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The standard test for measuring blood sugar control in people with diabetes is not accurate in those on kidney hemodialysis, according to new research at Wake Forest University Baptist Medical Center.

Wake Forest investigators reported in Kidney International that the hemoglobin A1c test (HbA1c) underestimates true glucose control in hemodialysis patients and could give false comfort to patients and physicians. Hemodialysis, in which blood is passed through an artificial kidney machine for cleansing, is used in cases of kidney failure.

"These results suggest that the nearly 200,000 diabetic hemodialysis patients in the United States who use this test may not be receiving optimal care for their blood sugar," said Barry I. Freedman, M.D., senior author and a professor of internal medicine and nephrology.

Diabetic dialysis patients who believe their blood sugars are in the ideal range may still have unacceptably high blood sugars. "This was a surprise to the nephrology community," said Freedman. "The test we've all come to accept as 'the gold standard' has proven to be inaccurate in this patient population."

HbA1c measures the percentage of hemoglobin (a protein in red blood cells) that has reacted with glucose. This measure, also known as glycosylated hemoglobin, reflects blood sugar control over the previous 30-120 days.
 

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How Do I Get My Blood Sugar Down?

How do I get my blood sugar down? Even when I have not eatten in several hours and have take my blood sugar medication, it still stays too high; usually in the 300's. Any suggestions would be appreciated.:confused:
 

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Hello Tracy:

If your diet isn’t working to keep your sugars in decent control
you may have to change it to low carb, if it isn’t already.

Foods that are often stored as fat and raise blood sugars the
highest are high in carbohydrates.
This is definitely not good for Type 2 Diabetics especially if they
are over-weight.

High carb foods such as pasta, potatoes, corn, white rice, pastries,
ice cream, rice cakes, pancakes, regular sodas, alcoholic beverages,
should be avoided or eat smaller portions.

Depending on gendre, height, etc., each meal should consist of 45 carbs
or less. With 2-15 carb snacks in between.

--Lower-carb cereals(read the labels on the package)
--Bacon, sausage or ham with scrambled, poached eggs and a slice of whole
wheat toast
--Meat, fish or egg sandwiches made with one slice of bread
--Any kind of meats, beef, turkey, pork, chicken, etc., with fat removed
--Use 2 small tortillas and just fill them up with veggies and beef or chicken.
--Make homemade clear soups and stews with lots of veggies and meat.
--Have caesar salad with sunflower seeds, chicken and bacon bits
--A small amount of steak with green beans and a sweet potato
--A half cup of cottage cheese with a slice of light rye bread
--Have low carb- popsicles, energy bars, fudgesicles, yogurts
--Crystal Light, Water, Iced Tea without sugar, Carbonated Water, Diet sodas, Flavored water,

-Exercise is important. Even some is better than none. Walking, stationary bike, push-ups, weight-bearing exercises, pilates, elliptical training, swimming, step aerobics, handball, dance, leg thrusts, treadmill or some other type of exercise at least three times a week.

If the medications that you are using are not sufficient in keeping your sugars in a decent range perhaps you need a higher dosage or meds. Or a switch to another drug that suits you better. You haven’t said much about yourself so I’m not sure if you need to lose weight.


Byetta is used by Type 2 Diabetics to get better blood sugar levels and to help them lose weight. This is not an Insulin.

Insulin Lantus or Levemir(long-acting)may also help to control your sugar levels. It Is Injected by syringe or pen once or twice a day.

Humalog, Novalog and Apidra are fast-acting Insulins usually used before meals. Injected by syringe, pen or pump.

You can discuss any of this information with your Dr., Dietician or CDE.
 
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