Type 1 diabetes: surveillance

self-monitoring

The goal is to adjust your insulin doses and eventually manage emergency situations. Self-monitoring is based on blood glucose tests on capillary blood and the patient pricks the middle finger, the ring finger or the little finger, preferably at the side faces (little innervated).

It should be done ideally at least 4 times a day : before each meal to determine the dose to inject and before bedtime (to prevent the risk of hypoglycemia (less felt at night).

The portable readers are more and more simple, fast, precise (variability 15% compared to the laboratory) and offering ancillary services: memory, electronic notebook, adapted advices, .

Since June 2017, the 1st self-monitoring flashless system measuring glucose continuously is now reimbursed by Social Security in T1D patients.

All you have to do now is pass a reader over a sensor at the back of the arm to scan and instantly measure the sugar level.

Medical supervision

Type 1 diabetes should be followed by a diabetologist or pediatric endocrinologist to monitor the following:

- the equilibrium of diabetes: with glycated hemoglobin (HbA1C), a reference examination, a sort of "black box" that informs about the glycemic balance during the last 3 months. The recommended reasonable goal is HbA1c <7% (some tolerate "around 7%" without exceeding 7.5%) for an adult subject (excluding pregnancy).

- the search for complications : foot sensitivity test, cholesterol, renal assessment, ophthalmological (with a fundus) and cardiological examination (electrocardiogram and Doppler of the arteries)

Type 1 diabetes in women

Contraception

The choice of contraceptive method depends on the age of the diabetes, the existence or not of complications, and lifestyle (smoking). Estrogen-progestin pills can be used in young, uncomplicated, non-smoking women with relatively well-balanced diabetes with clinical and metabolic monitoring.

Pregnancy

In the diabetic woman, the pregnancy must be programmed, the prognosis being almost normal if the equilibrium of the diabetes is perfect from the conception until the childbirth (risk of aggravation of certain complications if they are not perfectly stabilized before).

The glycemic targets are stricter and the diabetological and obstetrical follow-up at least monthly.

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Read also :

> Diabetes: it is important to be well followed ...
> Diabetic: take care of your feet!
> Diabetes: the list of associations near you.

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