Diabetes monitoring & Glycaemic targets Flashcards
what are the benefits of improved glucose control in diabetes patients
reduced risk of microvascular and macrovascular complications, as well as better well-being and overall health
what is the use of HbA1c monitoring
HbA1c gives a measure of average blood glucose levels over the last 6-8 weeks
what are some of the limitations of HbA1c monitoring
haemoglobin can be increased or decreased in some conditions, such as it is decreased in anaemia, pregnancy etc.
also doesn’t tell you about glycaemic variability, as it is an average
what is the normal range for HbA1c
<42mmol/mol, or <6%
what is the range of HbA1c for pre-diabetes and for diabetes
pre-diabetes = 42-47mmol/mol, or 6-6.4% diabetes = >/=48mmol/mol, or >/=6.5%
what is the HbA1c target for those with diabetes
most part <53mmol/mol, or <7%
some have target of 48
what are the target glucose levels in children with T1DM
on walking + before meals = 4-7mmol/l
after meals = 5-9mmol/l
what are the target glucose levels in adults with T1DM
on walking = 5-7mmol/l
before meals/anytime = 4-7mmol/l
90 mins after meals = 5-9mmol/l
what are the target glucose levels for people with T2DM
before meals = 4-7mmol/l
2hrs after meals = <85mmol/l
what are the target glucose levels for a pregnant women with diabetes
fasting = <5.3mmol/l
1hr after meals = <7.8mmol/l
2hr after meals = <6.4mmol/l
what is a patients insulin sensitivity factor
used to calculate the drop in glucose for every unit of insulin
(also called ‘correction factor’)
what are the benefits of self-monitoring of blood glucose(SMBG)
better glucose control, can see hypo or hyperglycaemia, lifestyle exercise, carb counting, frequency of SMBG associated with lower HbA1c due to better control
what are the problems with self-monitoring of blood glucose(SMBG)
painful, intrusive, self-conscious, discriminatory, time, memory(may forget),
how many point profiles are required to appropriately assess rapid acting analogue insulin with SMBG
7 point profiles(ie check 7 times a day)
what are the limitations with continuous glucose monitoring(CGM)
cost, accuracy(hypoglycaemia + 20 min delay), acceptability(some don’t want it)
what is flash glucose monitoring(FGM)
patch worn on arm all the time and a device can scan this patch at any time and give glucose reading from last 12hrs
how does FGM compare to CGM
FGM is cheaper than CGM, but FGM lacks alarm features and connectivity to CSII
CGM goes directly to phone doesn’t need to be scanned, and has alarms if hypo or hyperglycaemia and connects to CSII
