Diabetic Home Care and Monitoring (cont.)
Robert Ferry Jr., MD
Robert Ferry Jr., MD, is a U.S. board-certified Pediatric Endocrinologist. After taking his baccalaureate degree from Yale College, receiving his doctoral degree and residency training in pediatrics at University of Texas Health Science Center at San Antonio (UTHSCSA), he completed fellowship training in pediatric endocrinology at The Children's Hospital of Philadelphia.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
- Diabetic home care management facts
- What is diabetes?
- What is the treatment for diabetes?
- Exercise therapy
- Diet therapy (diabetic diet)
- Drug therapy
- How is diabetic treatment monitored at home?
- Blood glucose reagent strips
- Blood glucose meters
- Urine glucose tests
- Tests for urinary ketones
- What additional monitoring does the doctor do?
- Blood glucose
- Continuous glucose sensors (CGMS)
- Hemoglobin A1C testing
- Find a local Endocrinologist in your town
Drug therapy
Medications to treat diabetes are available only by prescription. Insulin must be given by injection or infusion beneath the skin. Oral medications are available that increase the release of insulin from the pancreas and/or increase the responsiveness of the body's cells to the insulin naturally produced by type 2 diabetes patients. Type 1 diabetes patients have stopped making insulin and thus must take insulin.
How is diabetic treatment monitored at home?
The goal of diabetic therapy is to control blood glucose levels and prevent the complications of diabetes. Glucose levels are lowered into a normal range, if possible, but it is important not to reduce the levels to abnormally low levels that can cause symptoms of hypoglycemia such as sweating, increased heart rate, and even loss of consciousness. Therefore, it is necessary not only to treat the diabetes, but also to monitor the effects of treatment on blood glucose levels to avoid overtreatment or undertreatment of diabetes.
There are two types of tests for blood glucose monitoring in the home. The first type uses a reagent strip, and the second type uses a reagent strip and a glucose meter.
Glucose and ketones also can be measured in the urine. Ketoacidosis is a serious but preventable complication caused by inadequate treatment of diabetes. This condition can be identified by testing urine for ketones.
Blood glucose reagent strips
Reagent strips are saturated with glucose oxidase, an enzyme that interacts with glucose. When a drop of blood is placed on the strip, the glucose oxidase chemically reacts with the blood glucose. The resultant reaction changes the color of the strip. The higher the glucose level, the greater the reaction, so the more dramatic the color change. The blood glucose level can be determined by comparing the color of the strip with a color chart. For accurate results, test strips should be stored at room temperature and away from moisture. To protect the strips from moisture, bottles should be closed after use.
The disadvantage of reagent strips alone is that they do not give an exact glucose measurement. They are accurate enough, however, to alert patients to seriously high or low levels of glucose. Examples of reagent strips available over–the–counter (OTC) are Chemstrip bG and Glucostix. To determine a more accurate blood glucose level, the reagent strip must be combined with a blood glucose meter. (See below.)
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