Glucose Monitoring

T1DM Risk Factors

genetic

autoimmune

environmental factors

T2DM Risk Factors 

age

obesity

lack of physical activity

family history

history of gestational DM

PCOS

hypertension

Dyslipidemia

Prediabetes

Major complications of uncontrolled diabetes

Stroke

Retinopathy

CVD

Foot/Leg amputations

ESRD

Treatment goals:

+A1C, bp, lipid management, smoking cessation

ADA

A1C:<7%

Preprandial: 80-130

2hr-post prandial: <180

AACE (stricter)

A1c: <6.5

Preprandial: <110

2 hr post prandial: <140

FOR BOTH

BP: <130/80

Lipids: Treatment with -statin

Smoking Cessation

Ketone testing in diabetes management +indications and when to test, testing methods, interpretation of results

Indication:

• poor glycemic control in patients who are prone to elevated ketone levels

test q4-6 hours when

• acute illness BG >240

• symptoms of DKA

Testing Methods:

• Urinary Ketone Testing

  • Positive test:

    • change in color after urine dip

    • change in color after contact with test tablet

• Blood Ketone Testing

  • shifting preference in ketone testing

  • “real time” results

  • Positive Test: > 0.6mmol/L

Diabetic Ketoacidosis

+labs, s/s

labs:

• BG >240

• urine ketones

• serum ketones

• pH <7.30

S/S

• Fruity breath

• Kussmaul breathing

• Flu-like symptoms

• Thirst

• Frequent urination

CGM (continuous glucose monitoring)

+what is it, benefits

medical device that measure interstitial glucose every 1-5 minutes

• regularly tracks glucose levels throughout the day and night

Benefits

• proven to lower A1C and reduce hypoglycemic events

• readily alerts hypo/hyperglycemia

• measurements are then translated into data to show glucose direction and rate of change