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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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