both systems, with automatic translation, but this requirement is not mandatory. Any person himself is able to convert the numbers of one system into another. This is quite easy to do.

You just need to multiply the value in mmol/l by 18.02, and you get the value in mg/dl. The reverse conversion is no more difficult. Here you need to divide the value by 18.02 or multiply by 0.0555.

Such calculations are specific to glucose, and are related to its molecular weight.

Glycated hemoglobin

In 2011 WHO has approved the use of glycosylated hemoglobin (HbA1c) for the diagnosis of diabetes.

Glycated hemoglobin is biochemical indicator, which determines the amount of sugar in a person’s blood over a certain period. This the whole complex, formed by their molecules of glucose and hemoglobin, irreversibly joined together. This is a reaction between an amino acid and sugar that occurs without the participation of enzymes. This test can detect diabetes in the earliest stages.

Glycosylated hemoglobin is present in every person, but in a patient with diabetes this figure is significantly higher.

As diagnostic criterion disease, an HbA1c level of ≥6.5% (48 mmol/mol) was selected.

The study is carried out using an HbA1c method certified in accordance with the NGSP or IFCC.

An HbA1c value of up to 6.0% (42 mmol/mol) is considered normal.

To convert HbA1c from % to mmol/mol, use the following formula:

(HbA1c % × 10.93) – 23.5 = HbA1c mmol/mol.

The inverse value in % is obtained in the following way:

(0.0915 × HbA1c mmol/mol) + 2.15 = HbA1c %.

Glucometers

Undoubtedly, the laboratory method gives a more accurate and reliable result, but the patient needs to know the value of sugar concentration several times a day. It is for this purpose that special devices, glucometers, were invented.

When choosing this device, you should pay attention to what country it is made in and what values ​​it shows. Many companies specifically make glucometers with a choice between mmol/l and mg/dl. This is very convenient, especially for those who travel, as there is no need to carry a calculator with you.

For people with diabetes, the frequency of testing is determined by the doctor, but there is a generally accepted standard:

• for type 1 diabetes, you will have to use the glucometer at least four times;
• for the second type - twice, in the morning and at lunch.

Choosing a device for home use, you need to be guided by:

• its reliability;
• the magnitude of the measurement error;
• units in which glucose concentration is displayed;
• the ability to automatically select between different systems.

To get the correct values ​​you need to know that different way blood sampling, the time of collection, the patient’s diet before the test and many other factors can greatly distort the result and give an incorrect value if they are not taken into account.

It is vital for diabetic patients to control their blood sugar levels. If you are faced with the need to measure glucose levels for the first time, the instructions for the device will help you understand the algorithm of actions and teach you how to use the glucometer correctly. Check out simple rules using this device to obtain the most reliable data regarding your own condition.

What is a glucometer

In diabetes, sugar control is carried out daily with a frequency of two or even three times a day, which makes visiting hospitals for measurements extremely difficult. Therefore, patients are recommended to use special devices– portable glucometers that allow you to obtain all the necessary data at home. Based on the results of analyzes carried out over a certain period, appropriate measures are taken to compensate for violations carbohydrate metabolism.

Operating principle

Modern analyzers operate based on the electrochemical method. Devices for home use are characterized by fast and highly accurate measurements, which makes them indispensable for diabetics. The operating principle of an electrochemical glucometer is based on the characteristics of changing current strength, which serve as the main parameters for measuring sugar.

Thus, a special coating is applied to the working surface of the test strips. When a drop of blood comes into contact with the latter, a chemical reaction occurs. Due to the cumulative effect of this reaction, specific substances are formed, which are read by the current applied to the test strip and become the basis for calculating the final result.

Species

It is permissible to use both very simple and more modernized models of analyzers. IN lately Photometric instruments are gradually being phased out, which determine the change in the luminous flux passing through a test plate coated with special solution. In this case, calibration of a glucometer of this type is carried out using a solid capillary blood. As practice shows, this method does not always justify itself.

Considering the impressive measurement error of such analyzers, experts are inclined to believe that measuring sugar with a glucometer operating on the photodynamic principle is not entirely appropriate and even dangerous. Today, you can purchase more modern glucometers in the pharmacy chain for individual use, which produce a much lower percentage of errors:

• optical biosensors for glucose – work based on the phenomenon of plasma surface resonance;
• electrochemical - measure the main indicators of glycemia according to the magnitude of the passing current;
• Raman - are among the non-invasive glucometers that do not require puncture of the skin; they determine glycemia by isolating its spectrum from the full spectrum of the skin.

Rules for using a glucometer

The automatic sugar detection device is easy to use. In case you don’t know how to use a glucometer correctly, there are instructions for the device and detailed video tutorials. If you have any additional questions related to the procedure, it is better to contact your doctor for clarification. Otherwise, you risk receiving unreliable data that directly affects the tactics of combating diabetic manifestations.

How to set up a glucometer

Most modern meters are equipped with an encoding function, which involves entering information about a new package of test strips into the device. In a situation where this procedure is not carried out, it is impossible to obtain accurate readings. The fact is that each model of glucometer requires strips with a certain coating. The presence of any inconsistencies makes it impossible to use the glucometer.

Therefore, before using the analyzer directly, it is extremely important to carry out preliminary setup. To do this, you will need to turn on the glucometer and insert the plate into the meter. After that, numbers will appear on the screen that must be compared with the code indicated on the packaging of the strips. If the latter coincide, you can start using the glucometer without worrying about the reliability of its readings.

When is the best time to measure sugar?

It is best to determine blood glucose levels before meals, after meals and before bed. At the same time, if you plan to do the test on an empty stomach, remember that the last meal should be no later than 18:00 on the evening before the procedure. In addition, you should use a glucometer to measure your sugar concentration in the morning before you brush your teeth or drink water.

Measurement frequency

For type 2 diabetes, it is recommended to use a glucose analyzer several times a week. Patients suffering from the primary form of the disease should monitor glycemia daily and even several times a day. It should be taken into account that the reception medications and spicy infectious processes may indirectly affect the accuracy of the data obtained. People with normal blood sugar are advised to check their glucose levels once a month.

Reasons for incorrect glucometer readings

The accuracy of the readings obtained can be affected by various factors. In most cases, the main reason for incorrect readings from the device is discharge from the puncture insufficient quantity blood. In order to prevent the occurrence similar problems You must wash your hands before using the device. warm water and then massage lightly.

As a rule, these manipulations help eliminate blood stagnation, as a result of which the patient is able to obtain the amount of fluid required for analysis. With all this, the glucometer often gives inadequate readings due to a violation of the integrity of the indicator surface of the test strips - remember, they must be stored in a place inaccessible to light and moisture. In addition, it is important to clean the device in a timely manner: dust particles can also affect the accuracy of the device.

How to measure blood sugar with a glucometer

In order to obtain the most accurate results, it is recommended to wash your hands with soap and dry them with a towel before performing the analysis. The next step is to prepare a test strip and turn on the device. Some models are activated by simply pressing a button, while others are activated by inserting a test strip. Upon completion preparatory stage you should proceed to puncture the skin.

Blood can be taken from any finger. At the same time, if you measure glycemia less than once a day, it is better to collect biological material from ring finger. The finger should be pierced from the side surface of the pad. Remember that the lancet (needle) cannot be used more than once. The first drop of blood must be removed with cotton wool. The next portion of liquid can be used for analysis. In this case, use test strips that are suitable for your device model.

Thus, capillary-type strips are brought to the drop from above, while the test liquid is applied to other types of indicator plate by touch. Analyzers of different models require 5-60 seconds to check the glucose level. The calculation results can be stored in the device’s memory, but it is preferable to also duplicate the obtained figures in the diabetes self-monitoring diary.

Accu Chek

The device of this brand is reliable and simple. Accu-Chek is equipped with a function for calculating the average sugar level and marking the readings. The device requires coding and turns on after inserting the test strip. The undeniable advantage of this glucose level meter is the large display. Along with the device, the Accu-Chek kit includes 10 test strips, 10 lancets (needles) and a lancing pen. The instructions for the device contain full information, how to use a portable glucose meter of this brand. The algorithm for determining glycemia using Accu-Chek is as follows:

1. Wash and dry your hands.
2. Remove one test strip from the tube and insert it into the special hole until it clicks.
3. Compare the numbers on the display with the code on the packaging.
4. Apply the resulting blood to the orange surface of the strip.
5. Wait for the calculation results.
6. Remove the test strip.
7. Wait until the device turns off.

Gamma Mini

This glycemic analyzer is the most compact and economical monitoring system, so it is very convenient to use. The Gamma Mini meter works without coding when using test strips. The analysis requires a minimum amount of biological material. You can get results in just 5 seconds. The supplier's kit, in addition to the device itself, includes 10 test strips, 10 lancets, and a lancing pen. You can read the instructions for the Gamma Mini device below:

1. Wash and dry your hands.
2. Turn on the device by holding the main button for at least 3 seconds.
3. Take the test strip and place it in the special hole in the device.
4. Prick your finger and wait for blood to appear on it.
5. Apply biological fluid to the test strip.
6. Wait for the calculation to complete.
7. Remove the strip from the slot.
8. Wait for the device to turn off automatically.
1. Wash and dry your hands.
2. Insert the test strip into the special hole until it clicks.
3. Use a lancet to prick your finger.
4. Apply the resulting blood to the surface of the strip.
5. Wait for the measurement results.
6. Remove strip.
7. Wait until the device turns off.

Video

Careful monitoring of blood sugar levels is essential successful treatment diabetes mellitus Regularly measuring glucose levels helps determine correct dosage insulin and glucose-lowering drugs, and determine the effectiveness of therapeutic therapy.

Especially important for diabetics, it is necessary to measure sugar after meals, since it is at this moment that the risk of developing hyperglycemia is especially high - sharp jump glucose in the body. If a hyperglycemic attack is not stopped in a timely manner, it can lead to severe consequences, including diabetic coma.

But correct analysis blood tests after meals should be carried out at the moment when the glucose level reaches its highest level. Therefore, every diabetic should know how long after eating to measure blood sugar in order to get the most objective glucose readings.

Why measure blood sugar?

For patients suffering from type 1 diabetes, checking your blood glucose levels is vital. With this disease, the patient needs to perform an independent blood test before going to bed and immediately after waking up, and sometimes during the night, before and after meals, as well as before and after meals. physical activity and emotional experiences.

Thus, in type 1 diabetes total number blood sugar measurements can be 8 times a day. At the same time, this procedure should be taken especially carefully in case of a cold or infectious diseases, changes in diet and changes in physical activity.

For people with type 2 diabetes, regular blood testing using a glucometer is also considered an important part of treatment. This is especially true for those patients who have been prescribed insulin therapy. At the same time, it is especially important for such patients to measure glucose levels after meals and before going to bed.

But if a patient with type 2 diabetes manages to stop taking insulin injections and switch to glucose-lowering pills, therapeutic nutrition and physical education, then it will be enough for him to check his blood sugar levels only a few times a week.

Why measure your blood sugar level:

1. Determine how effective treatment is and determine the degree of diabetes compensation;
2. Determine what effect the chosen diet and sports activities have on blood glucose levels;
3. Determine what other factors can affect sugar concentration, including various diseases and stressful situations;
4. Identify the reception of which medical supplies may affect sugar levels;
5. Determine the development of hyper- or hypoglycemia in a timely manner and take appropriate action necessary measures to normalize blood sugar.

Every person with diabetes should not forget about the need to measure their blood sugar levels.

Missing from time to time this procedure, the patient risks earning severe complications, which can lead to the development of heart and kidney diseases, blurred vision, the appearance of non-healing ulcers on the legs, and eventually to amputation of the limbs.

When to measure your blood sugar levels

Sugar level

The principle of operation of the glucometer is as follows: the patient inserts a special test strip into the device, and then dips it in a small amount of his own blood. After this, numbers appear on the glucometer screen that correspond to the glucose level in the patient’s body.

At first glance, everything seems very simple, but carrying out this procedure requires compliance with certain rules that are designed to improve the quality of the analysis and minimize any error.

How to properly use a glucometer to measure your blood sugar:

1. Wash your hands thoroughly with soap and then dry them well with a clean towel. Under no circumstances should you measure sugar if the patient’s hands are still wet;
2. Insert a special test strip into the glucometer. It must be suitable for the given device model and have a normal shelf life;
3. Using a special device - a lancet equipped with a small needle, pierce the skin on the pad of one of the fingers;
4. With the other hand, gently press your finger until a small drop of blood appears on the surface of the skin;
5. Carefully bring the test strip to the wounded finger and wait until it absorbs the patient’s blood;
6. Wait 5-10 seconds for the device to process the data and display the analysis result;
7. If your sugar level is elevated, you should additionally inject 2 units of short-acting insulin into your body.

It is important to emphasize that many modern glucometers measure sugar not in capillary blood, but in its plasma. Therefore, the result obtained may be slightly higher than that obtained during laboratory analysis.

Controlling blood sugar is an important part of diabetes treatment. In this article, you'll learn when you need to test your blood glucose, how to properly use a glucometer (a portable blood sugar tester), and much more.

If you have diabetes, you should constantly measure your sugars to combat chronic complications diabetes mellitus You can measure your blood sugar at home using a portable glucose meter, which provides results from a small drop of blood.

Why check your blood sugar if you have diabetes?

Self-monitoring of blood glucose levels gives useful information for quality management of diabetes mellitus. This regular routine can help:

• Determine how well you manage your diabetes on your own.
• Understand how diet and exercise affect blood sugar levels.
• Identify other factors that affect changes in blood sugar levels, such as illness or stress.
• Monitor the effect of certain medications on your blood sugar.
• Define high and low level blood sugar and take measures to bring it back to normal.

In other words, measuring blood sugar levels when diabetes mellitus is a mandatory and daily procedure of paramount importance, the purpose of which is to keep blood sugar within the recommended values, ensuring good diabetes compensation to prevent the development of diabetic complications.

When should you check your blood sugar?

Your doctor will tell you how often you should check your blood sugar levels. Typically, the frequency of measurements depends on your type of diabetes and your treatment plan.

• For type 1 diabetes mellitus. Your doctor may recommend testing your blood sugar 4 to 8 times a day if you have insulin-dependent diabetes (type 1). You should take measurements on an empty stomach, before meals, before and after exercise, before bed, and sometimes at night. You may also need more frequent checks if you are sick, have changed your daily routine, or started taking a new drug.
• For type 2 diabetes mellitus. If you are using insulin for type 2 diabetes, your doctor may recommend testing your blood sugar 2-3 times a day, depending on the type and amount of insulin. As a rule, self-monitoring is recommended before meals, and sometimes before bed. If you manage to switch your type 2 diabetes from insulin to tablets through diet and exercise, you may not need to check your sugars daily in the future.

Table of indicators of normal, high and low blood sugar

Your doctor may set blood glucose goals based on several factors, such as:

• Type and severity of diabetes
• Age
• Diabetic experience
• Presence of pregnancy
• Presence of diabetes complications
• General condition and presence of other diseases

Values ​​of normal, high and reduced level blood sugar:

What is the blood sugar level in diabetes (how to know if you have diabetes?)

The diagnosis of diabetes mellitus is established if the test results are as follows:

In order to delay the development of diabetic complications as much as possible, it is necessary to maintain your sugar levels in the range of 3.5-8 mmol/l. It is also recommended to take a blood test for HbA 1C once every three months, the results of which should be< 7%.

Step-by-step instructions for measuring blood sugar using a glucometer

To measure your blood sugar yourself, you need to use a small electronic device - a glucometer. It can be purchased at any pharmacy, the cost starts from 1200 rubles, the kit also includes the test strips necessary for the analysis.

When measuring, you squeeze a small drop of blood from your finger, then place it on a disposable test strip inserted into the meter.

Before measuring your blood sugar using a glucometer, you must complete the following steps:

Step 1. Wash your hands well with soap and dry them. Do not take measurements on wet fingers.

Step 2: Prepare your meter, test strip, and finger prick lancet.

Step 3: Insert the test strip into the meter.

Step 4. Puncture the side pad of your finger with a special device with a small needle (lancet), which is included with the glucometer.

Step 5: Gently squeeze or massage your finger until a drop of blood appears.

Step 6: Hold the edge of the test strip to the drop of blood and let it soak into it. After a few seconds, the glucometer will show the result.

It should be noted that most glucometers supplied to the Russian market measure sugar by plasma (calibration by plasma is established), and not by capillary blood. Blood plasma indicator a little higher than taken in laboratory conditions from capillary blood. To get an accurate result, you need to divide the resulting figure by 1.12.

For example, in the photo, the OneTouch Horizon glucometer, calibrated using blood plasma, showed the result 11.1 mmol/l. To determine the exact result, divide 11.1 by 1.12 = 9.9 mmol/l.

Step 8. If your blood sugar is high, take a small “prick” of ultra-short or short-acting insulin (advice for patients with type 1 diabetes). In the photo, the patient administers an additional 2 units. ultra-short insulin "Novorapid", because The analysis showed elevated blood sugar of 11.1 mmol/l.

To avoid misdiagnosis of blood sugar levels, you must adhere to the following recommendations:

• Read the instructions for using your meter carefully. Many devices require preliminary configuration (calibration), this is described in detail in the attached instructions.
• Use the blood sample as directed.
• Use test strips designed specifically for your meter model.
• Test the first test strip from the pack according to the instructions in the instructions.
• Do not use expired test strips.
• Almost every glucometer has a built-in memory, so you can take it to your doctor to look at your sugar levels and, if necessary, make adjustments to your insulin dose and nutrition.