BLOOD GLUCOSE MONITORING:
“WHAT IS THE PURPOSE? WHAT IS THE TARGET?”
Presented By: Nelda Rodriguez-Caceres, RN, CDE
Blood Glucose Monitoring
• Obtain a measurement of sugar in the blood
• Its also important to write the information down i...
Blood Glucose Monitoring
Glucose Targets
• Target: type 1 dm
80-180 mg/dL
• Target: type 1 dm
70-180 mg/dL
(ask your provi...
Meter & Supplies
• Purchase a meter whose strips are
preferred on your insurance plan - this will
cost less!
• Each meter ...
Meter and Supplies:
Control Solution
• Mix well before using – roll between hands
• Test strips for accuracy – test first ...
Sharps Disposal
• All sharps (lancets, pen needles, syringes, etc.)
must be disposed of properly
• DO NOT discard loose in...
Breakfast Lunch Dinner Bedtime
Mon 157 197 153 85
Tue 67 154 285 124
Wed 122 106 89 150
Thu 115 200 98 168
Fri 330 87 112 ...
Finding the Patterns:
• What are your BG goals?
• When are BG levels out of target?
• Why are BG levels out of target?
• H...
HemoglobinA1c
Measures the amount of glucose “stuck” on
the red blood cells
Control Protects Against Long
Term Complications!
ADA Guidelines: A1c less than 7.0%
•“Quality of Life” number
•Measures a...
eAG
Estimated Average Glucose
A1c Blood Sugar
6% = 126 mg/dl
7% = 154 mg/dl
8% = 183 mg/dl
9% = 212 mg/dl
10% = 240 mg/dl
...
Hands On Skills:
Glucose Monitoring
Presented by: Nelda Rodriguez-Caceres, RN, CDE
INSULIN THERAPY:
“DIFFERENT STROKES FOR DIFFERENT FOLKS”
Delivery Methods
 Insulin Syringe
 Insulin Pen
 Insulin Pump
Understanding Insulin
 Levemir
 Lantus
 Novolog
 Humalog
 Apidra
 Regular
 NPH
 Novolog 70/30
 Novolin 70/30
 Hu...
Insulin Type Onset Peak Duration
Levemir
Lantus
Long acting 1-2 hours No peak Up to 24
hours
Novolog
Humalog
Apidra
Rapid ...
Insulin Rules
• Give the Correct
insulin
• Know the Name of the
insulin
• Inspect the insulin
• Roll the cloudy inslin
(Ne...
Breakfast Lunch Dinner Bedtime
Mon 121 341 212 84
Tue 120 204 176 78
Wed 143 246 157 80
Sample Blood Sugar Log
Current dos...
Sample Blood Sugar Log
Breakfast Lunch Dinner Bedtime
Mon 121 341 212 84
Tue 120 204 176 78
Wed 143 246 157 80
Current dos...
Breakfast Lunch Dinner Bedtime
Mon 54 85 117 98
Tue 49 89 154 176
Wed 67 77 136 162
Sample Blood Sugar Log
Current dose: N...
Breakfast Lunch Dinner Bedtime
Mon 54 85 117 98
Tue 49 89 154 176
Wed 67 77 136 162
Sample Blood Sugar Log
Current dose: N...
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Blood glucosemonitoring

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A presentation for the April 26, 2014 Advanced Diabetes Seminar at Texas Lions Camp. Author is my friend and colleague Nelda Rodriguez-Caceres, RN, CDE -
ADA Outpatient Diabetes Program Coordinator
Diabetes Care Coordinator - Shoreline & CHRISTUS Spohn Hospital Corpus Christi.

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Blood glucosemonitoring

  1. 1. BLOOD GLUCOSE MONITORING: “WHAT IS THE PURPOSE? WHAT IS THE TARGET?” Presented By: Nelda Rodriguez-Caceres, RN, CDE
  2. 2. Blood Glucose Monitoring • Obtain a measurement of sugar in the blood • Its also important to write the information down in a logbook • In looking at patterns and trends consider • Meals • Exercise • Timing of insulin administered • Etc.
  3. 3. Blood Glucose Monitoring Glucose Targets • Target: type 1 dm 80-180 mg/dL • Target: type 1 dm 70-180 mg/dL (ask your provider for the specific child’s goals) Never GOOD or BAD! When to Check Glucose  Before meals  At bedtime  Can check 2 hrs after a meal  Has a low blood sugar  Exercise  Sickdays
  4. 4. Meter & Supplies • Purchase a meter whose strips are preferred on your insurance plan - this will cost less! • Each meter requires different strips. • STRIPS ARE EXPENSIVE! • Ask your Doctor for a prescription for strips for the number of times testing per day. Don’t compare one meter’s result with another! Best comparison is with a lab.
  5. 5. Meter and Supplies: Control Solution • Mix well before using – roll between hands • Test strips for accuracy – test first strip from new batch/vial • Only good for 3 months once opened – label with discard date • Use 1-800 number on meter if unable to find test solution
  6. 6. Sharps Disposal • All sharps (lancets, pen needles, syringes, etc.) must be disposed of properly • DO NOT discard loose in the trash • Use a non-see through, hard plastic container • Laundry detergent bottle, fabric softener bottle, bleach bottle • When full, tape the lid shut and write DO NOT RECYCLE on the container • Place in regular trash
  7. 7. Breakfast Lunch Dinner Bedtime Mon 157 197 153 85 Tue 67 154 285 124 Wed 122 106 89 150 Thu 115 200 98 168 Fri 330 87 112 134 Sat 135 65 217 115 Sun 101 336 110 119 Sample Blood Sugar Log
  8. 8. Finding the Patterns: • What are your BG goals? • When are BG levels out of target? • Why are BG levels out of target? • How will BG levels come back into target?
  9. 9. HemoglobinA1c Measures the amount of glucose “stuck” on the red blood cells
  10. 10. Control Protects Against Long Term Complications! ADA Guidelines: A1c less than 7.0% •“Quality of Life” number •Measures average glucose over the past 2-3 months •Should have this test done a minimum of twice a year •Most often it is drawn every 3 months
  11. 11. eAG Estimated Average Glucose A1c Blood Sugar 6% = 126 mg/dl 7% = 154 mg/dl 8% = 183 mg/dl 9% = 212 mg/dl 10% = 240 mg/dl 11% = 269 mg/dl 12% = 298 mg/dl
  12. 12. Hands On Skills: Glucose Monitoring
  13. 13. Presented by: Nelda Rodriguez-Caceres, RN, CDE INSULIN THERAPY: “DIFFERENT STROKES FOR DIFFERENT FOLKS”
  14. 14. Delivery Methods  Insulin Syringe  Insulin Pen  Insulin Pump
  15. 15. Understanding Insulin  Levemir  Lantus  Novolog  Humalog  Apidra  Regular  NPH  Novolog 70/30  Novolin 70/30  Humalog 75/25
  16. 16. Insulin Type Onset Peak Duration Levemir Lantus Long acting 1-2 hours No peak Up to 24 hours Novolog Humalog Apidra Rapid acting Approx. 15 mins 1 hour 3-5 hours Novolin R Humulin R Short acting Approx. 30 mins 2-5 hours 5-8 hours Novolin N Humulin N Intermediate 1-2 hours 4-14 hours 18-24 hours Novolog 70/30 Mix of rapid acting and intermediate (70%N/30% Novolog) 10-20 Mins 1-4 hours Up to 24 hours Humalog Mix 75/25 Mix of rapid acting and intermediate (75% N/25% Humalog) 15 mins 30 min- 2 ½ hours 16- 20 hours Novolin Mix 70/30 Mix of short acting and intermediate (70%N/30% R) 30 mins 2-12 Hours Up to 24 hours
  17. 17. Insulin Rules • Give the Correct insulin • Know the Name of the insulin • Inspect the insulin • Roll the cloudy inslin (Never Shake) • Use the Right syringe • Carefully Measure the dose • Do not inject in fatty lumps • Store insulin correctly • Opened vials are good for 1 month • Do not Skip any scheduled doses of insulin • Draw up the clear before the cloudy
  18. 18. Breakfast Lunch Dinner Bedtime Mon 121 341 212 84 Tue 120 204 176 78 Wed 143 246 157 80 Sample Blood Sugar Log Current dose: Novolog 70/30 = 28 units in AM Novolog 70/30 = 12 units in PM
  19. 19. Sample Blood Sugar Log Breakfast Lunch Dinner Bedtime Mon 121 341 212 84 Tue 120 204 176 78 Wed 143 246 157 80 Current dose: Novolog 70/30 = 28 units in AM Novolog 70/30 = 12 units in PM
  20. 20. Breakfast Lunch Dinner Bedtime Mon 54 85 117 98 Tue 49 89 154 176 Wed 67 77 136 162 Sample Blood Sugar Log Current dose: NPH = 30 units + Humalog = 10 units in AM Humalog = 10 units at Dinner Lantus = 15 units at bedtime
  21. 21. Breakfast Lunch Dinner Bedtime Mon 54 85 117 98 Tue 49 89 154 176 Wed 67 77 136 162 Sample Blood Sugar Log Current dose: NPH = 30 units + Humalog = 10 units in AM Humalog = 10 units at Dinner Lantus = 15 units at bedtime

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