The cornerstone of preventing the complications of diabetes is maintaining a patient’s hour-by-hour blood sugar as close as possible to that of a nondiabetic. High levels of blood sugar are poison to the body’s blood vessels, particularly the tiny blood vessels that feed sensitive areas like the retina of the eye, the filtering system of the kidneys, and the peripheral nerves of the hands and feet.
Many diabetics are treated with insulin therapy in order to normalize their insulin levels. Anyone treated with insulin should monitor their own blood glucose daily. This has been the accepted standard of care since at least 1986, when a consensus conference convened by the National Insitutes of Health advocated daily self-monitoring. Patients who learn about the toll on their bodies from poor blood sugar and who are properly educated by their doctor nearly always do a good job of regulating their blood sugar.
To monitor a patient’s blood sugar level, a doctor should perform a blood test on the glycosylated hemoglobin, or hemoglobin A1c, which measures the percentage of hemoglobin in the blood that is attached to molecules of sugar. This is a very accurate measure of the patient’s average blood-sugar levels over the previous six weeks. [See HBA1c to blood sugar conversion chart]
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