Monitoring diabetes

Question 1

Define what HBA1c is

Answer 1

A measure of average BG over a prolonged period of time (6-8weeks)

Question 2

What are the HBA1c vlaues which indicate normal BG, prediabetes and diabetes ?

Answer 2

• Normal BG - < 42 mmol/L
• Prediabetes - 42-47 mmol/L
• Diabetes - > 48 mmol/L

Question 3

What is the target HBA1c for people with diabetes ?

Answer 3

53 mmol/L but can be variable e.g. 48-57 mmol/L

Question 4

What are some of the limitations of HBA1c ?

Answer 4

You could have very poorly controlled diabetes giving a good average e.g. very low BG then periods of very high BG that average out to give a normal average but in fact its been very poorly controlled

Question 5

Have a rough idea of the BG monitoring targets

Answer 5

Question 6

What are the different BG monitoring options ?

Answer 6

• Urine or blood testing for ketones
• Continuous glucose monitoring system
• HBA1c
• Fingerprick test

Question 7

What are the limitations of continuous blood glucose monitoring ?

Answer 7

• Cost
• Acceptability
• Accuracy

Basically it can be useful sometimes

Question 8

What are the symptoms of hypoglycaemia ?

Answer 8

• Shaking
• Sweating
• Anxious
• Dizziness
• Hunger
• Fast heart beat/ palpitations
• Tremor
• Impaired vision
• Weakness/fatigue
• Headache
• Irritability

Question 9

What can severe hypoglycaemia lead to?

Answer 9

• Seizures
• Unconsciousness/Coma
• Death

Question 10

What is the immediate treatment of hypoglycaemia if concious?

Answer 10

• Consume 15-20 grams of glucose or simple carbs e.g. Lucozade, glucose tablets/gels, sweets etc
• Recheck BG after 15 mins
• If still hypoglycaemic, repeat
• Once BG normal eat a small snack until next planned meal

Question 11

What is the treatment of severe hypoglycaemia i.e. unconcious ?

Answer 11

Give glucose in the form of 10% dextrose or glucagon 1mg

Question 12

In what patients would glucagon not work in ?

Answer 12

Patients experiencing a hypo due to alcohol as the alcohol impaires the liver which means the glucagon cannot convert glycogen into glucose

Question 13

Define what hypoglycaemia is in terms of BG

Answer 13

BG < 4 mmol/L

Question 14

What is a risk factor of severe hypoglycaemia ?

Answer 14

Patient may not be aware they are having a hypoglycaemic attack

Question 15

What is the standard way to monitor blood glucose ?

Answer 15

1. Fingerprick test for T1DM or T2DM on insulin
2. HBA1c to monitor average control