The Data is GOLD!

I teach Living Well with Diabetes classes and a person said, “The way I see it, the data is gold.” He was referring to the discussion on home sugar testing for Diabetes.

Why do you suppose he said, …”the data is gold?” 

Sounds like it is pretty important. Well it is!

Checking your glucose (sugar) number tells you how well your treatment is working. It is one of the most important things to do to know how well your Diabetes is managed.  Checking sugar gives you much information so you are able to make informed choices according to what the number is.  Your doctor will let you know how many times a day you need to check it. It may depends on what diabetes medications you're taking. 

There are two ways to understand how your sugar level is in your blood, both are important. 

One way is called HbA1c- this is the approximate average of what your blood sugar has been over the previous 3 months. It is how your blood sugar is 24 hours/day. Prior to getting your blood tested for HbA1c, fasting the day before will not get a better HbA1c. The reason being, the sugar attaches to the red blood cell and the red blood cells in your body last for about 3 months. The test measures how much sugar is on each red blood cell. The HbA1c is usually done as a blood test that you need to go to the lab to get. The American Diabetes Association (ADA) recommends a HbA1 of 7% (the estimated glucose level is 154. This means some of the sugar is over 154, sometimes the sugar is under 154; it is the average. Ideally this test needs to be done every 6 months. If your HbA1c is over 8% (the estimated glucose level is 183) it is recommended to have the test done every 3 months. 

I like to think of the HbA1c as the big picture. It lets you know overall how your diabetes is doing.  

The second way is day-to-day sugar checking. This is the small picture; but it does not mean it is any less important. It is extremely important. It is the detail information that is needed on a daily basis to let you know how your life is affecting your blood sugar. From here you can make changes that are needed. For example; say you had a meal and you were unsure how that type of food affected your sugar. Be curious and check sugar before and 2 hours after the start of your meal. If sugar is 50 points over your pre-meal sugar you may have had too many carbohydrates.  An example is; Sugar =120 before meal and 2 hours after the start of the meal=180, that would mean either the quantity or the type of food was not ideal. It was 60 points over your pre-meal sugar. Aim for a sugar less than 50 two hours after the start of the meal. If your sugar was 120 before meal and 2 hours after meal it was 165, you were on track. This is just one way why checking daily sugar is important. Some people may need to adjust their insulin according to an insulin scale base on the sugar before a meal.

Also, some people check their sugar to see if they are having a low sugar. It is useful to know so you can treat your low sugar. It is also important to reflect the reason why sugar went too low so to possibly prevent it from happening again. Glucose fluctuates-Stress and food increases sugar and exercise/activity and diabetes medication usually lower sugar. There are many other things that can affect blood sugar. 

In my Diabetes book that will be published in 2020 there will a section on how to understand how to interpret blood sugar results. 

I encourage you to NOT call it testing. Most of us get nervous when we have to take a test. (I know I do!) It may “bring up stuff “for us. A better way may be to call it checking sugar. 

The day-to-day of glucose checking and learning and action from that learning is how you can manage the HbA1c number. 

Wouldn’t it be great to know your glucose levels day and night every few minutes? There are Continuous Glucose Meters (CGM) in which you apply a sensor on your body, and you can track your glucose continuously for 7-14 days, depending on the meter. These meters provide more data and help to inform decisions.

There are blood glucose meters which most people are using where you get a drop of blood and that number tells you how you are doing at that moment.

My November 2018 blog was also about checking sugar. It focused more on the history of blood sugar checking and how there is a product that continuously checks sugar, called CGM (Continuous Glucose Meter). I specifically highlighted a product called the Freestyle Libre. With a CGM you do not usually have to get a drop of blood except for very high or very low sugar or if the way you feel does not correlate with the number you see (See my blog 11/2018). There are more things to know about a CGM before you decide if this is for you. Even from 1 year ago there has been improvements. Now you can wear the sensor for 14 days instead of 10 days and have a 1-hour warm up period before it starts instead of 8 hour warm up period that use to be 1 year ago! It currently does not alert you like other CGMs (like Dexcom G6) but the company of the Freestyle Libre is working to have alerts by 2020!

Bottom line, whatever you are currently using to check your sugar, it is imperative to know where your sugar level is because left unchecked it can lead to long -term complications of diabetes such as stroke, heart attack, kidney failure, blindness or other complications. This does not have to happen!

Take charge now and know where you stand with the care of Diabetes!