How do diabetics monitor their blood sugar at home? What is considered hypoglycemia?

Author: Zhang Mingxia, deputy chief nurse, Peking University People's Hospital

Vice Chairman of the Diabetes Committee of the Chinese Nursing Association

Reviewer: Wei Junping, Chief Physician, Guang'anmen Hospital, China Academy of Chinese Medical Sciences

Deputy Director of the Integrated Traditional Chinese and Western Medicine Group of the Endocrinology Society of the Chinese Medical Association

Diabetes is a common and chronic disease.

After being diagnosed with diabetes, the doctor will choose a specific treatment plan for the patient based on the blood sugar level.

Paying attention to monitoring blood sugar levels during treatment can help doctors and patients determine whether the treatment plan is effective. If it is found that blood sugar levels are not well controlled, the treatment plan needs to be adjusted in time.

If diabetic patients can effectively control their blood sugar in the long term, they can delay the occurrence or development of chronic complications of diabetes.

1. What are the methods for diabetic patients to monitor blood sugar?

With the development of science and technology, there are many ways to measure, monitor and supervise blood sugar, including venous blood collection, peripheral blood collection and interstitial fluid measurement.

Figure 1 Original copyright image, no permission to reprint

Venous blood collection is the most accurate way to measure blood sugar, but it is not very convenient to use venous blood to measure blood sugar. You need to go to the hospital on an empty stomach to collect the blood sugar. However, when diagnosing diabetes, homeostasis and accuracy become particularly important, so venous blood needs to be collected for diagnosis.

If you have been diagnosed with diabetes, you are recommended to monitor your blood sugar control by performing peripheral blood glucose measurement, which can measure blood sugar at different time periods, such as fasting, after meals, before bedtime, etc., and obtain blood sugar values ​​instantly.

Interstitial fluid blood sugar measurement can be used for dynamic blood sugar measurement. A probe is buried under the skin for continuous measurement. A data is generated every 1-5 minutes. A dynamic and continuous blood sugar spectrum can be seen, which makes it easier for doctors to analyze the patient's blood sugar condition. The longest continuous monitoring period is 14 days. Interstitial fluid blood sugar measurement is very convenient, but the cost is slightly high.

It is generally recommended that diabetic patients monitor their blood sugar at home using portable peripheral blood collection and measurement. Portable blood glucose meters are more commonly used at home and can measure blood sugar very easily and quickly.

2. How to use a portable blood glucose meter to monitor blood sugar?

First, you need to prepare all the items: blood glucose meter, test strips, disposable blood collection device, alcohol cotton pads, and cotton swabs.

First wipe your fingers with an alcohol cotton pad to disinfect them. While waiting for them to dry, you can insert the test strip into the blood glucose meter. Once the test strip is inserted, the blood glucose meter will turn on.

When you see the blood drop symbol on the blood glucose meter, you can start drawing blood. Just prick your finger with the blood sampler and drop the blood on the test strip. It only takes a few seconds for the blood glucose data to come out. It is very fast.

Figure 2 Original copyright image, no permission to reprint

It should be noted that you should not use iodine tincture or iodine preparations to disinfect your fingers, because when iodine preparations come into contact with the test paper, they will destroy some enzyme components on the test paper and affect blood sugar data. Therefore, it is recommended to use only alcohol for disinfection when measuring blood sugar.

Diabetic patients can choose any finger to have their peripheral blood drawn. It is not recommended to prick the middle of the fingertip for two reasons: first, the middle position is more sensitive and will be more painful when pricked; second, when picking up things, the highest point of the fingertip is most likely to touch the object. If pricked here, the pain will last longer and will continue to hurt.

3. What blood sugar level is considered hypoglycemia?

A diabetic patient will enter hypoglycemia when his blood sugar level is lower than 3.9mmol/L, while a normal person may enter hypoglycemia only if his blood sugar level is lower than 2.8mmol/L.

When diabetic patients experience symptoms such as palpitations and hand tremors, they should measure their blood sugar immediately. If it is indeed lower than 3.9mmol/L, they should replenish sugar immediately.

When replenishing sugar, glucose or monosaccharides are preferred. If not, you can choose to drink sweet drinks to replenish it. After drinking and adjusting for 15 minutes, measure blood sugar again to see if the blood sugar value rises again.

It should be noted that if diabetic patients are treated with medium- and long-acting insulin, hypoglycemia may recur under the continued action of the drug. At this time, 15 grams of biscuits or bread should be supplemented to truly relieve the hypoglycemia through carbohydrates.

In addition, if hypoglycemia is an occasional occurrence, the cause of the hypoglycemia should be analyzed and eliminated; if hypoglycemia occurs frequently, it is recommended that the patient go to the hospital and let the doctor help analyze whether the current treatment plan is appropriate.

4. What are the causes of hypoglycemia in diabetic patients?

Adjustments to diabetes treatment plans can easily cause changes in blood sugar levels.

For example, some patients initially control their blood sugar only through diet and exercise, but as monitoring finds that their blood sugar is too high, the doctor will adjust the treatment plan and add hypoglycemic drugs. During the plan adjustment process, you must be highly vigilant about the occurrence of hypoglycemia.

After being diagnosed with diabetes, most patients will adjust their lifestyle as advised by their doctor, control their diet and exercise more. However, some patients over-adjust in this stage, that is, they eat too little and exercise too much. They should be especially careful about the occurrence of hypoglycemia.

In addition, if a diabetic patient experiences an infection or a major stressful event, or has other diseases such as liver and kidney dysfunction, drug accumulation may also cause hypoglycemia.