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Monitoring your blood sugar

Why should I keep a close watch on my blood glucose level?
Monitoring your blood glucose level should be the corner stone in your management plan. The main goal of managing your (or your child’s) diabetes is keeping the glucose level within 70–130 (mg/dL) before meals, and less than 180 mg/dL after meals (according to the American Diabetes association). Note that normal blood glucose level for non-diabetics should be between 70 and 100 milligrams per deciliter (mg/dL) in fasting conditions and below 125 mg/dL in random and post-prandial conditions. To accomplish the previously-mentioned target , a regular monitoring system is needed .a record of your blood glucose levels will greatly help you/your health care provider manage your exercise , diet , medications plan .keeping your blood sugar within the normal levels helps prevent both short-term and long-term complications.

How can I monitor my blood sugar?
monitoring your blood sugar is a home-held quantitative test that measures the amount of glucose in your blood, this can be performed using one of the following devices:-

A glucose meter:
it is the most commonly used method , it involves pricking your finger with a lancing device to obtain a tiny blood drop and using a blood strip inserted into the monitor to measure the blood glucose level ,meters have many different types .Some meters use a blood sample from a less sensitive -yet less accurate -areas than the fingertip, such as the upper arm, forearm, or thigh. To make the most out of it , you can write down the results regularly , or use a monitor with a memory/software program that lets you have a record of your results , and transmit them to your computer , having a record of your sugar levels is highly efficient in managing your diabetes. A less commonly use method is the Continuous glucose monitoring (CGM) system. This system uses a needle that contains a sensor , The needle is inserted under your skin , continuously and automatically checking your glucose level (once per a minute or once per 5 minutes max) in tissue fluid (not in blood) , results are sent to a wireless monitor . you can put the monitor in your bag , wear it on your clothes , or even put it besides you .the sensor is changed every few days . CGM systems are more expensive and less accurate than conventional glucose monitoring (especially when sugar level is rising rapidly), making its users in a need to

confirm results with a glucose monitor before they make any significant change in their treatment plan. On the other hand, CGM system enables tighter glucose control specially with people having difficulty in realizing symptoms of low blood sugar (hypoglycemic unawareness) . It also allows users to set alarms to alert them when their glucose level is too low or too high . Some CGM systems come with software programs that allow users to download data to a computer for tracking , and follow up purposes. Some CGM devices have been approved by the FDA (Food and Drug Administration) like those produced by MEDtronic and Abbott .

How can I select a suitable Monitor?
If you decided to get a new glucose monitor, but still unable to make up your mind , you should ask yourself the following 3 questions :-

can I afford it ?
This shouldn’t be such a big deal after all. With little effort, you can find yourself a reasonable offer. Most monitors on the market are available in affordable offers .However you need to keep in mind that the monitor supplies, like test strips, are going to cost you even more than the monitor did , on the long run. You can try getting your insurance carrier to cover the costs for you.

is it accurate ?
Usually, newer monitors are more accurate than old ones.
you can go over the“monitor accuracy section” of this article !

Is it easy to use?
This can be determined by the technique you’ll be using , the amount of blood needed (if it’s little , you’ll need a less painful finger prick)

Additional features can help you pick :- Time needed for the results to come up. - Accompanying software program that lets you transfer your results data to your computer for recording and comparing them, and….. - The monitor being designed to let you enter events like eating or exercising.

- Its size. - Technical support provided with the monitor (and for how long). - Automatic timing. - Remember that you can always consult your health care provider.

Are glucose meters Accurate enough?
As a general rule, blood glucose meters are reasonably accurate, however, you need to keep in mind that their results can be variably inaccurate in the following conditions:1- low quality devices or strips. 2- The way you perform the test, and use your glucose meter. 3- Hematocrit value (hematocrit means the amount of red blood cells in the blood). Abnormally high or low values will give less accurate results. If you are severely dehydrated or anemic, you’ll be having an abnormally high or low hematocrit values, respectively. 4- Physical factors like: temperature and humidity might interfere with your test results. 5- Some substances like acetaminophen (an analgesic. i.e.: Tylenol) or Uric acid (significantly important in people with gout) can interfere with your test results as well. After all, when your test results are compared with a laboratory results , there shouldn’t be any difference greater than 15 % . A larger difference indicates a problem with your monitor, blood strips, or technique, etc.

So Remember:Be alert , if a test result doesn’t get along with your symptoms , then may be you need to confirm the result with a more specific test .

Light at the end of the tunnel
The idea of replacing the natural malfunctioning pancreas of the diabetic person with an artificial pancreas has been a dream for a very long time. A natural healthy pancreas detects changes in blood sugar and responds to them by secreting adequate amounts of regulating hormones (insulin and glucagon), thus to create an artificial pancreas, the following three components are required:-

- A CGM system ( to monitor the blood sugar) - An insulin delivery system - A computer program that "closes the loop" between the CGM system and the insulin delivery system . Recently, many steps have been taken towards creating an artificial pancreas in the form of “the MiniMed Paradigm REAL-Time System”. It’s not exactly an artificial pancreas, but it represents a great deal in joining a monitoring system with a delivery system.