MONITOR YOUR SUGARAND CONTROL TYPE 1 DIABETES Ketki Damle (Registered Dietician)
TYPE 1 DIABETES MELLITUS Also known as Juvenile or insulin dependentdiabetes. Usually diagnosed in children and young adults. It results from bodys failure to produce insulin, ahormone which controls blood sugar. This leads to high blood sugar levels and requiresthe person to inject insulin. Common symptoms are frequent urination, increasedthirst, increased hunger and weight loss.
WHAT IS BLOOD SUGARMONITORING?•Blood sugar/glucose monitoring is away of testing the amount of glucose in your blood.•Besides lab tests, monitoring bloodsugar levels on a day to day basis isalso important.•For type 1 patients, frequentmonitoring helps improve blood sugarcontrol.
METHODS OF BLOOD SUGAR MONITORING FOR TYPE 1 PATIENTS Laboratory method Self monitoring of blood glucose (SMBG) Continuous glucose monitoring system (CGMS) Newer methods - Insulin pump & artificialpancreas
LABORATORY METHOD This includes various tests such as fasting bloodsugar (FBG) which is performed after an overnight fast of 10-12 hours. 2 hrs post lunch blood sugar test measures the postmeal blood glucose. Urine test - To detect the presence of glucoseand/or ketones in the urine. Glycated haemoglobin (HbA1c) measures theaverage blood sugar concentration over the past 8-10weeks. This test should be performed every 3 months.
SELF MONITORING OF BLOOD GLUCOSE • Referred as home blood glucose testing. For type 1 patients, it should be performed at least 3-4 times a day. • It gives detailed information about blood sugar levels at different time points in a home based setting. • Helps adjust your therapeutic regimen like your dietary intake, physical activity or insulin dose in response to the blood glucose values, thus improving glycemic control. • Helps recognize high and low blood sugar levels
ADVANTAGES OF SMBG•Effective and convenient methodto measure blood sugar levels.• Results are displayedimmediately. ••SMBG device is portable and can The results can be usedbe used at home, work , while to monitor sugar levelstravelling or over a period of time exercising. • helps us know the effect of food, medication and activity on blood glucose levels.
DISADVATAGES OF SMBG•Blood glucose levels cannot be monitoredcontinuously.•The patient needs to be pricked several times in aday to obtain results which can be quite painfuland lead to psychological burden on the patientespecially small children with type 1 diabetes.•The test can be demoralizing, if the results areoutside the target range.
CONTINUOUS GLUCOSE MONITORING SYSTEM (CGMS)Continuous glucose monitors measures glucose continuouslyand updates glucose levels every 1-5 minutes over a 72 hourperiod.A CGMS device consists of - A sensor that is inserted in the body tissue (A&B) A monitor to display information (C) A transmitter that transmits the sensor data to the monitor (D)The sensor inserted in the skin stays in placefor several days and the transmitter sends information aboutglucose levels via radio waves from the sensor to the monitor.
ADVANTAGES OF CGMS- It is more reliable and accurate and providescontinuous glucose readings.- Helps to identify fluctuations and trends inblood sugar levels which often go undetected.- It helps identify periods of high and low bloodsugars.- It also studies the impact of lifestylemodifications on blood glucose levels.
DISADVANTAGES OF CGMS- It is expensive.- It can be painful.- There are chances of dislodging of thesensor.- The sensor adhesive can cause skinirritation.- Calibration errors are possible.
INSULIN PUMPS•It delivers rapid acting and shortacting insulin over a period of 24hours.•Insulin pumps replace the need forperiodic insulin injections.•They deliver insulin more accuratelythan injections.•They help in management of bloodsugar levels with fewer large swingsin blood glucose.
ARTIFICIAL PANCREAS•The artificial pancreas uses a continuous automaticglucose monitor that continuously measures sugarand an insulin pump that delivers insulin.•This device allows you to modify insulin delivery in away that mimics natural pattern of pancreatic insulinre lease.•The problem in developing artificial pancreas is withthe continuous sensor that measures the blood sugarand the implanted insulin
IMPORTANCE OF BLOOD SUGAR MONITORING IN TYPE 1 DIABETES•Helps in identifying and responding to high and lowblood sugar levels and enables better sugar control.•Helps in making appropriate treatment choices(insulin, diet, exercise) on a daily basis.•Reduces the risk of future diabetic complications.
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