Diabetes Control including SMBG and Hypos
Hypoglycaemia and its associated problems are distressing to the patient and a barrier to establishing good glycaemic control.
A cause for hypoglycaemia should be established and general advice given on prevention.
The following should be referred to the specialist Diabetes team:
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If obvious causes for hypoglycaemia are identified (e.g. mismatch between insulin and carbohydrate intake, poor injection technique or abnormal injection sites) and simple measures have failed to prevent hypoglycaemia the multidisciplinary Diabetes specialist team may be able to identify a solution, re-educate and resolve the problem
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Patients with recurrent unexplained hypoglycaemia
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Patients with severe hypoglycaemia (requiring assistance with from a third party)
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Patients with hypoglycaemia unawareness
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Patients involved in accidents e.g. RTA where hypoglycaemia may have been implicated.
Self-monitoring blood glucose (SMBG) View Blood Sugar Chart
Those that self monitor blood glucose tend to achieve HbA1c targets more often than those who do not monitor.
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Self-monitoring should not be considered as a stand-alone intervention
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Self-monitoring should be taught with a clear need/purpose and agreed with the patient
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Self-monitoring can be used in conjunction with appropriate therapy as part of integrated self-care
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Educate and support patients to SMBG as per Bath, Wiltshire and N. Somerset NHS Trusts guidance and in accordance with Bath Diabetes Service Protocols.
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Enable patients to be able to interpret and respond appropriately to SMBG results
Checking the meter the patient is using to test their blood glucose is often beneficial, particularly:
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Age of machine
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Ease of use
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Dexterity problems
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Quality control checking
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Frequency of testing
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Technique used
The range of meters used can be extensive and patient preference is the most important factor. Ensuring that the above factors are addressed will promote accuracy and optimal testing.