(Contributing Author: Dr. Jia, Institute of Infectious Diseases, Tianjin Medical University) 
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I believe that many diabetic patients have experienced: when they measure their blood sugar multiple times a day at home, they find that every The measured values vary greatly, and the blood sugar fluctuates greatly. So what is the concept of blood sugar fluctuation? What caused it? Does it affect our health? And what should we do if it happens?
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01Do blood sugar fluctuations affect health?
First of all, blood sugar fluctuation is one of the important indicators to evaluate the effect of blood sugar control in patients, and it cannot be directly expressed by the HbA1C result of glycated hemoglobin , it takes a period of time, repeated measurement of blood sugar and complex calculation and statistics to get the exact result. Excessive blood sugar fluctuations have a greater impact on chronic complications of diabetes than persistent hyperglycemia. It will aggravate chronic inflammation, damage endothelial cell function, and cause irreversible vascular damage. Therefore, it should not be ignored or taken lightly because of its troublesome monitoring. < /g>
02Definition of blood sugar fluctuations
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Glucose fluctuations refer to erratic changes in blood glucose levels between peaks and troughs, including: short-term glucose fluctuations (ie, daytime and intraday glucose fluctuations) and long-term glucose fluctuations ( glycated hemoglobin HbA1C variability). The monitoring methods mainly include continuous blood glucose monitoring (CGM) and self-glucose monitoring (SMBG). Among them, the continuous blood glucose monitoring is accurate, but the cost is high and the operation is complicated. Therefore, patients can be observed through self-monitoring of blood glucose. g>
The common methods of self-monitoring of blood glucose are: 7-point self-test, observation of postprandial blood glucose fluctuation and Maximum blood sugar fluctuations observed.
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1, 7-point self-test method: fingertips Blood was taken to measure the fasting blood sugar in the morning, the blood sugar two hours after meals for three meals, the blood sugar before meals for lunch and dinner, and the blood sugar before going to bed. The standard deviation of these 7 values was calculated. Preferably not more than 2.0mmol/L. < /g>
2. Postprandial blood sugar fluctuation range: take blood from fingertips to measure three meals The mean value of the difference between the 2-hour postprandial blood glucose and the corresponding preprandial blood glucose. It is best not to exceed 2.2mmol/L. < /g>
3. Maximum blood sugar fluctuation range: within one day of fingertip blood test The difference between the maximum and minimum blood sugar values. It is best not to exceed 4.4mmol/L.
Due to the complex calculation, the patient The blood glucose value at the corresponding time point can be recorded correctly and brought to the doctor for calculation and judgment. Or follow the doctor’s advice to choose a monitoring method that suits you and review it regularly. For special patients such as: pregnant women, children and adolescents, elderly patients with poor blood sugar control, patients with poor control of diabetes at the initial stage of diagnosis, patients with poor islet function who need insulin, and patients with other underlying diseases, it is still recommended to go directly to the hospital Perform continuous glucose monitoring (CGM). < /g>
03What should I do if my blood sugar fluctuates too much?
1. Correctly learn diabetes-related knowledge, relax and face it positively, don’t overdo it psychological burden. Excessive stress and poor sleep quality can exacerbate blood sugar fluctuations. Be sure to get enough sleep. < /g>
2. Maintain regular diet and daily routine. Quit smoking and alcohol, and eat strictly according to the recipe recommended by the doctor. Carbohydrates, fats, proteins, and vegetables should be in a balanced ratio. The daily routine should be as regular as possible to prevent the abnormal secretion of hormones in the human body from affecting blood sugar.
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3, be strict Follow the doctor’s instructions to take medicine, use insulin, adhere to regular medicine, and avoid changing medicines at will, stopping medicines, increasing or decreasing dosages, or taking random medicines, which will affect blood sugar fluctuations.
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5. Appropriately increase the amount of exercise in daily life, especially some mild aerobic exercise, such as swimming, cycling, walking, jogging, etc., to help control blood sugar. But pay attention to avoid fasting exercise, exercise after taking medicine or insulin injection, to prevent the occurrence of hypoglycemia. And maintain the regularity of exercise time, so as to achieve planned and reasonable exercise.
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