Diabetes is an incurable disease reflecting a disorder of glucose absorption. It is characterized by a high level of sugar in the blood which is called hyperglycemia . The level of sugar in the blood (glycemia) varies during the day and, in diabetics, these variations are significant and require regular measurements. One method used by a large number of diabetics is the self-measurement of the glucose level , by analyzing the content of blood or interstitial tissues. The glycemic self-monitoring allows the patient to measure his own glucose level by means of a drop of blood taken at the fingertip, in order to adapt the treatment. Only the doctor can modify the frequency, the measurement schedules and the treatment according to the results. The fasting blood sugar level is considered normal if it is between 0.74 g per liter and 1.06 g / L. Below these values we fall into hypoglycemia, and beyond, it is hyperglycemia.
Self-measurement: for whom and why?
Self-measurement of blood sugar does not apply in the same way to all patients suffering from diabetes, since it is divided into two types with different causes and effects.
Type 1 and 2 diabetes on insulin
Self-measurement is most often used in patients with type 1 diabetes , that is to say, hereditary diabetes, which is expressed from childhood by hyperglycaemia in the blood and weight loss. Spikes in blood sugar can be quite random and sometimes require the use of insulin, which justifies frequent monitoring of blood sugar . Self-measurement is perfectly adapted to this pathology, but it is also used in cases of type 2 diabetes. This is caused by prolonged hyperglycemia which forces the pancreas to produce more insulin than it is capable of. to bear. This fact results from a reduction in the body’s sensitivity to insulin, which therefore cannot have the desired effect on the absorption of glucose. Thus it is possible to treat type 2 diabetes by regular injection of insulin for a period defined by the doctor and during which it is necessary to control his blood sugar .
In the first case, the blood sugar measurement is done over the long term, in order to be able to adapt your insulin treatment to the body’s shortcomings, while in the case of type 2 diabetes it is a question of controlling your blood sugar to allow the pancreas to produce sufficient insulin. In gestational diabetes, since the fetus requires increased amounts of glucose for growth, it can happen that blood sugar levels drop in pregnant women. Therefore, self-measurement can be justified to avoid hypoglycemia, malaise , etc.
In short, measuring the glucose level in the case of type 1 diabetes allows you to control your diet and adjust the amount of insulin injected by the pump that equips most patients. For people with type 2 diabetes, it is about being aware of the effects of insulin treatment and those of lifestyle in terms of energy consumption. Playing sports lowers blood sugar, while eating pastry makes it higher, for example.
Why measure your blood sugar?
The main argument of self-measurement is to be able to know your blood sugar very quickly , and to observe the effects of food on it. These measures make it possible to react as quickly as possible to hyperglycemia or hypoglycemia, respectively by the injection of insulin or the consumption of foods rich in glucose. Self-measurement also allows you to adjust your insulin doses with your attending physician and ensure their effectiveness following the initial injection.
As a general rule, measuring blood sugar allows treatment to be adapted to the situation to avoid complications, such as organ damage resulting from hyperglycemia in type 2 diabetes. Similarly, self-measurement allows ” Avoid the severe hypoglycaemia that type 1 diabetes can cause, which can go as far as fainting.
Convenient and fast, it should not replace the dosage of glycated hemoglobin (4 times a year) because it is less precise. The first provides a long-term view of the development of diabetes, while self-measurement represents a photo at an instant T, an analysis of the timing of blood sugar.
How to practice self-measurement?
What can vary depending on the means chosen is the method of blood sampling . It is indeed necessary to drill a small hole in the skin to draw a small amount of blood, without causing significant damage to tissue. Most often, people with diabetes are advised to prick themselves on the finger pulp. To pierce the skin, use a lancing device , in which are placed extremely fine lancets, between 0.40 and 0.65 mm in diameter.
These lancets are for single use , because their small size means that they deteriorate when they come under the skin. If reused, they can cause more than necessary tissue damage. If the lancets can be placed one by one in the pen, there are also pens that accept barrels, each containing 6 lancets. They are placed, after use, in the bottom of the barrel and can no longer be reused.
There are many ways to take blood to measure your blood sugar , but they all use a blood glucose meter , which can be found in pharmacies on prescription from your doctor. This reader analyzes the blood sugar level and displays it on a screen so that you can adapt your treatment to the situation. There are two ways to use these tools for reading blood: strips that react to sugar or electrodes .
Blood sugar strips create electrons when sugar in the blood is applied, and its electrons will act with a colored component, which when analyzed, determines the level of sugar in the blood . Conversely, the electrodes create electrons which are directly measured by the device, which makes the process both faster and more precise. These processes are disposable in nature and must therefore be replaced each time they are used.
Cassette systems also allow the role of the sensor and the glucose meter to be combined, but are limited to 50 or 100 measurements. Conversely, some systems opt for continuous monitoring of blood sugar by a sensor placed under the skin at the abdominal level and which must be changed from time to time. It is generally coupled to the insulin pump with which it communicates permanently. It issues an alarm when significant changes occur.
In this context, a new technology makes it possible to place a sensor under the skin of the arm to carry out a permanent analysis of the blood sugar level. Having to be renewed after two weeks, the sensor analyzes the blood sugar present in the interstitial tissue, without drawing blood, and can be scanned by the reader which goes with or via an application on your smartphone .
When measuring your blood sugar, it is good to remember a few rules regarding the procedure. To start, it is good to measure your blood sugar several times a day , after meals and between each to prevent possible hypoglycemia. Then, before pricking, it is important to wash your hands thoroughly and dry them, to avoid contamination, strips or micro wound. However, be careful not to use medical alcohol or hydroalcoholic gel , these solutions disturb the chemical reaction on the surface of the strip.
When choosing a finger to practice your dextro, avoid always pricking the same fingers while rotating on both hands. To make blood flow to the tips of the fingers, massage the palm of the affected hand by pushing towards the tip.
On the lancing device, you can select the depth of the lancet bite, then you just have to prick, on the side of the finger, not on the most sensitive part, and deposit the drop of blood on the strip or the electrode.
After performing the self-measurement, it is advisable to record each measurement in a notebook to allow you to observe changes during the day, or over several days or weeks. This booklet can be used to discern the points of the day when the blood sugar level rises or falls, and thus adapt your treatment with your doctor. Many blood glucose meters keep the results in memory, and some can also transfer them to your doctor via bluetooth .
Please note, however, that certain precautions should be taken before measuring blood sugar . For example, it is not recommended for people suffering from hemophilia, since the wound does not clot, it can cause problems for the patient.
Keep your equipment in good condition
Refer to the instructions for your blood glucose meter before use and at the time of maintenance. This must be regular to ensure the accuracy and speed of self-monitoring.
Absolutely avoid strips or expired electrodes, as they can completely distort the result. In the same way, keep them in their hermetically sealed packaging, as humidity can also damage their sensitive faces. If you doubt the effectiveness of a strip, it is possible to check it with a control solution, the result of which is already known.
You should also change your lancing device every year , as the spring used for injecting lancets deteriorates, implying more painful use, which can leave larger wounds that take longer to heal.
Do not exchange the lancing device
Under no circumstances should you share your self-monitoring equipment with others, the reader or the lancing device. Indeed, it is possible that blood is communicated from wound to wound, transmitting bacteria and viruses to both users.
Measuring and monitoring your blood sugar at any time of the day is an important part of treating people with diabetes . This requires fairly complete equipment and a good knowledge of the methods of use and maintenance. The equipment for self-monitoring of blood sugar is covered by Health Insurance. The strips are reimbursed up to a limit of 200 per year if you are not on insulin therapy. Blood glucose meters are guaranteed for a minimum of 4 years. In the event of a fault, they must be replaced by the manufacturer. This is why Health Insurance reimburses only one blood glucose meter every 4 years. The lancing device is reimbursable every year.