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Blood Glucose Testing Frequency Guidelines

Blood Sugar Testing: Why, When And How

Blood Sugar Testing: Why, When And How

Blood sugar testing is an important part of diabetes care. Find out when to test your blood sugar level, how to use a testing meter, and more. If you have diabetes, self-testing your blood sugar (blood glucose) can be an important tool in managing your treatment plan and preventing long-term complications of diabetes. You can test your blood sugar at home with a portable electronic device (glucose meter) that measures sugar level in a small drop of your blood. Why test your blood sugar Blood sugar testing — or self-monitoring blood glucose — provides useful information for diabetes management. It can help you: Judge how well you're reaching overall treatment goals Understand how diet and exercise affect blood sugar levels Understand how other factors, such as illness or stress, affect blood sugar levels Monitor the effect of diabetes medications on blood sugar levels Identify blood sugar levels that are high or low When to test your blood sugar Your doctor will advise you on how often you should check your blood sugar level. In general, the frequency of testing depends on the type of diabetes you have and your treatment plan. Type 1 diabetes. Your doctor may recommend blood sugar testing four to eight times a day if you have type 1 diabetes. You may need to test before meals and snacks, before and after exercise, before bed, and occasionally during the night. You may also need to check your blood sugar level more often if you are ill, change your daily routine or begin a new medication. Type 2 diabetes. If you take insulin to manage type 2 diabetes, your doctor may recommend blood sugar testing two or more times a day, depending on the type and amount of insulin you need. Testing is usually recommended before meals, and sometimes before bedtime. If you manage type 2 Continue reading >>

Final Recommendation Statement

Final Recommendation Statement

Importance Cardiovascular disease (CVD) is the leading cause of death in the United States, and nearly one quarter of deaths caused by CVD are considered to be preventable. Modifiable cardiovascular risk factors include abnormal blood glucose, hypertension, hyperlipidemia or dyslipidemia, smoking, overweight and obesity, physical inactivity, and an unhealthy diet. Type 2 diabetes mellitus is a metabolic disorder characterized by insulin resistance and relative insulin deficiency, resulting in hyperglycemia. Type 2 diabetes typically develops slowly, and progression from normal blood glucose to glucose abnormalities that meet generally accepted criteria for diabetes (Table) may take a decade or longer. Glucose abnormalities that do not meet the criteria for diabetes include impaired fasting glucose (IFG), an impaired response to oral glucose intake (impaired glucose tolerance [IGT]), or an increased average blood glucose level as evidenced by increased levels of hemoglobin A1c (HbA1c). Abnormal glucose metabolism is a risk factor for CVD and, in some individuals, may progress to meet the threshold for the diagnosis of diabetes. According to national data estimates from 2012, approximately 86 million Americans aged 20 years or older have IFG or IGT.1 Approximately 15% to 30% of these persons will develop type 2 diabetes within 5 years if they do not implement lifestyle changes to improve their health.1 Modifiable risk factors for abnormal glucose metabolism (manifested as either diabetes or abnormal glucose levels below the threshold for diabetes) include overweight and obesity or a high percentage of abdominal fat, physical inactivity, and smoking. Abnormal glucose metabolism is also frequently associated with other cardiovascular risk factors, such as hyperlipidemia and Continue reading >>

How Often Do I Need To Test My Blood Glucose?

How Often Do I Need To Test My Blood Glucose?

Tweet How often to test blood sugar levels is a common question particularly amongst people that are newly diagnosed with diabetes or that have moved onto a new treatment regimen. The frequency at which you should test your blood will be dependent upon the treatment regimen you are on as well as individual circumstances. Blood glucose testing can help you to identify any hypos and hypers and provide information on how to keep your diabetes under control It is sadly quite common for some people's healthcare team to suggest people with diabetes to test less often or not test at all even when their patients are keen. Should I test my blood glucose levels? If you are on medication that puts you at risk of hypos, you should test your blood glucose levels. Medications that can cause hypos include: Insulin (all types of insulin) Sulphonylureas (glibenclamide, gliclazide, glipizide, glimepiride, tolbutamide) Prandial glucose regulators (repaglinide, nateglinide) This means that all people with type 1 diabetes need to regularly test their blood glucose levels. If you have another type of diabetes and are not on any of the medication above, there is less necessity to test your blood sugar but there is still plenty of benefit to be had in testing your blood sugar. Read about the benefits of blood glucose testing It has previously been reported by research that some people may find blood glucose testing distressing. This is more likely to be the case when people have not received education about how to interpret and act upon the results. When people know how to interpret the results, blood glucose testing is usually regarded as a substantial benefit. Blood glucose testing for type 1 diabetes The 2015 NICE guidelines recommend that people with type 1 diabetes test their blood glucos Continue reading >>

Self-monitoring Of Blood Glucose

Self-monitoring Of Blood Glucose

Use, Frequency Drivers, and Cost in Argentina 1CENEXACentro de Endocrinologa Experimental y Aplicada (UNLP-CONICET LA PLATA, Centro Colaborador de la OPS/OMS en Diabetes), Facultad de Ciencias Mdicas UNLP, La Plata, Argentina 1CENEXACentro de Endocrinologa Experimental y Aplicada (UNLP-CONICET LA PLATA, Centro Colaborador de la OPS/OMS en Diabetes), Facultad de Ciencias Mdicas UNLP, La Plata, Argentina 1CENEXACentro de Endocrinologa Experimental y Aplicada (UNLP-CONICET LA PLATA, Centro Colaborador de la OPS/OMS en Diabetes), Facultad de Ciencias Mdicas UNLP, La Plata, Argentina 1CENEXACentro de Endocrinologa Experimental y Aplicada (UNLP-CONICET LA PLATA, Centro Colaborador de la OPS/OMS en Diabetes), Facultad de Ciencias Mdicas UNLP, La Plata, Argentina 1CENEXACentro de Endocrinologa Experimental y Aplicada (UNLP-CONICET LA PLATA, Centro Colaborador de la OPS/OMS en Diabetes), Facultad de Ciencias Mdicas UNLP, La Plata, Argentina Juan J. Gagliardino, MD, PhD, CENEXA (UNLP-CONICET LA PLATA), Facultad de Ciencias Mdicas UNLP. 60 y 120, 1900 La Plata, Argentina. Email: [email protected] Copyright 2014 Diabetes Technology Society Although test strips for self-monitoring of blood glucose (SMBG) represent around 50% of diabetes treatment cost in Argentina, little is known about their current use and relationship with different types of treatment. We therefore aimed to estimate the current use of test strips and identify the major use drivers and the percentage they represent of total prescription costs in 2 entities of the social security system (SSS) of Argentina. Observational retrospective study measuring test strip prescriptions delivered by pharmacies from the province of Buenos Aires (8115 records collected during 3 months provided by the Colegio de Farmacuticos d Continue reading >>

Blood Glucose Monitoring

Blood Glucose Monitoring

Blood glucose monitoring is a way of testing the concentration of glucose in the blood (glycemia). Particularly important in diabetes management, a blood glucose test is typically performed by piercing the skin (typically, on the finger) to draw blood, then applying the blood to a chemically active disposable 'test-strip'. Different manufacturers use different technology, but most systems measure an electrical characteristic, and use this to determine the glucose level in the blood. The test is usually referred to as capillary blood glucose. Healthcare professionals advise patients with diabetes mellitus on the appropriate monitoring regimen for their condition. Most people with type 2 diabetes test at least once per day. The Mayo Clinic generally recommends that diabetics who use insulin (all type 1 diabetics and many type 2 diabetics) test their blood sugar more often (4-8 times per day for type 1 diabetics, 2 or more times per day for type 2 diabetics),[1] both to assess the effectiveness of their prior insulin dose and to help determine their next insulin dose. Purpose[edit] Blood glucose monitoring reveals individual patterns of blood glucose changes, and helps in the planning of meals, activities, and at what time of day to take medications.[2] Also, testing allows for quick response to high blood sugar (hyperglycemia) or low blood sugar (hypoglycemia). This might include diet adjustments, exercise, and insulin (as instructed by the health care provider).[2] Blood glucose meters[edit] Main article: Glucose meter Four generations of blood glucose meter, c. 1991–2005. Sample sizes vary from 30 to 0.3 μl. Test times vary from 5 seconds to 2 minutes (modern meters are typically below 15 seconds). A blood glucose meter is an electronic device for measuring the blood Continue reading >>

Hba1c Testing Frequency: A Review Of The Clinical Evidence And Guidelines

Hba1c Testing Frequency: A Review Of The Clinical Evidence And Guidelines

Product Line: Rapid Response Research Type: Drug Report Type: Summary with Critical Appraisal Result type: Report Report in Brief Context Diabetes is one of the world's fastest growing chronic diseases. In 2011, there were approximately 366 million people with diabetes worldwide, and this number is projected to reach 500 million by 2030 — a projected increase of 50% in only 19 years. Wide fluctuations in blood glucose levels from untreated or poorly treated diabetes result in complications such as kidney failure, cardiovascular disease, blindness, and nerve damage. One test used to track blood glucose control is the glycated hemoglobin (hemoglobin A1C) test. Technology The hemoglobin A1C test monitors a patient's average blood glucose levels over a period of time. Patients with diabetes find this test more convenient compared with other methods for measuring blood glucose over the long term because it is quick, does not require fasting, uses only a drop of blood, and can be done at any time of day or night. And, if refrigerated, the blood samples can remain stable for over a week. Issue As the prevalence of diabetes increases, so does the amount of hemoglobin A1C testing. A review of the evidence on the effect of different hemoglobin A1C testing frequencies and of guidelines on the timing of testing will help inform treatment decisions for patients with diabetes. Methods A limited literature search was conducted of key resources, and titles and abstracts of the retrieved publications were reviewed. Full-text publications were evaluated for final article selection according to predetermined selection criteria (population, intervention, comparator, outcomes, and study designs). Results The literature search identified 255 citations, with 5 additional articles identified Continue reading >>

Changes To Pharmacare Coverage - Blood Glucose Test Strips

Changes To Pharmacare Coverage - Blood Glucose Test Strips

Clinical studies continue to show that frequent blood-sugar testing for persons with Type II Diabetes is unnecessary and for those with Type I Diabetes (insulin-dependent), testing frequency should follow clinical guidelines. Effective June 15, 2017, the Manitoba government is making changes to Pharmacare and Employment and Income Assistance coverage for blood glucose test strips. The changes will more closely align with guidelines endorsed by Diabetes Canada. The new coverage levels include: 3650 test strips a year if a patient uses insulin; 400 test strips a year if a patient uses an oral diabetes agent with higher risk of hypoglycemia; 200 test strips a year if a patient uses oral diabetes agent with lower risk of hypoglycemia or manages diabetes with diet and exercise alone. Patients will also be able to access additional test strips if medically necessary. Frequently-Asked Questions Why is this change being made? Clinical studies continue to demonstrate that routine self-monitoring of blood glucose levels does not significantly improve the conditions of most patients with non-insulin treated, Type 2 diabetes. Additionally, Diabetes Canada, a national organization that supports people living with diabetes through research, advocacy, education and services has developed clinical guidelines recommending blood glucose testing frequency based on the medication prescribed. Manitoba is modifying coverage for blood glucose test strips to ensure benefits are aligned with best evidence and clinical guidelines so patient needs will continue to be met. Manitobans expect a system that improves their health and provides quality care while remaining cost-effective. The changes will also ensure coverage is medically appropriate and financially efficient. It is estimated the change Continue reading >>

Quality Control Considerations For Point Of Care Blood Glucose Meters

Quality Control Considerations For Point Of Care Blood Glucose Meters

Point of Care Blood Glucose Testing has been adopted as a convenient, rapid and inexpensive way to evaluate blood glucose (BG) results. Accordingly, hospitals perform a huge number of point-of-care (POC) BG tests annually (1-3x105) and insulin administration decisions are frequently based on the results. Several glucose meters have been designed specifically for POC BG testing in health care facilities. Accuracy standards for POC BG meters are set by the FDA and follow CLIA guidelines. The adequacy of these standards for hospitalized patients has been questioned. Quality control (QC) procedures to minimize clinically relevant errors related to POC BG testing are of critical importance to patient safety. Current Joint Commission (JC) standards require daily QC testing for every meter used for any patient test. In contrast, manufacturer recommendations for QC testing are much less frequent (eg. when opening a new bottle of strips, after meter is cleaned or dropped). We investigated whether JC mandated QC testing identifies meter or test strip error and is likely to improve patient safety. Our study was limited to the ROCHE Inform blood glucose meter in one 400+ bed urban trauma center where 103,580 QC tests were performed during 2008/2009 on 117 meters (2008) and 244 meters (2009). POC BG QC tests were analyzed to evaluate operator and strip/meter error rates and institutional cost. QC errors that occurred were related to both operator familiarity with QC testing (total error rate for operators performing >50QC tests/month, 2.4%; <50QC tests/month, 3.8%, p< .001) and strip/meter failure (strip/meter error (1.2 ± 0.3%) accounted for 50% of total error among the most competent users). POC BG QC test failure (17/103,580 over 24 months) was low and no meters failed subsequen Continue reading >>

Diabetes Management Guidelines

Diabetes Management Guidelines

Source: American Diabetes Association. Standards of medical care in diabetes—2016. Diabetes Care. 2016;39(suppl 1):S1-S106. Available here. Refer to source document for full recommendations, including class of recommendation and level of evidence. Jump to a topic or click back/next at the bottom of each page Insulin & Glucose Monitoring Self-monitoring of blood glucose (SMBG) Encourage individuals receiving multiple dose insulin or insulin pump therapy to perform SMBG: Prior to meals and snacks Occasionally after meals (postprandially) At bedtime Prior to exercise When low blood glucose is suspected After treating low blood glucose until normoglycemia is achieved Prior to critical tasks, such as driving SMBG results may be useful for guiding treatment and/or self-management for individuals using less frequent insulin injections or noninsulin therapies It is important to provide ongoing instruction and regular evaluation of SMBG technique, results, and the patient’s ability to use the data to adjust therapy Continuous Glucose Monitoring (CGM) CGM is useful for A1C lowering in select adults (aged ≥25 yrs) with type 1 diabetes who require intensive insulin regimens The technique may be useful among children, teens, and younger adults* Success is related with adherence to ongoing use CGM may be a useful supplement to SMBG among individuals with: Hypoglycemia unawareness and/or Frequent hypoglycemic episodes *Evidence for A1C lowering is less strong in these populations Any pharmacologic agents discussed are approved for use in the United States by the U.S. Food and Drug Administration (FDA) unless otherwise noted. Consult individual prescribing information for approved uses outside of the United States. January 2016 This content was created by Ashfield Healthcare Comm Continue reading >>

Frequency Of Blood Glucose Monitoring In Relation To Glycemic Control In Patients With Type 2 Diabetes

Frequency Of Blood Glucose Monitoring In Relation To Glycemic Control In Patients With Type 2 Diabetes

OBJECTIVE—The aim of the study was to investigate the relationship between blood glucose level, measured as HbA1c, and frequency of self-monitoring in patients with type 2 diabetes. Daily self-monitoring is believed to be important for patients treated with insulin or oral agents to detect asymptomatic hypoglycemia and to guide patient and provider behavior toward reaching blood glucose goals. RESEARCH DESIGN AND METHODS—A national sample of patients with type 2 diabetes was studied in the third National Health and Nutrition Examination Survey. Data on therapy for diabetes, frequency of self-monitoring of blood glucose, and HbA1c values were obtained by structured questionnaires and by clinical and laboratory assessments. RESULTS—According to the data, 29% of patients treated with insulin, 65% treated with oral agents, and 80% treated with diet alone had never monitored their blood glucose or monitored it less than once per month. Self-monitoring at least once per day was practiced by 39% of those taking insulin and 5–6% of those treated with oral agents or diet alone. For all patients combined, the proportion of patients who tested their blood glucose increased with an increasing HbA1c value. However, when examined by diabetes therapy category, there was little relationship between HbA1c value and the proportion testing at least once per day or the proportion testing at least once per week. CONCLUSIONS—In this cross-sectional study of patients with type 2 diabetes, the increase in frequency of self-monitoring of blood glucose with increasing HbA1c value was associated with the higher proportion of insulin-treated patients in higher HbA1c categories. Within diabetes therapy categories, the frequency of self-monitoring was not related to glycemic control, as me Continue reading >>

New Ada Guidelines For Blood Glucose Self-monitoring

New Ada Guidelines For Blood Glucose Self-monitoring

Home / Resources / Articles / New ADA Guidelines for Blood Glucose Self-monitoring New ADA Guidelines for Blood Glucose Self-monitoring The new ADA blood glucose self-monitoring recommendations do not prescribe how many tests should be done but rather focus on the individual situations in which testing should occur. For patients with type 1 or type 2 diabetes who take multiple daily doses of insulin or are on pump therapy, the previous recommendation had been that these patients perform blood glucose self-monitoring "three or more times daily." Some payers had interpreted that to mean that three tests a day was sufficient for all patients, Dr. Richard Grant (Kaiser Permanente Division of Research, Oakland, CA), incoming chair of the ADA Professional Practice Committee, noted. The 2013 ADA advice for patients on intensive insulin therapy is for testing at least before meals, occasionally after eating, at bedtime, before exercise or critical tasks such as driving, when low blood glucose is suspected, and after treating low blood glucose to ensure normoglycemia has been reached. "Were trying to say its very situation-dependent...both by the patient and the patients context," he said. In contrast, for patients with type 2 diabetes who take basal insulin or noninsulin diabetes treatments, blood glucose self-monitoring is still recommended as being potentially helpful to guide treatment decisions "when prescribed as part of a broader educational context," but only when patients are educated about how to make use of the results. In general, Grant said, for patients not taking insulin, blood glucose self-monitoring "is really not any use if its not being acted on....If no one looks at the results, theres no sense testing." With regard to the removal of the three-times-daily nu Continue reading >>

Diabetes: Self-monitoring Of Blood Glucose

Diabetes: Self-monitoring Of Blood Glucose

Tight control of blood sugar levels is difficult to achieve. Levels can fall too low even with the best adherence to demanding daily self-monitoring schedules. The proportion of people in the US with a diagnosis of diabetes who undertake self-monitoring of glucose has risen dramatically - from 36% in 1994 to 64% in 2010.1 All patients newly diagnosed with type 1 diabetes will receive training on how to do their blood sampling and how to act on readings. Increasing numbers of people with type 2 diabetes - even those who do not need insulin treatment - are also recommended to self-monitor their blood glucose levels. What is blood glucose self-monitoring? The aim of self-monitoring is to collect detailed information about blood glucose levels over time at multiple points. It helps maintain constant glucose levels and prevent hypoglycemia, and allows the following to be scheduled accordingly:2-4 The treatment regime/insulin doses Dietary intake Physical activity. Such glycemic control is important in the prevention of the long-term complications of diabetes.4,5 In addition to monitoring diabetes treatment effects and identifying blood sugar highs and lows, self-monitoring is a strategy that guides overall treatment goals. Self-monitoring also gives insight into how diet, exercise and other factors, such as illness and stress, affect blood sugar levels.5,6 Self-monitoring helps patients improve their knowledge of glucose levels and the effects of different behaviors on their blood glucose.5,6 Patients on glucose-lowering drugs can take their self-monitoring records to their health care provider, allowing them to measure prescriptions accordingly and recommend any adjustments to diet and exercise.4 Strict glycemic control in type 1 diabetes is difficult to achieve - even with Continue reading >>

Self-monitoring Of Blood Glucose In Type 2 Diabetes

Self-monitoring Of Blood Glucose In Type 2 Diabetes

Introduction A recent systematic review from Canada1 suggests that patients with type 2 diabetes who are not taking insulin do not require self-monitoring of blood glucose (see box). Type 2 diabetes is increasingly common, so there may be significant costs associated with widespread use of blood glucose testing by these patients. For example, in Ontario blood glucose test strips represented the third largest annual cost to the Ontario Public Drug Program – over CA$107 million, or 3.3% of total drug expenditure in the program. On 1 January 2010, the Australian Government increased the co-contribution for blood glucose test strips under the National Diabetes Services Scheme from AU$14.10 to AU$14.30 for 100 strips. However, the overall cost is much higher – around $50–60 per box of 100. The National Diabetes Services Scheme supplied nearly three-quarters of a million boxes of varying size to these patients in 2008. If this ceased, significant sums of money could be spent on other areas of diabetes care. Current practice in Australia Many doctors would recommend self-monitoring to people with type 2 diabetes who do not require insulin. Self-monitoring of blood glucose is discussed as part of their diabetes education. The choice of test and timing and frequency of monitoring is negotiated between the patient and their healthcare professionals, taking into account the type of therapy, level of glycaemic control, risk of hypoglycaemia and need for short-term adjustment of treatment. Self-care of diabetes often varies in the course of a person's life, with periods of intense monitoring around medical crises and clinic visits, and little or no monitoring at other times. In theory, patients, doctors and diabetes educators review the results of self-monitoring and together Continue reading >>

Test Center

Test Center

Test Guide Laboratory Testing for Diabetes Diagnosis and Management This Test Guide discusses the use of laboratory tests (Table 1) for diagnosing diabetes mellitus and monitoring glycemic control in individuals with diabetes. Diagnosis Tools for diagnosing diabetes mellitus include fasting plasma glucose (FPG) measurement, oral glucose tolerance tests (OGTT), and standardized hemoglobin A1c (HbA1c) assays (Table 2). FPG and OGTT tests are sensitive but measure glucose levels only in the short term, require fasting or glucose loading, and give variable results during stress and illness.1 In contrast, HbA1c assays reliably estimate average glucose levels over a longer term (2 to 3 months), do not require fasting or glucose loading, and have less variability during stress and illness.1,2 In addition, HbA1c assays are more specific for identifying individuals at increased risk for diabetes.1 Clinically significant glucose and HbA1c levels are shown in Table 2.1 The American Diabetes Association® (ADA) recommends using these values for diagnosing diabetes and increased diabetes risk (prediabetes). Management Following a diagnosis of diabetes, a combination of laboratory and clinical tests can be used to monitor blood glucose control, detect onset and progression of diabetic complications, and predict treatment response. Table 3 shows the recommended testing frequency and target results for these tests. Different laboratory tests are available for monitoring blood glucose control over the short, long, and intermediate term to help evaluate the effectiveness of a management plan.1 Self-monitoring of blood glucose (SMBG) is useful for tracking short-term treatment responses in insulin-treated patients, but its usefulness is less clear in non–insulin-treated patients.1 By co Continue reading >>

Type 2 Diabetes In Adults: Management

Type 2 Diabetes In Adults: Management

Having high blood glucose makes you more likely to get other health problems, so keeping your blood glucose levels as close to normal as possible is very important. Your doctor or nurse will help you with this. Having your blood glucose checked: HbA1c The HbA1c blood test reflects your average blood glucose level over the past 2 to 3 months. Keeping your HbA1c levels as close to normal as possible is an important part of managing diabetes. Your doctor or nurse should discuss this with you, and together you should agree a personal HbA1c target to aim for. If you find that reaching or staying at the target level is affecting your day‑to‑day life and making things worse, you should discuss this with the doctor or nurse. Your HbA1c should be tested every 3 to 6 months. It might be done more often if your blood glucose levels are changing quickly. When your HbA1c level is stable, you should then have an HbA1c blood test every 6 months. The HbA1c result is given in a unit of measurement that is written as 'mmol/mol'. HbA1c used to be given as a percentage (%), so you may still see this. The HbA1c target for most people with type 2 diabetes is 48 mmol/mol (or 6.5%), but your doctor might suggest a different target for you. You should be offered support, diet and lifestyle advice, and medicine if you need it, to help you reach and stay at your HbA1c target. Questions to ask about HbA1c Testing your own blood glucose Usually, blood glucose testing is done by your doctor or nurse. But some people, for example people using insulin, might be able to do this at home with a home‑testing kit. This is called self‑monitoring. If your doctor or nurse thinks self‑monitoring would be suitable for you, you'll be given training on what to do, and your doctor or nurse should assess Continue reading >>

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