Urban Dictionary is the best to use to define conundrum, of which tight glycemic control has become for many patients. In it’s first definition, says origin unknown and then says it is a kind of riddle based upon some fanciful or fantastic resemblance between things quite unlike; a puzzling question, or which the answer is or involves a pun. Not so unlike the other dictionaries. But definition 2 says it is a question to which only a conjectural answer can be made. And that is the definition that is closest to helping to define tight glycemic control.
In theory, tight glycemic control is a wonderful thing. The problem comes now when you try to fit tight glycemic control on each patient, exactly the same! This is where the Urban Dictionary answer of it is a question to which a conjectural answer can be made is most applicable! Some patients can function at a blood sugar of 70. Others cannot. So what was a good idea of keeping the sugar level under tight control to prevent infection, now becomes a major problem, as there is not enough sugar in the system to maintain cognition and normal functioning of the body. Every body needs help with this one. The patient help comes from the instructions of the nurses and physicians at first. Then the patient help comes from the patient him/herself who is very keen and aware and knows how their body feels when their sugar is low. And who also does a fairly good job at monitoring themself. You can try all you might, but that patient is not going to let you take them away from their normal routine or insulin course or veer off of their diabetic medication schedule. Come with whatever information you may have or physician request!
And rightly so, because now even the physicians have come to know that, yes it is a conundrum to keep up with the hemoglobin A1c – HA1C levels and regulate and treat for diabetes, the dietary regimen and it’s complications of heart disease. Here I cite an Annals of Medicine Article and articles related to it; Monsori, V (2009, June 2). Glycemic Control in Type 2 Diabetes: Time for an Evidence-Based About-Face?Annals of Internal Medicine Volume 150, 803 – 809.
You must monitor your patient and make sure that he/her is at the best for him or her, and can follow the prescribed regimen.
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