All diabetic patients need to monitor their blood sugar, but in clinical practice, there are still many patients who do not know enough about some details or fall into monitoring misunderstandings, resulting in inaccurate, unreliable and sometimes unexpected monitoring results. Don’t be misled anymore by the following misunderstandings in monitoring diabetic patients.
Misunderstanding 1: Stop taking hypoglycemic drugs before taking blood tests
Many people with diabetes mistakenly believe that only by conducting a blood glucose test after stopping taking medications can the accuracy of the results be guaranteed. In fact, it is not advisable to stop taking the medicine whether it is testing fasting blood sugar or postprandial blood sugar.
When testing fasting blood sugar, the medicines (including insulin) taken the night before should be used as usual; when testing blood sugar 2 hours after a meal, the medicines (including insulin) taken before the meal should also be used as usual. Because the purpose of the test is to understand the patient’s blood sugar control under drug treatment.
Correct approach: Patients must not stop taking medicine without authorization because of blood tests for blood sugar. Not only will the test results not accurately reflect the condition, but it will cause blood sugar fluctuations and worsen the condition.
Misunderstanding 2: Deliberately eat less the day before the examination
In order to obtain a satisfactory test result, some patients consciously go on a diet before the test. The fasting blood sugar result measured in this way may be “ideal”, but it cannot represent the true blood sugar level in daily conditions.
Correct approach: The night before the examination, you should eat as usual and get a good sleep. In addition, please note that strenuous exercise, smoking and stimulating drinks (such as coffee, etc.) should be avoided before the blood test the next morning.
Myth 3: As long as you don’t eat breakfast, your blood sugar is fasting blood sugar.
Strictly speaking, only the blood sugar measured after fasting overnight for 8 to 12 hours and taking blood before 8:00 the next day is considered “fasting blood sugar.” The “super fasting” state for more than 12 hours and the blood sugar before lunch and dinner cannot be called “fasting blood sugar”. The result may be low due to long fasting time, and of course it may be high (rebound after hypoglycemia). hyperglycemia).
Fasting blood glucose can reflect the patient’s basal insulin secretion level and whether the food and medication taken the night before are appropriate.
Correct approach: Test fasting blood sugar. The fasting time should not exceed 12 hours. It cannot be defined by whether you have eaten breakfast.
Myth 4: “2-hour post-meal blood sugar” refers to blood sugar 2 hours after eating.
The “2-hour post-meal blood sugar” mentioned here refers to the blood sugar value measured from the patient’s first bite of meal to 2 hours after blood collection, rather than starting after the meal. Why is 2 hours calculated from the first bite of the meal instead of from the end of the meal? It’s just because the reference value now stipulated is such a conventional standard.
Under normal circumstances, blood sugar rises to the highest level 0.5 to 1 hour after a meal, and 2 hours after a meal, blood sugar should basically fall back to the fasting level before the meal. Blood glucose 2 hours after a meal can reflect the reserve function of the patient’s pancreatic islet B cells (the body’s ability to increase insulin secretion after increasing the sugar load), as well as whether the meal and medication dosage are appropriate.
Correct approach: 2-hour postprandial blood glucose refers to the blood glucose value measured from the patient’s first bite of meal to 2 hours after blood collection.
Misunderstanding 5: Only measure fasting blood glucose
Many diabetic patients only pay attention to fasting blood sugar and ignore postprandial blood sugar. In fact, blood sugar during the day includes fasting blood sugar and postprandial blood sugar. Since people spend most of the day in a postprandial state (referring to within 4 to 6 hours of eating), postprandial blood sugar plays an important role in the overall day. Blood sugar contributes even more.
Studies have confirmed that when diabetes occurs, postprandial blood sugar often rises first, and then fasting blood sugar rises. Compared with fasting hyperglycemia, postprandial hyperglycemia is more closely related to chronic complications (especially cardiovascular complications) in patients with diabetes, and the harm is more serious.
Correct approach: Merely testing fasting blood glucose is not enough. Blood glucose monitoring must be done around the clock.
Misunderstanding 6: Fasting blood sugar is high and nighttime blood sugar is not measured
The cause of fasting hyperglycemia may be caused by insufficient dosage of antidiabetic drugs (or insulin) the night before, or may be caused by overdose of drugs and rebound hyperglycemia after nighttime hypoglycemia. Although both cases have high fasting blood sugar, the clinical treatments for the two are completely different. In the former case, the dosage of antidiabetic drugs needs to be increased, while in the latter case, the dosage of antidiabetic drugs needs to be reduced.
Correct approach: For patients with high fasting blood sugar, it is necessary to measure nighttime (early morning) blood sugar to determine what is causing the high blood sugar. If you increase the dose rashly, it is likely to worsen nighttime hypoglycemia and even cause accidents.
Misunderstanding 7: Monitoring follows feelings
Due to the different circumstances of individuals with diabetes, there are also differences in self-perception. Therefore, in many cases, the level of blood sugar is not completely consistent with self-perception, and the severity of self-perceived symptoms cannot fully represent the true condition of the patient’s disease.
Especially for some elderly patients, although their blood sugar is very high, their symptoms are not obvious. If they only rely on their feelings without regular monitoring, this high blood sugar state is likely to be ignored and effectively controlled, leading to complications of diabetes. The risk of developing the disease is greatly increased.
Correct approach: Blood glucose monitoring cannot be based on feeling, but should be determined based on blood glucose monitoring rules.
Misunderstanding 8: Only monitoring without recording and can be done once and for all
In addition to the results of each monitoring, the content of blood sugar monitoring records should also include the corresponding diet, exercise and medication. These detailed information are not only helpful for patients to self-summarize their sugar control rules, but also provide reference for doctors’ diagnosis and treatment.
Blood glucose monitoring should be done regularly, and the specific frequency depends on the patient’s specific situation. For patients with severe illness and large blood sugar fluctuations, in order to fully understand the condition, it is often necessary to select two days a week to measure the “blood sugar spectrum” throughout the day, including fasting (or before three meals), after three meals, before going to bed and in the early morning. Blood sugar at 3:00. In addition, if your living habits change (such as traveling on a business trip, attending a banquet, etc.) or if you have a physical condition (insomnia, cold, angina, pregnancy, etc.), you should also increase the frequency of self-tests.
But if the patient’s condition is stable, just choose one day a week to monitor fasting and postprandial blood sugar.
Correct approach: Blood glucose monitoring results must be recorded, the causes of high and low blood glucose levels must be analyzed, and treatment strategies should be improved in a timely manner.
Misunderstanding 9: Not paying attention to regular monitoring of glycated hemoglobin
Random blood sugar reflects the immediate blood sugar level at the time of blood collection, while glycated hemoglobin reflects the average blood sugar level in the past three months. The meanings of the two are different. The former is greatly affected by certain accidental factors (such as diet, sleep, cold and fever, etc.), while the latter is not affected by accidental factors and can more accurately and objectively reflect the overall level of blood sugar control of patients in the past three months.
Correct approach: Comprehensive monitoring of fasting blood sugar, postprandial blood sugar and glycated blood sugar can fully reflect blood sugar control.
Misunderstanding 10: When taking a fasting blood test, take insulin at home and then go to the hospital
Some patients who require pre-meal insulin injections for treatment take insulin injections in advance as usual before going to the hospital for fasting blood tests for certain items, but do not eat for the time being due to the fasting test. In fact, it is very dangerous for patients to do this.
Because it is difficult to control the time spent on the way to the hospital and waiting in line for blood drawing. If the blood drawing cannot be completed within the specified time, the meal time must be postponed, which makes the patient prone to hypoglycemia.
Correct approach: It is recommended that such patients bring their insulin pen to the hospital. After drawing blood, inject insulin immediately and then eat. This will not delay treatment and avoid unexpected situations.
