- Why do people with diabetes need to check more than their glucose?
- Good glycemic
control is the cornerstone for proper diabetes management; however, people
who have diabetes are prone to dyslipidemia, CVD, PVD, eye disease, kidney
disease and limb amputation. Cholesterol, HDL cholesterol, triglycerides,
HgbA1c, ketone bodies, creatinine and microalbumin are all important to
measure on a regular basis to keep on top of the complications associated
with diabetes. In fact, the majority of people die from complications of
the disease and not the disease itself.
- Why do other people need to monitor lipids?
- Coronary artery
disease affects over 12 million Americans, and is the leading cause of death
in the US for both men and women. (High cholesterol is the leading risk
factor for heart disease). Ninety seven million Americans have elevated
cholesterol levels. Studies have shown that lowering cholesterol in middle-aged
men with hypercholesterolemia reduces the incidence of myocardial infarction.
(A co-operative trial in the prevention of ischemic heart disease using
clofibrate, The Lipid Research Clinics Coronary Primary Prevention Trial
results. Helsinki Heart Study.) In addition, a 1 percent reduction in cholesterol
levels offers a 2 percent reduction in risk of heart attack. One in five
American men ages 30-34 may have an advanced case of clogged arteries that
creates a high risk of a heart attack in the next 10 to 15 years (Source:
Journal of the American Heart Association). About half of those who die
suddenly of heart disease die without any warning sign like chest pain (American
Heart Association). Given the fact that elevated cholesterol levels are
a treatable risk factor to lower the risk of CAD and/or MI, early detection,
interventions when appropriate and continual monitoring are necessary for
all individuals.
- How often should cholesterol be monitored?
- According to the American Heart Association cholesterol levels should be
measured every 1-5 years in healthy adults. For people with elevated cholesterol
levels every 6 months and for people on drug therapy every six weeks until
stable and then at least every 6 months. With poor dietary habits, your
cholesterol can increase in as little as 2 weeks.
- Who needs to monitor ketones?
- Ketones are a
bi-product of fat metabolism. In diabetics with elevated blood sugar, acute
infections or during times of stress diabetic ketoacidosis can develop.
This is a life-threatening event that needs timely, accurate diagnosis so
appropriate medical treatment can be received. Ketones should be monitored
when blood sugar is over 240 mg/dL, during illness, when you are planning
to exercise and blood sugar is over 300 mg/dl if you are using insulin and
400 mg/dl if you are not using insulin. Pregnant women should test for ketones
each morning before breakfast and anytime the blood sugar is over 180 mg/dl
In addition, patients on low-carbohydrate, Atkinís type diets; it
is recommended that they monitor their ketone levels to determine if they
are in ketosis and losing weight.
- How much faster and more accurate is blood ketones versus
urine ketones?
- Ketones may be
measured in blood and show up approximately 2-4 hours before they will be
present in the urine. In addition, with blood ketones your physician is
able to get an accurate reading on your level and know when you need medical
intervention.
- What
variance is normal in cholesterol values?
- Cholesterol levels can vary by 15 percent from day to day. An 8 percent
difference can even be identified within the same day. According to
the annual survey sponsored by the CAP (College of American Pathologist),
acceptable variations for chemistries follow:
| Evaluation
Limits |
+/-
10% |
+/-
30% |
+/-
25% |
+/-
10% |
+/-
.3 mg/dl |
|
| While daily blood glucose testing tells you what your blood sugar level is at the time you test, HbA1c testing tells you your "average" blood sugar level over the past 2-3 months. These tests are very important in protecting your long-term health. Maintaining good HbA1c levels will help reduce your risk of diabetes complications such as blindness, kidney disease, nerve damage, stroke, and heart failure. |
