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April 23, 2008 > Diabetes Matters: Do You Have Questions About Insulin and Glucose Monitoring?

Diabetes Matters: Do You Have Questions About Insulin and Glucose Monitoring?

Most people are aware that diabetes is caused by the body's inability to produce insulin or by the body's inability to use insulin effectively. That's why treatment for all people with Type 1 diabetes and some people with Type 2 diabetes requires insulin injections.

But did you know that it wasn't until 1922 that the first human patient received an injection of insulin? Or that there are different ways insulin is used to control blood sugar? And are you aware of the important role careful blood glucose monitoring plays in effectively treating diabetes - whether you require insulin injections or not?

To help you learn more about insulin and glucose monitoring for people with diabetes, Washington Hospital is sponsoring a free "Diabetes Matters" class, featuring lectures by diabetes educators Sandra Mertesdorf, RN, and Vida Reed, RN, CDE. A question-and-answer session will follow the lectures. The class is scheduled for Thursday, May 1 from 7 to 9 p.m. in the Conrad E. Anderson, M.D. Auditorium in the Washington West Building at 2500 Mowry Avenue in Fremont.

"Insulin is a hormone produced in an organ called the pancreas," says Mertesdorf. "The role of insulin is to help sugar leave the blood and enter into your body's cells to be used for fuel. When the body doesn't produce enough insulin or the body's cells don't respond to insulin properly, the result is high levels of blood sugar that can lead to serious complications."

Mertesdorf explains that insulin works in two ways. "Basal - or 'background' - insulin is a longer-acting insulin that controls blood sugar levels when not eating," she says. "It provides the fuel required to support basic functions of daily living, such as breathing and heart rate. Bolus - or 'mealtime' - insulin is a shorter or more rapid acting insulin which helps to control an after-meal rise in blood sugar or to correct high levels at other times of the day."

In addition to discussing the history and function of insulin, Mertesdorf also will offer information about topics related to the proper use of insulin in treating diabetes, such as:
* Carbohydrate to insulin rations
* Mealtime dosages
* Storage
* Injection sites
* Needle size, reuse and discarding

Reed, who is the Coordinator for the Diabetes Education Program at Washington Hospital, will discuss the importance of careful glucose monitoring.

"Glucose monitoring tells you how you're doing and if the steps you are taking to control your diabetes are working," she explains. "The frequency of glucose testing depends on the individual's needs and the treatment program the doctor has worked out. Some people, for example, test only once a day, but in those cases, they should vary the time of day for testing - sometimes before eating, sometimes in the morning when they first get up, sometimes at night after eating. It's very important to know what time of day levels are higher, such as after meals, because the physician will adjust the insulin doses based on the pattern of blood glucose values."

While the general guidelines from the American Diabetes Association for glucose levels are 70 to 120 mg/dL before meals and less than 160 two hours following a meal, Reed notes that physicians may set different targets for patients with diabetes. "Your doctor may even give you interim targets as you work toward controlling your diabetes," she says.

The Diabetes Education Program offers instruction in the proper techniques for both insulin injections and blood glucose monitoring. "We teach people how to minimize the pain of injections and glucose testing, as well as how to reduce errors in testing," Reed says. "The current meters for monitoring blood glucose don't require as much blood as older meters, so the finger-prick requires only a very small lancet. The lancet doesn't go as deep, so it can be less painful."

Participation in the Diabetes Education Program requires a physician referral. Physician referral forms will be available at the Diabetes Matters session. For more information, you can call (510) 745-6556.

"Diabetes Matters" is a monthly program sponsored by Washington Hospital that provides science-based information to people interested in increasing their knowledge about diabetes. The classes are free and require no pre-registration.

Washington Hospital's Outpatient Diabetes Program is located at 1860 Mowry Avenue, Suite 200. To learn more about services and programs available through the Diabetes Program, call (510) 745-6556 or visit, click on "Services and Programs", and select "Diabetes Services" from the drop-down menu.

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