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 in a logbook

• In looking at patterns and trends consider• Meals• Exercise• Timing of insulin administered• Etc.

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

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.

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

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

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

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?

Hemoglobin A1c

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 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

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

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

LevemirLantusNovologHumalogApidraRegularNPHNovolog 70/30Novolin 70/30Humalog 75/25

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

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

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

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

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

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