Diabetes Glucose Monitoring and Complications (Diabetes Week 9)

Question 1

Monitoring for diabetes mellitus

Answer 1

Self-monitoring blood glucose is an essential part of diabetes management for people using insulin or antihyperglycemic agents.
* People with Type 1 diabetes should measure their BG at least 3 times per day.
* For people with Type 2 Diabetes it can be variable, but at least once per day is recommended.

Question 2

What is HbA1c?

Answer 2

Hemoglobin A1C (glycosylated hemoglobin)
* High blood sugars cause many cells to become glycosylated where glucose attaches to the surface and happens over time

HbA1C shows long term glucose control
* past three months Goal: <0.07
* normally ~ 5% of hemoglobin (0.05)

Question 3

Reccomended HbA1c targets for glycemic control in diabetes

Answer 3

1. Patients should be treated to achieve target HbA1c level of ≤7% to reduce microvascular complications in all and macrovascular complications in T1D
2. To reach an HbA1c level ≤7% people with diabetes should aim for the following:
   * fasting plasma glucose or preprandial plasma glucose target of 4.0-7.0 mmol/L and
   * 2-hr postprandial plasma glucose target of 5.0-10.0 mmol/L
3. (3) Further post prandial blood glucose lowering to 5.0-8.0 mmol/L might be considered if HbA1c target are not reached with the postprandial target of 5.0-10.0 mmol/L

Question 4

Complications of diabetes

Answer 4

Microvascular
* Retinopathy
* Nephropathy
* Neuropathy

Macrovascular
* Coronary Artery Disease (CAD)
* Cerebrovascular Disease
* Peripheral Vascular Disease

Question 5

nephropathy

Answer 5

Question 6

retinopathy

Answer 6

Question 7

neuropathy

Answer 7

Question 8

What are diabetic complications related to?

Answer 8

• Blood Glucose Control (most important variable for complications)
• Duration of the disease
• Genetic Predisposition
• Other risk factors (smoking, hypertension, elevated serum lipids)