Home Blood Glucose Monitoring Why, When

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Home Blood Glucose Monitoring Why, When How

• Julie Freeland
• Hilary Yule

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A few questions

• Why?
• When?
• How?

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Why?

• Type 1 Diabetes Mellitus
• -Strongly recommended
• -Improve control
• -Special circumstances
• Type 2 Diabetes Mellitus
• -Patient choice
• -Individual
• -Inform food and exercise
• -Increase motivation

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Why?

• Lifestyle change
• Record and understand results
• To involve Diabetes Team
• Patient empowerment

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Why?

• HbA1c lt7 delay or prevent problems with eyes,
  kidneys and nerves than those with HbA1c gt8
• Lower HbA1c - improvement
• Reference DCCT 1993

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When?

• Individual patient choice
• Treatment changes
• HbA1c ?
• Lifestyle change
• Optimal control FOR PATIENT
• Record and Understand results

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When?

• HBGM (Home Blood Glucose Monitoring)
• Meter
• Strips
• TIMING
• Different times
• -Pre-meals
• -Fasting
• -Before bed
• -2am

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How?

• Using an appropriate meter suitable for
  individual needs.
• Diabetes Team are here to help

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Special CircumstancesType 1 Diabetes Mellitus

• During illness or Ketonuria
• Before/After moderate Physical Activity
• Before Driving (any distance)
• Psychological/Emotional Stress
• Hypoglycaemia, alcohol
• Pregnancy or Pre-pregnancy planning

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Special CircumstancesType 1 Diabetes Mellitus

• After a change of insulin/regimen
• DAFNE
• Change in lifestyle job/shift work

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Special CircumstancesType 2 Diabetes Mellitus

• During illness, steroids
• Before/After moderate Physical Activity
• Psychological/Emotional Stress
• Hypoglycaemia
• Pregnancy or Pre-pregnancy planning

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Target?

• Individual basis
• Aim 4-9 mmol/l
• Discuss with the team
• 17 and above check for ketones
• Illness

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HbA1c Average Mean plasma blood glucose(mmol/l)
12 19.5
11 17.5
10 15.5
9 13.5
8 11.5
7 9.5
6 7.5
5 5.5

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Adjusting treatment

• Diabetes Team to educate and follow up on an
  individual basis

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Ketone Testing

• Urine ketostix
• Blood ketones

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Thank You Any Questions?