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Poziom cukru we krwi PDF Drukuj Email
01.05.2009.
 

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Jedną z najważniejszych kwestii w życiu z cukrzycą jest codzienne dokonywanie pomiarów cukrów we krwi. By to wykonać potrzebne nam jest odpowiednie oprzyrządowanie, czyli coś takiego jak glukometr i nakuwacz. Sam zabieg nie jest zbytnio bolesny i nie wydaje mi się, by sprawiał jakiekolwiek niedogodności cukrzykom. Polega on mianowicie na nakuciu bocznej częsci opuszków palców, wyciśnięciu z nich kropli krwi i nałożeniu jej na pasek badź sensor, w zależności jaki glukometr posiadamy.


 

Starsze modele mają jeszcze osobne paski, które musimy za każdym razem wkładać. Nowsze natomiast posiadają tak zwane sensory, których plusem jest to, że nie trzeba ich za każdym razem wkładać do urządzenia oraz to, że pobierają znacznie mniej krwi niż standardowe paski. Jedynym minusem jest ich cena. Mimo iż są stosunkowo drogie, to łatwość i wygoda w ich użyciu szybko sprawiają, że zapominamy o tych paru ładnych setkach, które wydaliśmy przy ich zakupie.

Przed pomiarem należy dokąłdnie umyć ręce pod bieżacą wodą i je dokładnie osuszyć. Po nałóżeniu kropli na pasek bądź sensor najlepiej byłoby zatamować płynącą krew wacikiem i ponownie umyć ręce, gdyż na palcach pozostaje krew, którą możemy pobrudzić otaczające nas przedmioty.

Prawidłowe poziomy cukrów:
>> na czczo: 80-120mg%
>> godzina po posiłku: do 180mg%
>> dwie godziny po posiłku: do 160mg%
>> przed posiłkiem: 80-135mg%

Stężenie cukru we krwi można podać w dwóch jednostkach: mg% lub mmol/l Oto tabela, która przelicza obie te jednostki:

PRZELICZNIK JEDNOSTEK STĘŻENIA GLUKOZY

Wiadomo, że życie byłoby za proste, gdyby takie poziomy utrzymywały się w naszej krwi przez cały czas. Mogą nam się często przytrafiać stężenia cukru wyższe bądź niższe. Jeśli jednak nie będą przekraczały granicy 140-180mg%, to sądzę, że nie ma się czym zbytnio przejmować. Ewentualnie jeśli cukier powyżej 140mg% pojawił się przed posiłkiem dodatkowym, należy go zmniejszyć o 1-2WW. Czasami może to być spowodowane jakimś stresem lub złym dobraniem posiłku, dlatego też należy zostawić taki cukier w spokoju i sprawdzić, jaki będzie następnego dnia o tej porze. Jeśli nadal jednak się nie obniży i ciągle na liczniku będzie nam się pojawiało to uporczywe "170", to nalezy albo zmienić rodzaj produktów zjadanych na posiłek przed mierzeniem (jeśli w oba dni jedliśmy to samo) albo zwiększyć odpowiednią insulinę.

Musimy takze wiedzieć, że może zdarzyć się sytuacja, kiedy przez dłuższy czas będą nam towarzyszyć bardzo wysokie stężenia cukrów we krwi. Wówczas odczujemy je w postaci:

1. Wzmożonego pragnienia;
2. Częstszego oddawania moczu;
3. Uczucia pragnienia, suchości ust, drętwego języka
4. Chudnięcia;
5. Uczucia głodu;
6. Dokuczliwych skurczy mięśni łydek, stóp;
7. Bóli brzucha, nudności, wymiotów

Jednakże takie przypadki raczej należą do rzadkości, bo większość przecukrzeń da się szybko wyeliminować, głownie są to HIPERGLIKEMIĘ rzędu 240mg%, 300mg% lub 350%. Jednakże absolutnie nie nalezy ich lekceważyć. Trzeba zadziałać! Co w takiej sytuacji nalezy zrobić? Musimy najpierw wiedzieć przed jakim posiłkiem mamy tak wysoki cukier. Jeśli przed głównym - wówczas wraz z normalną dawką insuliny należy dostrzyknąć korektę, czyli taką dawkę insuliny, która obniży nam zbyt wysoki poziom cukru. Następnie odczekujemy około pół godziny i jemy posiłek, ewentualnie możemy go zmieniejszyć o 1-2 WW, w zależnosci od wysokości cukru i okresu czekania. Jeśli natomiast taki wysoki cukier zauważymy przed posiłkiem dodatkowym, wówczas należy przede wszystkim zrezygnować z niego (cóż, nasza insulina nie poradziłaby sobie z nim i poziom cukru przed następnym posiłkiem byłby taki sam albo nawet większy). Jeżeli takie stężenie nastąp także i w dniu nastepnym, należy skorygować insulinę przed posiłkiem podstawowym

Dlaczego doszło do hiperglikemii? Możliwości jest kilka:

1. Zbyt mała ilość insuliny;
2. Zjedłeś zbyt obfity w WW posiłek;
3. Miałeś stres;
4. Byłeś chory (np. na grypę, anginę);
5. Wynik kontrregulacji (tzw. efekt jo-jo) - zbyt dużo zjadłeś na niedocukrzenie lub przed wysiłkiem fizycznym
6. Twój Pen jest uszkodzony
7. Zjadłeś posiłek natychmaist po podaniu insuliny

Zdarza się także, że glukometr pokaże nam cukier "55" albo go sami poczujemy. W przeciwności do przecukrzeń, HIPOGLIKEMIĘ odczujemy prawie za każdym razem i to bardzo dobrze. Dlaczego? Ponieważ kiey nieocukrzenia pojawiają się zbyt często, organizm się na nie uodporni i nie bedzie dawał znaków, ze coś nie jest tak, jak być powinno. Wtenczas nietrudno jest przegapić hipoglikemię i doprowadzić do utraty przytomności. Hipoglikemie dzielimy na dwa rodzaje: lekką i ciężką. Oto objawy lekkiego niedocukrzenia:

1. Znaczne osłabnienie, uczucie niepokoju;
2. Drżenie rąk, uczucie braku sił;
3. Bladość skóry i jej nadmierne pocenie się;
4. Kołatanie serca;
5. Uczucie głodu;
6. Zaburzenia widzenia: mroczki przed oczami, rozmazywanie się liter;
7. Trudności w wykonywaniu precyzyjnych ćwiczeń;
8. Zaburzenia pamięci;
9. Bóle i zawroty głowy;
10. Zmiana nastroju: nadmierna agresja, złość, histeria, płaczliwość, rozdrażnienie;

Jednakże gdy poziom cukru zniża się do niebezpiecznej dla nas granicy lub gdy niedocukrzenia trwają przez długi okres czasu, nasz mózg wysyła nam odpowiednie znaki, czyli na przykład:

1. Silne bóle głowy;
2. Zaburzenia widzenia: przestrzennego, kolorów, kształtów;
3. Zaburzenia koordynacji ruchowej;
4. Trudności w wysłowieniu się;
5. Krótkotrwałe zaniki pamięci;
6. Trudności w zebraniu myśli;
7. Zmiany w nastroju: nadmierna agresja lub płaczliwość;
8. Zaburzenia świadomości;
9. Utrata przytpomności;
10. Drgawki

Pamiętaj, aby nie czekać aż te wszystkie objawy się u Ciebie pokażą, bo możesz się na nie nie doczekać. Kiedy tylko poczujesz na przykład drżenie rąk, zmierz cukier, gdyż nie zawsze w/w objawy muszą świadczyć o hiopglikemii. Czasami właśnie drzenie rąk powoduje silny i gwałtowny stres. Dlatego powinniśmy najpierw się upewnić, ile mamy cukru we krwi. Jeśli nasze przypuszczenia się potwierdzą to nalezy niezwłocznie coś zjeść. Jakość produktu zalezy od naszej glikemii. Jeśli glukoza we krwi wynosi 75-60 mg% to najlepszym jej podniesieniem byłoby zjedzenie 1-2 WW np. pół bułki z dżemem, owoca, ciasto drożdżowe, etc. W przypadku poziomu cukru we krwi poniżej 55mg% wskazane byłoby spożycie soku lub coli na ok. 2WW oraz na przykład kromki chleba czy bułki.

Jeśli stracimy przytomność, konieczne jest podanie glukagonu domięśniowo przez osoby drugie. Nie mogą one podawać nam żadnych płynów doustnie, gdyż możemy się nimizachłystnąć. Następnie, po wykonaniu zasrzyku należy wezwać pogotowie lub zawieść chorego do szpitala.

Instrukcja wykonania zastrzyku z glukagonu, szczególnie przydatna osobom przebywającym z cukrzykami, gdyż to od nich zależy nasze życie. My chwilowo nie mamy nic do gadania.

1. Wbij strzykawkę z igłą do filki zawierającej proszek.
2. Wstrzyknij całą zawartość płynu.
3. Wymieszaj płun z proszkiem.
4. Nabierz zawartość fiolki do strzykawki.
5. Wykonaj zastrzyk, wbijając igłę prostopadle do powierzchni skóry (uda lub ramienia) na całą głębokość igły.
6. Po 20 minutach jeśli cukrzyk nadal nie daje znaku życia, można podac jeszcze raz 1mg glukagonu.

Gdy już dojdziemy do siebie należałoby zastanowić się, dlaczego doszło do hipoglikemii i jak jej uniknąć. U cukrzyków najczęstszymi powodami są:

1. Zbyt duża dawka insuliny;
2. Błąd dietetyczny: za mało WW, źle wyliczone WW;
3. Za długi odstęp czasu między podaniem insuliny a posiłkiem;
4. Gorąca kąpiel, masaż okolicy, w którą podałeś insulinę, nasłonecznienie ciała;
5. Nadmierny wysiłek;
6. Uszkodzony Pen

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