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2256 pages added, reviewed or updated during the last month (last updated: 21/4/2021)


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NICE - blood glucose (BM) self monitoring for type 1 diabetics

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Self-monitoring of blood glucose

Frequency of self-monitoring of blood glucose

  • routine self-monitoring of blood glucose levels for all adults with type 1 diabetes for at least 4 times a day, including before each meal and before bed

  • support adults with type 1 diabetes to test at least 4 times a day, and up to 10 times a day if any of the following apply:
    • the desired target for blood glucose control, measured by HbA1c level, is not achieved
    • the frequency of hypoglycaemic episodes increases
    • there is a legal requirement to do so (such as before driving, in line with the Driver and Vehicle Licensing Agency [DVLA] At a glance guide to the current medical standards of fitness to drive)
    • during periods of illness
    • before, during and after sport
    • when planning pregnancy, during pregnancy and while breastfeeding (see the NICE guideline on diabetes in pregnancy)
    • if there is a need to know blood glucose levels more than 4 times a day for other reasons (for example, impaired awareness of hypoglycaemia, high-risk activities)

It may be necessary to self monitor more than 10 times per day

  • because of the person's lifestyle (for example, driving for a long period of time, undertaking high-risk activity or occupation, travel) or if the person has impaired awareness of hypoglycaemia

Blood glucose targets

  • advise adults with type 1 diabetes to aim for:
    • a fasting plasma glucose level of 5-7mmol/litre on waking and
    • a plasma glucose level of 4-7mmol/litre before meals at other times of the day

  • advise adults with type 1 diabetes who choose to test after meals to aim for a plasma glucose level of 5-9 mmol/litre at least 90 minutes after eating - this timing may be different in pregnancy

  • clinicians should agree bedtime target plasma glucose levels with each adult with type 1 diabetes
    • take into account timing of the last meal and its related insulin dose, and are consistent with the recommended fasting level on waking

Reference:

Last reviewed 01/2018

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