Tight Glucose Control in the Hospital

How Important is tight glucose control while you are in the hospital ?

Most everyone with diabetes knows how important tight glucose control is. However, many are concerned with their hospital health care professionals who are not overly concerned with their glucose levels during their stay.
Even today, most scientists don’t know what the best glucose levels are for hospitalized patients with or without diabetes. Recent studies have looked into the question of whether the possible damage from hypoglycemia from intensive insulin therapy is more harmful than any caused by a temporary period of too high glucose levels.
The study in March 2009 compared glucose levels in the ICU of patients with Type 1 and Type 2 diabetes, along with non-diabetics because severely sick patients have a rise in glucose levels. Half of the patients were put on a strict glucose goal of 81-108mg/dl. The other half had a target of 180mg/dl or less.
Ninety days later, it was found that the intensive control group had a 14% higher death rate than the less controlled group. The researchers concluded that intensive glucose control in the ICU is putting patients at an increased risk of severe hypoglycemia and the risk of dying within 90 days. Therefore, they advise against tight glucose control in the ICU.
Other studies have shown no greater death rate, but a 6-fold increase in the risk of severe hypoglycemia. Neither study supports the current guidelines for use of insulin therapy in the ICU .
In another study, in individuals with diabetes who were hospitalized for various reasons, low blood sugar occurred in approximately 8% of the patients. Each additional day with a hypoglycemic episode was linked with an 85% increase in the risk of death while hospitalized.
If you plan on being in the hospital, it is recommended that you ask your doctor what kind of control he wants you to maintain during your stay, and make sure he conveys that to the hospital staff.
(Diabetes Self-Management Sept/Oct 2009,Pharmacy Times Sept 2009)

Diabetes and your Feet

Diabetes and Your Feet

    Diabetics have to take special care of their feet, or they can become more susceptible to problems in two ways: reduced blood circulation and nerve damage.

Here’s what to look for and some prevention ideas.

If your feet are constantly cold, your legs are sore when you walk, or your feet hurt in bed at night, you may be suffering from poor blood circulation. This, in turn, can slow down the process of healing when you have cuts or other damage to your feet.

Staying physically active is one way to help improve your circulation. You also need to control your blood fat and sugar levels, as well as your blood pressure. Massage is an effective tool to incorporate in your daily foot check routine to ensure increased circulation, manage blood glucose levels and blood pressure.

And of course, don’t smoke. My mother was a smoker and it causes so many complication with many medications and most importantly her circulation. I picked up smoking from my mother’s bad habit at a young age and am very happy to say I have not been a smoker in over 8 years. I am proof quitting cold turkey works when you are committed to it. I knew in my heart I would NOT allow smoking to kill me slowly anymore.

If your feet are numb, you have a burning sensation on the soles of your feet or pins and needles in your feet, you have signs of possible nerve damage.

Foot nerves are the longest in our bodies and are therefore susceptible to damage by diabetes. If these nerves are damaged, the feelings are lessened, so we could have the cuts or blisters that can lead to ulcers, and we wouldn’t even know about it.

Check your feet regularly to be sure there are no signs of injury. If you develop corns or calluses, have them treated immediately by a podiatrist. Wash and dry carefully between your toes, and keep your nails trimmed and smooth.

Everyone likes to have their feet pampered, but for us diabetics it not only feels good, it also prevents serious health problems in the future. So book that foot massage now!

Massage can become costly when it is not covered by insurance. As a solution, check out my FREE REPORT on the benefits of massage for diabetics.

Claim your Free Report: “The Benefits of Diabetes Massage”

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