The goal of the analysis is to know and monitor the level of sugar in the blood in order to organize the patient’s treatment program and to avoid an extreme increase or decrease, and to prevent the risk of chronic complications from problems of the eyes, heart, kidneys, nerves and feet.
- Method of analysis using a special device: pharmacies have many types of blood glucose analyzers available. Therefore, the patient should consult a doctor and a specialist for education and training of diabetics before purchasing these devices. The specialist must also ensure the accuracy and quality of the device or read the brochure attached to it to know the correct way to operate it and maintain it before training patients to use it.
When training a diabetic patient on self-analysis of blood, the specialist must follow the following:
- Clarify the fact that the results may differ from one device to another and that there are ratios (10% – 15%) between the results of the laboratory and the results of home appliances, because the blood sample used is taken from the tiny capillaries in the case of the home device, while the vein sample is sent to the laboratory.
- Checking the expiry date of the tapes and stressing the importance of tightly closing the tapes after each use.
- Ensure the necessity of contacting the specialist if the blood sugar level is high more than 240 mg (13.3 mmol) or lower than 60 mg (3.3 mmol) and then the proper behavior in both cases.
- Ensuring that the analyzes should be carried out according to a daily or weekly regime agreed upon by the doctor and specialist, in proportion to the needs of each patient.
Sugar appears in the urine when the blood sugar level exceeds 180 mg (10 mmol), but this percentage is not fixed and is affected by many factors. Many people have to analyze sugar in the urine due to the ease of analysis, but it is better not to rely on the results in changing or modifying the patient’s treatment program.
The importance of urine analysis lies in detecting the presence of ketones (acetone), and this type of analysis must be done in the following cases: –
Various cases of infections – fever – cold – diarrhea. vomiting…
- Cases of severely elevated blood sugar level greater than 250 mg (14 mmol).
Cases of psychological stress and crises.
- The detection of ketone content in the urine requires an adjustment in the daily prescribed insulin dose if the blood sugar level is more than 200 mg (11.1 mmol) depending on the result of the analysis (1+, 2+, 3+) and this is done according to Following a system agreed upon by the doctor and specialist is as follows:
- In the event that one ketone (1+) appears in the urine, an increase of 5% of the total dose of insulin can be made within 24 hours so that the increase is only pure insulin.
- In the event that two degrees of ketones (2+) appear in the urine, an increase of 10% of the total insulin dose within 24 hours can be increased, the increase will be from pure insulin only.
- In the event that three degrees (3+) of ketones appear in the urine, an increase of 15% of the total insulin dose can be made within 24 hours so that the increase is only pure insulin.
It is possible to repeat excess doses of pure insulin as described above (before breakfast, before lunch, before dinner) as long as blood sugar levels are high and ketones appear in the urine.
- Consultant of Pediatric Endocrinology and Diabetes and Member of the Board of Directors of the Association
Dr.. Bassam Saleh bin Abbas *
Source: Al-Riyadh newspaper