WEBVTT

00:00.840 --> 00:02.880
glycemic control or trying to keep

00:02.880 --> 00:04.991
blood glucose levels within a desired

00:04.991 --> 00:07.090
range is key to managing diabetes .

00:07.640 --> 00:09.862
This means working with the health care

00:09.862 --> 00:12.029
team to set a blood glucose goal or an

00:12.029 --> 00:13.973
A one C . Target . Each patient is

00:13.973 --> 00:16.084
unique . So a one C targets will vary

00:16.084 --> 00:18.320
between individual patients . Doctor

00:18.320 --> 00:20.542
Patel . What else can you tell us about

00:20.542 --> 00:23.070
glycemic control ? Well dr Reynolds and

00:23.080 --> 00:26.670
A one C target between seven and 8%

00:26.680 --> 00:28.910
has been shown to significantly

00:28.910 --> 00:31.240
decrease the risk of long term

00:31.240 --> 00:34.160
complications for patients younger than

00:34.160 --> 00:36.600
18 and a one C target of

00:36.600 --> 00:40.530
7.5% or less is recommended

00:40.540 --> 00:43.770
for most adults with diabetes . It's

00:43.770 --> 00:46.820
appropriate to set an A one C target as

00:46.820 --> 00:49.350
close to non diabetic levels as

00:49.350 --> 00:52.010
possible , which means aiming for an A

00:52.010 --> 00:55.870
one C . Of 6.5% or less .

00:55.880 --> 00:58.890
However , there are certain conditions

00:58.890 --> 01:00.557
that make this kind of target

01:00.557 --> 01:02.910
potentially more harmful than helpful

01:02.920 --> 01:05.610
for some people On normal , A one C

01:05.610 --> 01:08.020
level could increase their risk for

01:08.020 --> 01:11.250
severe hypoglycemia or blood glucose

01:11.250 --> 01:14.180
levels that drop too low , mild

01:14.180 --> 01:16.320
hypoglycemia can make a person feel

01:16.320 --> 01:19.750
faint , Week or shaky and severe

01:19.750 --> 01:23.480
hypoglycemia can cause falls , seizures ,

01:23.490 --> 01:26.580
accidents with machinery or vehicles or

01:26.590 --> 01:29.210
other injuries . A person who is

01:29.210 --> 01:31.850
experiencing hypoglycemia should eat or

01:31.850 --> 01:34.430
drink something with fast acting or

01:34.430 --> 01:36.930
simple carbohydrates like glucose

01:36.930 --> 01:40.100
tablets , fruit juice or a simple candy

01:40.110 --> 01:43.620
and recheck their blood glucose in 15

01:43.620 --> 01:46.590
minutes . They should repeat every 15

01:46.590 --> 01:48.630
minutes until the blood glucose is

01:48.630 --> 01:51.290
within their desired range . This is

01:51.290 --> 01:55.200
known as the rule of 15 . In the case

01:55.200 --> 01:57.910
of severe hypoglycemia where the person

01:57.910 --> 02:00.260
is unconscious or can't eat or drink ,

02:00.540 --> 02:03.420
a glue Kogan injection is necessary .

02:03.430 --> 02:06.320
Glue Cogan is a hormone that stimulates

02:06.330 --> 02:09.080
the liver to convert stored glycogen

02:09.090 --> 02:11.670
into glucose and release it into the

02:11.670 --> 02:13.690
blood to raise the blood glucose

02:13.690 --> 02:16.700
rapidly back to normal . A glue coogan

02:16.700 --> 02:19.120
kit must be prescribed and the

02:19.120 --> 02:21.160
injection administered by a family

02:21.160 --> 02:25.140
member or friend . Severe hypoglycemia

02:25.150 --> 02:27.210
can be an even bigger problem for

02:27.210 --> 02:29.700
someone who's Type one diabetes has

02:29.700 --> 02:32.110
caused damage to the autonomic nerves

02:32.120 --> 02:33.676
that let them know they are

02:33.676 --> 02:36.870
experiencing hypoglycemia . This is

02:36.870 --> 02:40.470
called hypoglycemia unawareness with

02:40.470 --> 02:42.470
this condition , the person may not

02:42.470 --> 02:44.470
realize that they need to normalize

02:44.470 --> 02:47.280
their blood glucose until it's too late .

02:47.290 --> 02:50.150
It's critical that an emergency glue

02:50.150 --> 02:52.510
Kogan kit be prescribed for people who

02:52.510 --> 02:56.010
have hypoglycemic unawareness and a

02:56.020 --> 02:57.909
family member or friend should be

02:57.909 --> 03:00.040
trained to deliver the injection .

03:00.050 --> 03:02.400
Parents of Children with Type one

03:02.400 --> 03:05.020
diabetes need to be able to recognize

03:05.030 --> 03:07.820
the signs of hypoglycemia and be ready

03:07.820 --> 03:11.100
to offer fast acting carbohydrates or

03:11.110 --> 03:13.660
emergency glue keegan if necessary .

03:14.340 --> 03:16.650
People who have other extensive

03:16.650 --> 03:18.870
conditions in addition to diabetes and

03:18.870 --> 03:21.540
people who have advanced complications

03:21.540 --> 03:24.440
from diabetes such as cardiovascular

03:24.440 --> 03:27.120
disease are at a greater risk for

03:27.120 --> 03:30.490
severe hypoglycemia . These patients

03:30.490 --> 03:32.601
need to talk to their providers about

03:32.601 --> 03:35.580
setting a less rigorous A one C target ,

03:35.590 --> 03:38.640
for example , 8% instead of

03:38.640 --> 03:42.500
6.5 , however , there's no one size

03:42.500 --> 03:45.460
fits all A one C target , and patients

03:45.460 --> 03:47.627
should revisit their target with their

03:47.627 --> 03:50.710
providers often and change it as needed .