Standard Blood Sugar Guidelines Recommended
While less strict blood sugar control may be appropriate for some diabetes patients, most should adhere to the target goal of an A1C level of less than 7 percent that has long been recommended for reducing the risk of diabetes-related complications. A1C is a measure of blood glucose levels over the previous two or three months.
The recommendation came in a joint statement by the American Diabetes Association, the American College of Cardiology, and the American Heart Association.
The group based its decision on the findings of three recently-released clinical trials that found no significant benefit or risks related to intensive glycemic (blood sugar) control and heart disease prevention in people with long-standing type 2 diabetes and high cardiovascular risk.
The three studies - ACCORD, ADVANCE and VADT - produced conflicting results.
The ACCORD study was halted early because of an increase in the death rate among patients in the intensive glycemic control group.
The other two studies found that while intensive glycemic control did not increase the risk of death, it did not provide any significant cardiovascular benefit, either.
"Given the confusion created by these conflicting results, we thought it imperative to review our recommendations for all people with diabetes," says Dr. Jay Skyler, head of the recommendation writing group.
"What we conclude is that for most people with diabetes, there's no need to change treatment goals in light of these findings and many reasons to continue to strive for good glycemic control," he says. "But for some people with type 2 diabetes, depending upon their history and current medical condition, it may be wise to make adjustments."
He and his colleagues say the recommendations are consistent with prior guidelines that blood sugar goals should be matched to individual patients, based on their medical history.
Study data also suggests that good glycemic control may provide a cardiovascular benefit for people who have had diabetes for a short period of time and who have no known cardiovascular disease.
"The lack of significant reduction in CVD (cardiovascular disease) events with intensive glycemic control should not lead clinicians to abandon the general target of A1C (a measure of blood glucose level over the prior two to three months) levels of less than 7 percent, and thereby discount the benefit of good control on what are serious and debilitating microvascular complications," the joint statement says.
However, less stringent A1C goals should be considered for diabetic patients who have a history of severe hypoglycemia, a limited life expectancy, advanced micro or macro vascular complications, and established diabetic patients with chronic glycemic control problems.
The recommendations were published online in the journals of each of the three organizations.
For more information consult MUSC MED-U-NURSE or your physician.
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Checking blood glucose levels regularly is very important in proper diabetes management. Current methods of blood sugar monitoring require a blood sample.
Blood sugar monitoring can be done at home with a variety of invasive devices to obtain the blood sample (invasive means the penetration of body tissue with a medical instrument).
Usually a drop of blood obtained through a finger prick is sufficient to use on a test strip that is then measured in a monitor.
A finger prick can be done with a small lancet (special needle) or with a spring-loaded lancet device that punctures the fingertip quickly. The drop of blood is placed on a testing strip. The testing strip is then placed in a blood glucose monitor (also called a glucose meter) which reads the blood sugar level.
Pricking the finger several times a day to monitor blood sugar levels is often a necessary task in the lives of many persons with diabetes.
There are many types of monitors on the market today, ranging in price, ease of use, size, portability, and length of testing time.
Each monitor requires its own type of testing strip. Blood glucose monitors have been found to be accurate and reliable if correctly used, and most monitors provide results within two minutes.
Some glucose monitors can also give verbal testing instructions and verbal test results for people who are visually or physically impaired.
There are also glucose monitors available that provide verbal instructions in Spanish and other languages.
Persons with diabetes may have to check their blood sugar levels up to four times a day.
Certain blood glucose monitors are equipped with data-management systems, which means your blood glucose measurement is automatically stored each time.
Some physician offices have computer systems compatible with these data-management systems, which allows the blood sugar level recordings, and other information, to be transferred electronically.
For more information consult MUSC MED-U-NURSE or your physician. |