"Hypoglycemia" is more likely to lead to hospitalization than high blood sugar! More than 50% are asymptomatic? Doctor: Make good use of CGM to help blood sugar control reach standard
Be careful with palpitations, night sweats, and trembling hands! Doctor: More than half of cases of hypoglycemia are asymptomatic
People with diabetes should not only pay attention to high blood sugar, but also “hypoglycemia” should not be ignored. Severe and prolonged hypoglycemia can lead to increased diabetes-related complications and impaired cognitive function. According to research, about 30% of people with type 2 diabetes in Taiwan who take traditional oral medications have experienced symptoms of hypoglycemia. Hypoglycemic events may not only cause immediate danger, but also affect patients’ compliance with medication and increase the risk of poor blood sugar control.
Dr. Cai Shize, chairman of the Diabetes Care Foundation and director of the Department of Metabolism/Nutritional Therapy of Zhenxing Hospital, pointed out that the frequency and distribution of hypoglycemia (with or without symptoms) are one of the important clinical indicators for judging the quality of blood sugar control. The most typical symptoms of hypoglycemia are: numbness of hands and feet, tremors, palpitations, and night sweats. However, more than half of hypoglycemia cases have no obvious symptoms. How to accurately record the time period of hypoglycemia events can help stabilize the blood glucose variability rate. For diabetes Management is paramount.
If there are no symptoms, then there is no hypoglycemia? Is hypoglycemia more likely to result in hospitalization than hyperglycemia?
“Many people think they don’t have hypoglycemia because they have no symptoms. This is a very big blind spot!” Dr. Cai Shize said that in the past, people with diabetes could not immediately detect whether hypoglycemia was present. Once it occurred during exercise or when it was difficult to call for help, it would cause Immediate physical damage and psychological impact affect subsequent blood sugar control. For patients who have experienced hypoglycemia, the “TIR” (Time in range, time to reach blood glucose target ratio) target can be relaxed from 70% to 50%. “Safety compliance is the most important!”
Dr. Cai Shize pointed out that for ordinary people with diabetes, it is recommended to control fasting (before meals) blood sugar between 90-130mg/dL; after meals (before going to bed) it is recommended to control between 120-160mg/dL; at least in the middle of the night. Above 70 mg/dL. It is worth noting that hypoglycemia is more likely to lead to hospitalization in elderly patients than hyperglycemia. For elderly patients with diabetes, individualized control goals should be set to reduce the occurrence of hypoglycemia as a priority.
However, there are more than 42 factors that affect blood sugar changes, including food, drugs, activities, biology, environment, behavior and decision-making. Only with the intervention of more advanced technology can we help patients better understand the full picture of blood sugar changes and help with diabetes management. .
Don’t just look at glycated hemoglobin! Blood sugar control “paradigm shift” relies on technology
“With the advancement of medicine, there has been a “paradigm shift” in blood sugar control in diabetes. In the past, it only focused on glycated hemoglobin, fasting blood sugar, and postprandial blood sugar, and now it also includes TIR (time to reach blood sugar target), TBR (hypoglycemia) Temporary ratio), TAR (ratio of time when blood sugar is too high) and other indicators, how to empower patients and allow them to control their blood sugar is the key!”
Dr. Cai Shize pointed out that in the past, diabetic patients had to use a single blood collection to monitor blood sugar. Even if blood was collected four times a day, hyperglycemia or hypoglycemia events might still be missed. With the advancement of medical technology, continuous glucose monitoring (CGM) can monitor glucose for 14 consecutive days through sensors, and automatically record change curves and fluctuation patterns through a mobile app to help diabetic patients fully understand their glucose values. It can also be uploaded to the cloud for patients and care teams to review at any time.
Dr. Cai Shize said that the introduction of CGM (continuous glucose monitoring) allows patients to move towards the three goals of reducing the occurrence of hypoglycemia, reducing blood sugar variability, and better managing overall blood sugar levels (glycated hemoglobin). In addition, continuous blood glucose monitoring provides average values every three hours, allowing diabetics to be alert to changes in blood sugar caused by different periods and different diets in a timely manner, allowing diabetics to become their own “big data blood sugar management experts” and truly achieve “sugar control.” The goal of care is to “see things that are not difficult” and “look at things without asking for help”.
Dr. Cai Shize reminded that only simple blood sugar monitoring is still not comprehensive enough for blood sugar control. More meaningful indicators must be included to help people with diabetes take correct actions, including immediate changes and long-term behavioral strategies. Reasonable warning values should be set when using CGM. If extreme high or low values are detected, corrections should be made in time to avoid being misguided by data. We look forward to the widespread use of blood sugar monitoring technology tools to help more diabetics understand the full picture of their blood sugar and achieve a better quality of life.
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