Understanding the five point Blood Glucose measurements
Diabetes is perhaps one of the most common problems affecting the global population. In fact, the World Health Organisation estimated that diabetes has become one of the leading causes of deaths in many first world and developed nations. It is also projected that there will be over 300 million people with diabetes worldwide by 2025.
Blood glucose test has become a benchmark measurement in identifying and managing diabetes.
In recent years, the blood glucose test has taken the place of urine testing in laboratories and healthcare facilities due to its accuracy in diagnosing diabetes at an earlier stage as compared to the former. Furthermore, the advent of technology and the development of portable, affordable and user-friendly products like the glucometer and glucose strips for example, have also allowed these tests to be conducted at screening centers, public places and even at home by concerned individuals and non medical professionals.
There are many variations and means to the test according to experts. The American Diabetes Association has identified the following tests to measure the amount of glucose in a person’s blood; fasting blood glucose test, random blood glucose test, post prandial blood glucose test and the oral glucose tolerance test (OGTT)3. These tests have become common in Malaysia. However, as a practicing nurse in Europe for many years, I have found the five-point blood glucose test to be more commonly practiced there.
The five-point blood glucose measurement also known as the gluco-quant method is carried out by combining elements of the above-mentioned methods into timeline specific series of tests conducted at precise intervals whilst a person go about his daily activities. Generally, it is recommended that the blood glucose test be carried out at least three times a day by a person at home. However, the gluco-quant method requires the individual to carry out the test up to five times in a day in order to identify a specific pattern to a person’s glucose distribution levels, which will inadvertently result in a more accurate picture of his or her condition.
With the five-point blood glucose test, a person will take his first blood glucose test early in the morning before breakfast, similar to the fasting blood glucose test. This is followed by another test at about two hours after breakfast or the first meal and another test immediately after lunch or the second meal, both similar to the post prandial test. The fourth test will be carried out at about an hour before dinner or the third meal and the final test will be conducted at about one hour after the final meal.
Indeed, many have expressed some reservations of this method due to the frequency of the tests which is deemed as a hassle. Nevertheless, it has served the purpose of confirming a diagnosis of diabetes as well as identifying the severity of the situation for existing pre-diabetic and diabetic patients.
It is also important for individuals to understand the nature of the pancrease system. In many pre diabetes and diabetes patients, the pancreas is still able to produce a limited amount of insulin. This amount may be sufficient to process the sugar and carbohydrate consumed by an individual in the last meal prior to bedtime, as the person would then go into a fasting state of between 6-10 hours during his sleep, before his next meal in the early morning of the following day. This will result in a normal reading during an early morning fasting blood glucose test.
However, as the day progresses, a person will usually have at least several meals within a six to ten-hour period. Depending on the diet, this may lead to a saturation of carbohydrate in the bloodstream, which the limited production of insulin in pre-diabetic and diabetic individual may not be able to handle. This can explain why the early morning reading for a fasting blood glucose test can be normal, yet it may rise to dangerous and nerve damaging levels in the later part of the day. In such instances, should an individual only be tested for a fasting blood glucose test or at just two intervals during the day, his actual condition may not be accurately identified.
I myself has had a similar experience with a patient. About two years ago I was approached by a young man of 28 who shared with me his anxiety of developing diabetes. Having lost his father to the same condition earlier, he was apprehensive about going through a similar ordeal. Despite obtaining a normal reading for his fasting blood glucose test on several occasions, he was experiencing the common symptoms associated with diabetes and pre-diabetes such as fatigue, blurred vision, frequent urination and lethargy.
I suggested that we conduct the gluco-quant test and the result was that whilst he recorded a blood sugar level of 5.5 mmol/l in the first early morning test, his subsequent tests registered a blood sugar level of 10.8 mmol/l, 12.5 mmol/l, 14.0 mmol/l and 14.3 mmol/l respectively, indicating a high glucose level pattern consistent with diabetic patients. The patient was subsequently put on insulin by a specialist. This is a clear example of how the five-point glucose test have been able to save a person from potentially severe diabetes related medical complications in the future.
Despite its effectiveness in diagnosing diabetes and indicating the severity of a diabetic's condition, many may still question its feasiblity due to its frequency and the cost involved. However it should be noted that should an individual find it difficult to conduct the test on such a frequency at home, there are medical and nursing professionals who offer such services. A person may opt to be detained at a healthcare facilty for a one-day period to conduct the test or for his added comfort and convinience, the test can also be conducted in his home by certified nursing professionals who are also known as 'mobile nurses'.
Further, it should also be noted that the five-point blood glucose measurement is an effective diagnostic and management tool. As such it need not be carried out on a daily basis, suffice that a person take the initiative to conduct the test at a regular monthly intervals which would indeed save him the time, money and hassle, yet provide him with the needed information that can save his life.
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ABOUT THE AUTHOR
Born and educated in Germany, Yakob Scholer has been in Malaysia since 1963 and was instrumental in the establishment of Hospital Fatimah, Ipoh. Since then he has played a prominent role in the creation of the first drug rehabilitation organisation in Perak the Yayasn Pusat Pertolongan and Yayasan Alkoholisma in Ipoh in 1974 of which he was the managing director and principal therapist.
In 1989, upon returning from the International AIDS Congress in Montreal, he initiated Malaysia's first AIDS Awareness Committee and Malaysian AIDS Hotline which subsequently become known as the Malaysian AIDS Council. In 2004, he founded a private mobile nursing agency, based in Petaling Jaya Malaysia. Today, as the author of “Guide to Home Nursing” Mr Scholer also lectures at a local university on Health Psychology and conducts
3 http://www.diabetes.org/
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