1 / 12

Self-monitoring of blood glucose to achieve a good HbA1c

Self-monitoring of blood glucose to achieve a good HbA1c. Richard Croft Diabetes Lead Berkshire West. The impact of a 1% reduction in HbA1c. Correlation with complications. Audit of correlation between number of pots of strips used and HbA1c amongst diabetics at Tilehurst.

abrial
Download Presentation

Self-monitoring of blood glucose to achieve a good HbA1c

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Self-monitoring of blood glucose to achieve a good HbA1c Richard Croft Diabetes Lead Berkshire West

  2. The impact of a 1% reduction in HbA1c

  3. Correlation with complications

  4. Audit of correlation between number of pots of strips used and HbA1c amongst diabetics at Tilehurst ((There is no correlation at all!)

  5. Think: why is he testing? What will he do with the result? What will YOU do with the result?

  6. Who should use them? • Diabetics who use insulin – Type 1, and Type 2 who use insulin • Women with gestational diabetes • Some patients who use sulphonylureas (eggliclazide), especially if they drive • Other patients with intercurrent illness

  7. And who should not use them (usually)? • Everybody else!!

  8. Why test at all? • To detect hypo- and hyper-glycaemia in diabetics who use insulin (and SUs) • To help patients prevent immediate serious illness (hypoglycaemic attacks and DKA) • As part of the long-term management of diabetes to maintain good control and prevent micro- and macro-vascular complications

  9. Targets for SMBG • In Type 1 DM • Before meals 4-7mmol/l • 2hrs after meals < 9mmol/l • In Type 2 DM • Before meals 4-7mmol/l • 2 hrs after meals < 8.5mmol/l

  10. Monitoring in Type 1 DM • Twice daily insulin therapy • Test 2-3x day, varying testing times between fasting, premeal and postmeal to identify trends • Intensive insulin therapy (basal bolus) • Monitor 2-4x day normally • Monitor at least 4x day if they alter doses at mealtimes • More frequent testing during intercurrent illness

  11. Monitoring in Type 2 diabetics who use insulin • Twice daily insulin regime • Test 1-2x day varying times between fasting, premeal and postmeal • Intensive insulin therapy (basal bolus) • Monitor 2-4x day normally • Monitor at least 4x day if they alter doses at mealtimes • Once daily insulin (basal regime) • Test fasting BG once daily during initiation, can then be reduced to 1-2x week)

  12. How can we do better? • Naseem is going to talk some more about testing in Type 1 diabetes • We are going to introduce carbohydrate counting as a means of improving control in people with Type 1, and a very smart device to help patients calculate their correct dose of insulin

More Related