Blood glucosemonitoring
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BLOOD GLUCOSE MONITORING:
“WHAT IS THE PURPOSE? WHAT IS THE TARGET?”
Presented By: Nelda Rodriguez-Caceres, RN, CDE
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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.
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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
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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.
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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
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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
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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
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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?
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Hemoglobin A1c
Measures the amount of glucose “stuck” on the red blood cells
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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
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eAGEstimated 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
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Hands On Skills:
Glucose Monitoring
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Presented by: Nelda Rodriguez-Caceres, RN, CDE
INSULIN THERAPY:“DIFFERENT STROKES FOR DIFFERENT FOLKS”
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Delivery Methods
Insulin Syringe
Insulin Pen
Insulin Pump
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Understanding Insulin
LevemirLantusNovologHumalogApidraRegularNPHNovolog 70/30Novolin 70/30Humalog 75/25
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Insulin Type Onset Peak Duration
LevemirLantus
Long acting 1-2 hours No peak Up to 24 hours
NovologHumalogApidra
Rapid acting Approx. 15 mins 1 hour 3-5 hours
Novolin RHumulin R Short acting Approx. 30 mins 2-5
hours5-8
hours
Novolin NHumulin N
Intermediate 1-2 hours 4-14 hours 18-24 hours
Novolog 70/30
Mix of rapid acting and intermediate
(70%N/30% Novolog)
10-20Mins 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
hours16- 20 hours
Novolin Mix 70/30
Mix of short acting and intermediate
(70%N/30% R)30 mins 2-12
HoursUp to 24
hours
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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
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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
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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
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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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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