Reducing blood sugar checks

DEAR DR. ROACH: I am a 53-year-old female, and I weigh 190 pounds. A year and a half ago, I had gastric sleeve surgery. I have lost 24 pounds. I have been diabetic since 2013. My last blood analysis, in August 2018, my A1C was 6.5, which I understand is still high. In January 2018, my A1C was 6.6. When I had my surgery, these numbers were higher.

I do an average of 109 blood tests per week by finger prick. Should I continue to do the daily blood pricks to my finger, or can I do them less often? — K.

ANSWER: With an A1C of 6.6 percent, your diabetes is under very good control. How often to do fingersticks depends on your treatment. If taking insulin, more frequently is necessary, insulin can cause dramatic shifts in blood sugar. If you are on oral medication or if your diabetes is controlled by diet and exercise, less frequent is probably OK.

Providers want lots of information. If it doesn’t bother you too much to get them daily, your provider will be happy with the information — the more we have, the better we can make adjustmentsn.

However, you may not need adjustments often, so as long as you aren’t seeing numbers that are over, say, 200, I would think a few times a week would be OK. If your weight and A1C continue to decrease, you may need fingersticks even less frequently.

No matter how often you get readings, I recommend you get some readings fasting and some 1-2 hours after eating. Some have excellent fasting glucose that goes sky-high after eating.

DEAR DR. ROACH: My husband had a stroke March 23, 2018. It was on the base left side of his brain. It affected his balance on the left side. The doctor said it could take up to a year to get over it.

He has had weeks of therapy. He continues to walk on the treadmill twice a day for 30 to 40 minutes, and he lifts weights for 10 minutes. He doesn’t seem to have improved much. His balance is still off. He is using a walker but struggles. He is a farmer and does what he can to feed the cows. He has fallen down a few times. He wanted me to send you this e-mail and ask if you think he could ever get over this. — D.S.

ANSWER: I am sorry to hear about your husband. Strokes are losses of brain cells and function in discrete areas. They run from almost unnoticeable to devastating, and it sounds like your husband’s is in between. Preventing strokes is critical, because brain cells do not regenerate well. However, other parts of the brain sometimes can take over, allowing for better function.

If the stroke was in the base of the brain and on the same side as the symptoms, the stroke may have been in the cerebellum, which is responsible for coordinating movement on the same side of the body (as opposed to most of the brain, which controls the opposite side). Many people with a stroke in the cerebellum have clumsy movements and can fall.

Since it has been nearly a year, further spontaneous improvement is less likely. I know he has had therapy, but balance exercises and occupational therapy may still be of benefit.

(Roach is a columnist for the North American Press Syndicate. Write to him at 628 Virginia Drive, Orlando, FL 32803.)

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