Home Blood Glucose Monitoring Why, When & How Julie Freeland Hilary Yule.

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Presentation transcript:

Home Blood Glucose Monitoring Why, When & How Julie Freeland Hilary Yule

A few questions… Why? When? How?

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

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

Why? HbA1c 8% Lower HbA1c - improvement Reference DCCT 1993

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

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

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

Special Circumstances Type 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

Special Circumstances Type 1 Diabetes Mellitus After a change of insulin/regimen DAFNE Change in lifestyle – job/shift work

Special Circumstances Type 2 Diabetes Mellitus During illness, steroids Before/After moderate Physical Activity Psychological/Emotional Stress Hypoglycaemia Pregnancy or Pre-pregnancy planning

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

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

Adjusting treatment Diabetes Team to educate and follow up on an individual basis

Ketone Testing Urine ketostix Blood ketones

Thank You Any Questions?

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