Glycemic profile: preparation and analysis. Which group of patients should conduct this examination without fail

How to pass?

The study is performed using a blood test at different times of the day. It should be noted that 2-3 studies per day can not give a complete picture. For obtaining volumetric information, it is necessary from 6 to 9 studies per day.

Ask your question to the doctor of clinical laboratory diagnostics.

Anna Ponyaeva. Graduated from Nizhny Novgorod Medical Academy (2007-2014) and Residency in Clinical and Laboratory Diagnostics (2014-2016).

Next to the words "glycemic profile" there will definitely be one more word - "diabetes". This does not mean that if you are not sick of them, you do not need to read this article. The issue of the spread of diabetes throughout the world is more than serious, so awareness of the basic “diabetic” risks and factors is included in the package of knowledge necessary for a high quality of life.

The glycemic profile is not roof, not fence and not analysis. This is a graph, more precisely - a curved line. Each point in it - the level of glucose at certain hours of the day. The line has never been and will not be straight: the glycemia is a capricious lady, with a changing mood, her behavior must not only be monitored, but also fixed.

Sweet blood and diabetic epidemic

It is no exaggeration to say about the global epidemic of diabetes. The situation is catastrophic: diabetes is getting younger and is becoming more and more aggressive. This is especially true for type 2 diabetes, which is associated with defects in nutrition and lifestyle in general.

Glucose is one of the main players in human metabolism. This is how the oil and gas sector in the national economy is the main and universal source of energy for all metabolic processes. The level and effective use of this "fuel" is controlled by insulin, which is produced in the pancreas. If the work of the pancreas is impaired (namely, it happens in diabetes), the results will be devastating: from heart attacks and strokes to loss of vision.

Glycemia or blood glucose is the main indicator of the presence or absence of diabetes. The literal translation of the word "glycemia" is "sweet blood." This is one of the most important controlled variables in the human body. But it would be a mistake to take blood for sugar in the morning once and calm down on it. One of the most objective studies is the glycemic profile - the “dynamic” technology for determining the level of glucose in the blood. Glycemia is a very variable indicator, and it depends primarily on nutrition.

How to take a glycemic profile?

If you follow strictly the rules, you need to take blood eight times, starting in the morning before the night portions. The first fence - in the morning on an empty stomach, all subsequent - exactly 120 minutes after eating. Night portions of blood are taken at 12 o'clock at night and exactly three hours later. For those who do not have diabetes or do not receive insulin as a treatment, there is a short version of the analysis for the glycemic profile: the first fence in the morning after sleep + three servings after breakfast, lunch and dinner.

Blood is taken with the help of the meter in compliance with the following mandatory rules:

• Wash hands with soap, without fragrances.
• Do not treat the skin with alcohol at the injection site.
• No creams or lotions on the skin of the hands!
• Keep your hand warm, massage your finger before the injection.

The norm in the analysis

If the limits of the sugar content in the blood of a healthy person are 3.3 - 6.0 mmol / l, then the profile values ​​are considered normal with other figures:

• With a diagnosis of type 1 diabetes mellitus, the daily rate of the glycemic profile is 10.1 mmol / l.
• With a diagnosis of type 2 diabetes, the morning glucose level is not higher than 5.9 mmol / l, and the daily level is not higher than 8.9 mmol / l.

The diagnosis of diabetes mellitus is made if the lean-toe (after an 8-hour night fast) rates are equal to or higher than 7.0 mmol / l at least twice. If we are talking about glycemia after a meal or carbohydrate load, in this case the critical level is equal to or greater than 11.0 mmol / l.

It is extremely important that glycemic rate indicators may vary depending on age and some other factors (in older people, for example, slightly higher rates are acceptable), therefore the limits of the norm and pathology of the glycemic profile should be determined strictly individually only by an endocrinologist. advice is not worth it: on the scales, too serious decisions about the tactics and dosage of diabetes treatment. Each tenth share in indicators can play a critical role in the further development of the “sugar” life of a person.

Sweet nuances

It is important to distinguish the glycemic profile from the so-called (glucose tolerance test). The differences in these analyzes are fundamental. If blood is taken on a glycemic profile at regular intervals on an empty stomach and after routine meals, the sugar curve records the sugar content on an empty stomach and after a special “sweet” load. For this, the patient after taking the first blood sample takes 75 grams of sugar (usually this is sweet tea).

Such analyzes are often called lean. They, together with the sugar curve, are the most significant in making a diagnosis of diabetes. The glycemic profile is an extremely informative analysis for developing a treatment strategy, controlling the dynamics of the disease at the stage when the diagnosis has already been made.

Who needs verification and when?

It should be remembered that the analysis is prescribed for GP, as well as interprets its results, only a doctor! This is done:

1. With the initial form of glycemia, which is regulated by diet and without drugs - every month.
2. When detecting sugar in the urine.
3. When you take glycemic drugs, every week.
4. When taking insulin - a shortened version of the profile - every month.
5. In type 1 diabetes, an individual sampling schedule based on the clinical and biochemical landscape of the disease.
6. Pregnant in some cases (see below).

Glycemia control in pregnant women

Pregnant women can develop a special type of diabetes - gestational. Most often, after childbirth such diabetes passes. But, unfortunately, there are more and more cases when gestational diabetes of pregnant women without proper control and treatment turns into type 2 diabetes. The main culprit is the placenta, which secretes insulin-resistant hormones. Most clearly, this hormonal power struggle manifests itself for a period of 28 to 36 weeks, during which time the glycemic profile during pregnancy is prescribed.

Sometimes the blood or urine of pregnant women sugar content exceeds the norm. If these cases are isolated, there is no need to worry - the physiology of pregnant women “dances”. If elevated glycemia or glycosuria (sugar in the urine) are observed more than twice and on an empty stomach, you can think about diabetes of pregnant women and prescribe an analysis of the glycemic profile. Without hesitation and immediately need to assign such an analysis in the following cases:

• overweight or obesity during pregnancy;
• diabetes in first-line relatives;
• ovarian disease;
• age of the pregnant woman is over 30 years old.

Blood glucose meters: requirements, features

Since sampling and measurements must always be carried out with the same meter (they may vary calibrations), ease of use and accuracy of analyzes are absolute and mandatory requirements. Additional benefits of blood glucose meters when choosing:

• Memory (saving previous data).
• Display size and compactness.
• The volume of a drop of blood needed for analysis (the smaller, the better).

Diabetes mellitus is a common and quite dangerous pathology.

It requires regular monitoring.

A glycemic profile is recognized as one of the most effective ways.

With the observance of the technique of conducting, it is possible to observe the indications of the concentration of sugar in the blood for 24 hours.

Letters from our readers

Theme: Grandma's blood sugar returned to normal!

To: Administration site

Kristina
   Moscow

My grandmother has been ill with diabetes for a long time (type 2), but lately complications have gone to her legs and internal organs.

If you diagnosed with type 2 diabetes, the patient is obliged to regularly monitor the indicator of sugar and assess their health. The glycemic profile helps to assess results monitoring - testing, which is carried out at home according to certain rules. To measure using a blood glucose meter.

Many factors affect glucose concentration:

• the amount of carbohydrates supplied with food;
• the functioning of the pancreas;
• the performance of hormones that improve the action of insulin;
• motor and emotional stress.

With regular excess of the norm of sugar, it is required to pass testing on the glycemic and glycosuric profile. It is always prescribed for type 2 diabetes, determines the nature of changes in indicators of sugar.

The biomaterial is collected three times a day: in the morning on an empty stomach, 2 hours after the first and second feeding. In some situations, a specialist may prescribe a six-time blood glucose test (the first collection - in the morning after sleep and after 2 hours after each feeding) and eight times (the analysis is given even at night). How many times to check the blood and how often only the doctor prescribes.

This procedure allows you to control the treatment used. The doctor monitors the effectiveness of therapy, makes the necessary adjustments to the amount and frequency of insulin intake, replaces glucose-lowering drugs and corrects the diet.

Thanks to these actions, the progression of the disease is prevented, the patient is protected from possible complications.

There is a group of people who are shown to conduct a glycemic profile analysis.

These include:

• patients who constantly make injections;
• during pregnancy, if diabetes is diagnosed (in the later stages, the analysis is used to exclude the possibility of the appearance of gestational diabetes);
• type 2 diabetics who apply a diet developed by specialists (a blood test for the glycemic index is taken monthly);
• type 2 diabetics are insulin-dependent (full glycemic profile - monthly, incomplete - once a week);
• when glucose is detected in urine;
• patients who are not dieting.

Indicators can be determined at home, but experts do not recommend this. Reliable interpretation of indicators is carried out by a doctor. At the beginning of the development of hyperglycemia, testing is carried out once a month with a diet.

To obtain normal results of the glycemic profile, it is required to carry out a high-quality material sampling.

To this end, follow some rules:

• Well disinfect hands with soapy water. It is forbidden to use the area of ​​the skin for the fence with the help of alcohol-containing preparations.
• You shouldn’t put a lot of pressure on your finger: normally blood flows out by itself. You can massage the area used finger.
• Before taking the blood glucose test for sugar, it is forbidden to smoke, use carbonated and alcoholic beverages; avoid excessive motor and mental stress.
• The day before the procedure, refrain from using funds that change the indicators of sugar (insulin is not included in this category).

The first blood test for glycemic profile should be taken in the morning on an empty stomach. Each person should use an individual blood glucose meter.

To reliably detect the glycemic index, it is recommended to follow a specific pattern.

It includes the following steps:

• first of all the blood test is given in the morning on an empty stomach;
• then - before breakfast and 1.5 hours after it;
• before lunch and 1.5 hours after;
• before dinner and after 1.5 hours;
• further checked at bedtime;
• at 00:00;
• last time at 3:30 at night.

Glycemic blood test for sugar is performed using only one blood glucose meter.

After the study, the results are compared with the norm indicators:

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• glucose concentration up to 6.1 mmol / liter;
• 2 hours after meals to 7.8 mol / liter;
• fasting - 5.6-6.9 mmol / liter;
• in urine sugar should not be.

  Organization

* - not regulated, potentially after feeding no more than 8.9 mmol / liter.

On the basis of the data obtained, the specialist makes an opinion. He draws attention to the results of laboratory studies of the body and instrumental examinations.

The results show the presence or absence of pathologies:

• a blood glycemic index of 3.5–5.5 is considered normal;
• fasting sugar concentration of 5.7-7.0 indicates the occurrence of changes;
• if the result is more than 7.1 mmol / liter, diabetes is diagnosed.

In addition, the type of diabetes directly influences the test. Thus, the glycemic index of a blood test with dependence on insulin can be 10.0 mol / liter (the reading of sugar in the urine is up to 30 g / day). Type 2 diabetes suggests the absence of sugar in urine, its concentration in the fasting blood is not more than 6.0 mmol / liter (after eating up to 8.3 mmol / liter).

Elevated sugar during childbirth harms him: provokes spontaneous abortion or premature birth.

The glycemic profile during pregnancy must be checked by women who have had diabetes before. The rate generally corresponds to:

• venous blood: before meals no more than 6.0 mmol / liter, after meals no more than 9.0 mmol / liter;
• at 22:00 results less than 6.0 mmol / liter.

The level of thyroid stimulating hormone during pregnancy may vary, a slight increase or decrease is recognized as an acceptable norm.

The resulting figures are compared with normal indicators, which differ in individual age criteria of people.

Norm glycemic profile:

• adults and children from 1 year - 3.3 - 5.5 mmol / liter;
• elderly people - 4.5 - 6.4 mmol / liter;
• newborns - 2.2 - 3.3 mmol / liter;
• infants under 1 year - 3.0 - 5.5 mmol / liter.

After the procedure, the indicators are recorded and analyzed.

The accuracy of the analysis on the glycemic index means the veracity of the obtained indicators. Some reasons may distort them, for example, non-compliance with research rules.

The results are misrepresented by improper fulfillment of analysis points per day, by omitting one or several fences Preparatory measures also have a significant impact on the accuracy of testimony.

Shortened GP

If there are assumptions about the change in glycemia, a shorter monitoring is applied, consisting of 4 biomaterial intakes: on an empty stomach and three times after meals. The rest is a standard procedure. When the diagnosis is confirmed, the treatment plan is adjusted, the full glycemic profile is conducted two days after the shortened one.

The frequency of the daily profile is determined by the doctor.

It depends on the characteristic features of the disease (monthly or weekly):

• type 1 diabetics examine blood as prescribed by a doctor or their own sensations;
• a patient with type 2 diabetes who is on a special glycemic diet makes a weekly shortened version and once a month;
• if type 2 diabetes is accompanied with medication, they do a shorter diagnosis weekly;
• insulin-dependent patients of type 2 weekly carry out a shortened version and monthly daily;

Thus, patients diagnosed with diabetes are required to take the blood sugar concentration under personal control.

The glycemic profile is a very effective method of control, which allows you to adjust the therapy based on the data obtained for the best effect.

The effectiveness of the therapy of a disease such as diabetes mellitus depends largely on the results of testing the concentration of glucose contained in the patient's blood.

The control of this indicator is most conveniently carried out with the help of the glycemic profile (HP). Following the patient's rules of this method allows the doctor to determine the appropriateness of the prescribed drugs and, if necessary, adjust the treatment regimen.

What is a glycemic profile?

In case of diabetes mellitus type 1 or 2, it is important to constantly measure the level of glucose in the blood. Monitoring indicators are best performed on the basis of a glycemic profile assessment method.

It is a testing by measuring on the meter, which is carried out at home. Monitoring the indicator is carried out several times a day.

GP is needed by the following group of people:

1. Insulin-dependent patients. The frequency of control measurements should be set by the endocrinologist.
2. Pregnant women who have already identified a gestational form of diabetes, as well as women who are at risk of developing it during the childbearing period.
3. Patients suffering from type 2 disease. The number of tests within the glycemic profile depends on the drugs taken (tablets or insulin injections).
4. Patients with diabetes who do not comply with the required diet.

Each patient is advised to record the results obtained in his diary in order to subsequently show them to his doctor. This will allow him to assess the general condition of the patient’s body, track glucose fluctuations, and adjust the doses of insulin injections or medications taken.

Rules for blood sampling for research

To obtain a reliable result when controlling a profile, it is important to follow the basic rules:

1. Hands should be clean before each measurement. It is advisable to disinfect the puncture site with alcohol.
2. Treat the puncture area with cream, as well as any other means intended for body care, before the study should not be.
3. The blood should protrude onto the surface of the finger easily, it is not necessary to press on the finger.
4. Massage of the area prepared for puncture helps to improve blood circulation before the test.
5. The first measurement is performed on an empty stomach, and the subsequent time of control studies is set according to the recommendations of the doctor. They are usually performed after meals.
6. At night, monitoring of indicators also continues (before sleep, at midnight and at 3 am).

Video lesson with a detailed description of the technique of measuring blood glucose:

After consultation with the physician, it may be necessary to cancel the sugar-lowering drugs for the period of glycemic monitoring. The exception is insulin injections, they can not be stopped. Before measuring the indicator, it is not necessary to inject the hormone subcutaneously, since it is impractical to pass the analysis after the injection. Glycemia will be artificially understated and will not allow to give a correct assessment of the state of health.

Normal blood sugar levels

The decryption of the glucose values ​​obtained during the measurements should be carried out immediately.

Norm of indicators of a glycosuric profile:

Allowable changes in glucose based on snacks:

• sugar should not exceed 6.1 mmol / l.
• 2 hours after a snack with any products containing carbohydrates, the level of glycemia should be no more than 7.8 mmol / l.
• the presence of glucose in the urine is unacceptable.

Deviations from the norm:

• glycemia on an empty stomach above 6.1 mmol / l;
• sugar concentration after meals - 11.1 mmol / l and above.

Many factors can influence the correctness of the results of self-control of glycemia:

• incorrect measurement during the analyzed day;
• missing important research;
• failure to comply with the established diet, as a result of which the blood measurement put on schedule turns out to be uninformative;
• ignoring the rules of preparation for monitoring indicators.

Thus, the exact results of the glycemic profile depend directly on the accuracy of the actions at the time of the measurements.

How to determine the daily GP?

The daily value of the glycemic profile displays the state of the sugar level during the analyzed 24 hours.

The main task of monitoring the indicator at home is to conduct measurements in accordance with the established temporary rules.

The patient should be able to work with the meter and record the result with the corresponding entry in a special diary.

The frequency of daily GP is set individually for each person (usually 7-9 times). The doctor may prescribe a one-time monitoring of studies or in the amount of several times a month.

A shorter glucosuric profile is used as an additional method for monitoring the glycemic level.

It consists of 4 blood measurements with the determination of sugar content in it:

• 1 study on an empty stomach;
• 3 measurements after the main meals.

Daily GP compared with shortened allows you to see a more complete and reliable picture of the patient and glucose values.

Shortened screening is most often recommended for the following patients:

1. People faced with the initial manifestations of hyperglycemia, which is enough to regulate compliance with the diet. The frequency of GP is 1 time per month.
2. Patients who manage to keep glycemia within the normal range by taking medications. They need to monitor GP once a week.
3. Insulin-dependent patients. The shortened GP is recommended for daily control. Most often, the normal level of glycemia can be maintained by patients who constantly monitor it, regardless of the doctor's prescription.
4. Pregnant with a gestational form of diabetes. It is especially important for such patients to monitor blood glucose daily.

Video material about the signs and symptoms of diabetes mellitus:

What influences the profile definition?

The result of the testing and its frequency of repetition depends on several factors:

1. Used blood glucose meter. For control it is better to use only one model of the meter to avoid inaccuracies. When choosing a device, it is necessary to take into account that models of devices measuring plasma glucose concentration are more suitable for testing. Their measurements are considered accurate. To identify errors in glucometers, periodically compare their data with the results of blood sugar levels taken by laboratory staff.
2. On the day of the study, the patient should stop smoking and also exclude physical and psychoemotional stresses as much as possible, so that the results of HP are more reliable.
3. The frequency of testing depends on the course of the disease, type of diabetes. The frequency of its implementation is determined by the doctor, taking into account the individual characteristics of the patient.

People suffering from any type of disease should have self-monitoring of glycemia all the time. GP is an indispensable tool and effective method for monitoring this indicator throughout the day.

The use of the test in combination with diabetes therapy makes it possible to control the situation and together with the doctor to make changes to the treatment regimen.

All patients with confirmed diabetes or suspicion of it are recommended to measure their glycemic profile. It is necessary to control blood sugar levels continuously throughout the day. This approach allows you to adjust the amount of insulin injected and feel better.

Sugar profile

Blood glucose levels change dynamically throughout the day. Saturation of sugar depends on food intake, mental, physical and mental activity, quality of work of digestive glands and adipose tissue. Usually, people do not pay attention to such trifles, since such changes do not affect their lives (unless you want to eat more often). But there are diseases and conditions that require increased attention to glucose levels. These include:

Suspicion of reduced insulin susceptibility;

Confirmed diabetes;

Insulin replacement therapy;

Diabetes pregnant;

Increased amount of excreted glucose in urine.

The glycemic profile is compiled based on measurements of blood carbohydrates 5-6 times during the day, and sometimes at night. Responsibility for accuracy and integrity is passed on to the patient.

Methods for determining sugar

The endocrinologist individually explains to his patients why they need to record the results and how to decipher them.

Blood glucose testing should be done six to eight times a day at the same time. This will make it possible to work out a regimen and adhere to it further after prescribing therapy.

The measurement results are recorded in a notebook with the date and time. This will help to systematize the data and derive patterns. If the patient does not use insulin to normalize his condition, the glycemic profile changes once a month.

The rate of sugar is set for each person individually. But in order to compare the results with each other, doctors recommend using one meter and the same test strips.

Features of the test

Some rules must be followed in order to collect the blood properly. If the patient fills his glycemic profile every day, then over time, the skills become automatic, and he no longer needs to be reminded of these rules.

1. Before the procedure, you need to thoroughly wash your hands, it is not recommended to use aromatic soap.

2. To disinfect a finger before the injection, alcohol is never used. This can be done after the procedure. Scarifiers are sterile and are in individual packages.

4. To improve blood circulation, warm the palm of your hand before the injection by holding it in warm water or above the radiator of the battery.

5. Do not put any substance on the fingers before taking blood.

These are five simple rules, the observance of which will help to avoid mistakes when conducting a study.

Method for determining the glucose profile in 24 hours

How is the glycemic profile? The rate of glucose is always selected individually. For healthy people, this is 3.3-5.5 mmol / l. But for patients of the endocrinology department, this may be too low, threatening a comatose state.

The patient donates the first portion of blood in the morning, after getting out of bed. Be sure to go on an empty stomach. This allows you to determine the basic level of sugar. Then the person has breakfast and after two hours does the analysis again. And so on throughout the day. Even if the patient just had a snack, then after a hundred and twenty minutes he must check the sugar level and write it down.

Before going to bed, the patient checks the sugar level again. The following analysis is carried out at midnight, the last at three in the morning. This is done because the pancreas works unevenly during the day and behaves more actively at night, so the risk of hypoglycemic coma increases sharply in the morning.

Glycemic profile during pregnancy

The level of glucose in the blood of women who are expecting a child may change not only because of diabetes, but also for physiological reasons, because the child also loves sweets. A significant increase in the level of sugar in the physiological fluids of a pregnant woman is a warning sign and requires careful monitoring.

Patients of the antenatal clinic, who previously had diabetes or who have been pregnant with diabetes during the previous gestation, should fill out their glycemic profile every day. For them, the concept of the norm is identical to that of a healthy person and should not exceed 5.8 mmol / l per liter per empty stomach and 8.7 mmol / l 120 minutes after eating.

The doctor regularly checks the urine of a pregnant woman for the presence of acetone and ketone bodies. They are an indicator of liver and kidney function. This approach allows early detection of violations in the activities of the authorities and take measures to preserve the child and the health of the woman.

Interpretation of the results of the glycemic profile

Determining the glycemic profile helps patients with diabetes to keep the disease under control and becomes a good help for endocrinologists.

If blood glucose is maintained between 3.3–5.5 mmol / l, then the person can be considered healthy. The amount of simple carbohydrates in his diet is balanced.

If the glucometer shows from 5 to 7 mmol / l on an empty stomach, this indicates a violation of glucose tolerance. Of course, there is no disease yet, but the likelihood that diabetes will develop is very high. It is necessary to take measures to improve metabolism. Blood sugar levels above 7 mmol / l indicate the presence of diabetes. But these are indicators for those who have not been diagnosed with the disease.

What is the situation with those who already have diabetes? For them there are individual standards that are established in the process of monitoring the patient during inpatient treatment. In diabetes mellitus of the first type, the average value of blood glucose can reach up to 10.1 mmol / l, while for the second type, the indicator is considered to be a figure of 8.3 mmol / l.