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Blood glucose testing in type 2 diabetes

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  • Blood glucose testing in type 2 diabetes

    1. How often should type 2 diabetics be testing?

    Any guidance out there that say a specific amount of times a week? Most sources Ive read say it should be dependant on the patient and the frequency should be made on a case by case basis. Which to me sounds daft as quite a lot of type 2 diabetics I have contact with are not even refered to a diabetic clinic or nurse once diagnosed and have not had there treatment 'taylor made' to their needs, and therefore usually get confused as to when and how often to test there glucose levels. Which in turn has left me confused as to when and how often they need to test. Some sources say that its a total waste of time and NHS resources for type 2's to even test there glucose levels.

    2. If they need to test whens to best time to test, before food, after food if so how long after, fasting levels?

    Whats peoples thoughts?

  • #2
    Re: Blood glucose testing in type 2 diabetes

    Found this via google

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    • #3
      Re: Blood glucose testing in type 2 diabetes

      I've got a nice chart in my consulting room which I'll have a look at tomorrow for you. If a patient is just on metformin (which should be first line treatment, especially for the obese) then they do not need to test, unless they are unwell or on steroids. If on SFUs, need to test a few times a week and before long journeys due to risk of hypos.

      Many people with type 2 diabetes test far more than they need to, and monitoring of diabetes costs far more than treatment. Self testing often results in gratuitous data collection, with no action being taken - type 2 diabetics don't adjust the dose of their metformin or SFU based on their glucose levels. Poor diabetic control will be picked up from HbA1c levels, which give an idea of the average glucose level over the past three months.

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      • #4
        Re: Blood glucose testing in type 2 diabetes

        I agree with Steve. I think that a good source would be the American Diabetes Association website (I think ada.org). They just published new guidelines in January. Basically, the frequency of testing is based on how well controlled the patient is, as evidenced by their a1c or home blood sugar readings if on insulin. As far as oral agents, if on a sulfonylurea+metformin, there is a greater liklihood of hypoglycemia and therefore a greater need to test (just to keep an eye on it). The frequency would be up to the discretion of the provider because having more numbers doesn't necessarily change your plan of action. You would not titrate oral agents based on home readings (usually), but rather based on the a1c as it is a better predictor of overall control. When on insulin, the need for monitoring becomes greater because then you gain the ability to look for glucose patterns throughout the day and can tailor the insulin dose based on this. It is also useful at revealing inconsistencies in patients' eating habits or may cause you to question why "lows" or "highs" are occurring.

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        • #5
          Re: Blood glucose testing in type 2 diabetes

          Great advise guys, thanks.

          I'll have a look at the websites and see what I can do with it.

          Steve where did you get that poster from?

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          • #6
            Re: Blood glucose testing in type 2 diabetes

            I queried why a pt had two different makes of strips. four boxes of each. His wife said he tested upto 13 times a day with two machines to check both working.
            johnep

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            • #7
              Re: Blood glucose testing in type 2 diabetes

              I bet he has an e-bay account as well.

              Comment


              • #8
                Re: Blood glucose testing in type 2 diabetes

                how does an ebay account connect with blood glucose testing, the patients finger tips would be too sore to be tapping at a keyboard after 13 checks a day,

                and did anyone point out to himurine testing. It would prove less of a hassel and also atleast he wont be checking 13 times a day, lol.

                The above could be absolete information if there was a good reason for the checks, e.g. (overweight) patient with snacking habbit on chocolates etc.. so needs to check blood glucose levels before injection of insulin.
                We are the music makers, We are the dreamers of dreams and God damn we are that good

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                • #9
                  Re: Blood glucose testing in type 2 diabetes

                  and did anyone point out to himurine testing
                  above should read did anyone point out urine testing to him.
                  We are the music makers, We are the dreamers of dreams and God damn we are that good

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                  • #10
                    Re: Blood glucose testing in type 2 diabetes

                    Originally posted by SolomonQ View Post
                    above should read did anyone point out urine testing to him.
                    Urine testing??? please explain..As far as I know, mainly in type 1 diabetics to check for ketones. Not very cost effective or practical in type 2. Only use in type 2 would be to check a microalbumin to creatinine ratio to quantify the protein in the urine.

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                    • #11
                      Re: Blood glucose testing in type 2 diabetes

                      Relevance of ebay. My you are an innocent. Grannies supplement their pension by selling Temazepam. Other items regularly diverted to earn extra cash are babyfood, nicotine patches, and all the usual drugs of abuse. Similar to all the food aid items sold in local markets in Africa.
                      johnep

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                      • #12
                        Re: Blood glucose testing in type 2 diabetes

                        re-ebay. Also gluten free food. Do you really think Mrs X needs 24 white loaves, 12 fibre loaves 12 packs baps and 4 cornflakes every 4 weeks???

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                        • #13
                          Re: Blood glucose testing in type 2 diabetes

                          Originally posted by SolomonQ View Post
                          how does an ebay account connect with blood glucose testing, the patients finger tips would be too sore to be tapping at a keyboard after 13 checks a day,
                          Going a bit OT here, but when we dispense NRT or other goodies that can leak onto eBay we use a felt tip marker and write NHS over the barcode.
                          47 BC : Julius Cesar : Veni Vidi Vici : I came, I saw I conquered.
                          2018 AD : Modern Man : I shopped, I clicked, I collected.
                          How times change.

                          If you find you have read something that has upset or offended you an anyway please unread it at once.

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                          • #14
                            Re: Blood glucose testing in type 2 diabetes

                            about the urine test eefectiveness etc... well in the above situation it wouldnt matter

                            Grannies supplement their pension by selling Temazepam
                            I wonder where theyre seelin it than, sound unlikely grannies sellin temazepam (computer literacy etc..) on ebay and cant imagine em sellin tablets on street corners, whod buy it? the youths who normally kick granies to death for £5?

                            Going a bit OT here, but when we dispense NRT or other goodies that can leak onto eBay we use a felt tip marker and write NHS over the barcode.
                            how does that prevent anyone selling them on ebay???
                            We are the music makers, We are the dreamers of dreams and God damn we are that good

                            Comment


                            • #15
                              Re: Blood glucose testing in type 2 diabetes

                              Just as youths hang around post offices waiting to mug pensioners for the money, so they hang around outside surgeries. Grannies only have to go to the nearest street corner to find a willing dealer.
                              johnep

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