Medical Edge Newspaper Column

Managing Diabetes, Monitoring Blood Sugar

Dec. 24, 2006
DEAR MAYO CLINIC:
I am a 32-year-old woman, recently diagnosed with diabetes. My blood sugar stays around 250. I prick my fingertips to test my blood, and this leaves them very sore. I would like more information on treatment, including diet and exercise, and any alternatives to blood testing. -- Bryan, TX

ANSWER:
The risks of complications from diabetes can be significantly reduced by lowering the blood glucose to as close to normal as possible. Blood glucose recommendations by experts vary slightly. In general, an ideal range is 90 to 130 milligrams per deciliter (mg/dL) before eating and below 180 mg/dL two hours after eating. You won't know if you reach these goals without testing your own blood glucose in your everyday life.

Many of the glucose measuring devices require only a tiny drop of blood. If you draw a larger drop or draw the blood from the middle rather than the edge of the fingertip, it can hurt more than necessary. You can also reduce discomfort more with a meter that allows testing at a site other than the fingertip. This technique (called alternative site testing) uses the forearm or the palm near the base of the thumb, where there are fewer nerve endings so there is less pain.

Many people with newly diagnosed diabetes can reduce their blood glucose to the recommended ranges with regular physical activity and a healthy diet. A high blood glucose reading after one meal -- but not after another -- is a clue that the meal with the higher following blood glucose is not a good choice.

Even with healthy lifestyle choices, some people cannot control their diabetes without medication. These people simply have a different type or a different stage of diabetes. It's not unusual for people your age to need insulin soon after the diagnosis.

If your blood glucose levels remain elevated despite your best efforts, then you may need a medication or a change in your current medications. Do not become discouraged if you need medications to control your diabetes. Optimal control of your diabetes will improve your health now and protect your health in the future.

There is much to learn, and many excellent resources, to help you manage diabetes. Many clinics have nurse educators who focus on diabetes. Mayo Clinic (mayoclinic.com) and the American Diabetes Association (diabetes.org) are excellent resources to help you learn more.

--Geoffrey S. Gates, M.D., Division of Endocrinology, Mayo Clinic, Jacksonville, Fla.