It is already known that in all types of Diabetes the main problem is excess blood glucose or hyperglycemia. Today we have different methods for determining glucose values to be able to establish the diagnosis of the disease, for periodic control and for daily control that helps in making decisions about the installed treatment. They are used: simple laboratory analysis with extraction of venous blood (glycosylated hemoglobin and glycemia), reaction in specific strips after pricking the fingertip with a lancet (capillary blood glucose measurement), enzymatic or fluorescence reaction (interstitial blood glucose measurement using continuous blood glucose sensors). glucose that are inserted under the skin).
It is also known that the better we have diabetes controlled, the short and long-term benefits will be obtained by avoiding complications related to the disease such as retinopathy, nephropathy, peripheral vascular pathology and cardiovascular disease. To know if this control is adequate, it is necessary to establish glycemic control objectives.
In adults (not pregnant) and older adults, children and adolescents in general, we can establish the following as control goals:
- Glycosylated Hemoglobin (HbA1c) values less than 7%. Glycosylated Hemoglobin is an estimated average of glycemic control over the last 3 to 4 months. As its name implies, its concentration is influenced by the concentration of hemoglobin in the blood. Therefore, in special situations such as anemia, some drugs, blood transfusions or pregnancy, they can generate a limitation to take this value as a control parameter.
- Values of Time in Range (IRR) greater than 70%. Time in range is established through the use of continuous glucose sensors and determines the average percentage of time that a person maintains their glucose in the desired range of 70 to 180mg/dL.
- Capillary glucose or by sensor before meals between 80 and 130mg/dl and less than 180mg/dl 2 hours after meals.
It should be clarified that it is essential to individualize the control objectives, establishing said goals in each consultation that the patient makes with their acting professional, taking into account the patient’s current situation. For example, in an individual who presents recurrent severe hypoglycemia, who has a low life expectancy, or who does not have the means to monitor their glucose frequently, less demanding control goals may be established (HbA1c 7.5-8% ). On the other hand, those people who have access to technologies that allow a simpler, more effective and safer control, and with the appropriate education, will be able to establish more demanding goals (HbA1c less than 6.5%) that provide greater benefits in the long run. term in prevention of complications.
Understanding what, why and how we measure the control of Diabetes is essential to establish a good treatment strategy that generates the greatest possible well-being in each person who lives with this disease.
Dr. Laura López – Encocrinologist – MN 137194 MP 2409 ME 1438
Santa Rosa Sanatorium – Tel 457000 (int 221)
Cell: 2954-311912
Santa Rosa – La Pampa
by CEDOC