How to Monitor Blood Glucose

Blood glucose testing provides important information about the effectiveness of the diabetes management plan and assists nurses to monitor the clinical situation and take appropriate action. Nurses should consider the rationale for performing a blood glucose test every time they test a patient’s blood glucose level and commit to acting on the results, including whether the results are abnormal for the patient.

RESULTS OF QUICK DETECTION OF DIABETES ON ELDERLY AT SOME COMMUNES IN THAI NGUYEN CITY

Objectives: Describe the rate of diabetes by rapid detection on elderly in some communes of ThaiNguyen city.Materials and Methods: A cross-sectional study had been conducted on 520 elderly.Results: The rate of diabetes in the elderly in the 7 studied communes is 23.6%, of which 12.1% isnew discovery through rapid test. The proportion of subjects with pre-diabetes accounts for 19.5%,of which 8.3% are fasting blood glucose disorders and 11.2% are impaired glucose tolerance. Thehighest prevalence of diabetes is found in the age group 60-69 (26.6%); in which, Tich Luong wardhas the highest rate of diabetic subjects (32.8%) and Linh Son commune has the lowest rate ofdiabetic subjects (15.4%). There were 417 subjects (80.19%) that complied with the required fastingtime with the highest blood sugar test result of 16.3 mmol /l, of which 35.5% of subjects who fastedfor 8 hours or more had blood glucose test ≥7 mmol /l. As a result, adding a glucose tolerance testrevealed 13 more subjects (accounting for 11.4%) with diabetes.Conclusion: It is necessary to apply the rapid testing for blood sugar to all at-risk subjects, elderlyin community.

What We Should Consider in Point of Care Blood Glucose Test; Current Quality Management Status of a Single Institution

Background and Objectives: Point of care test (POCT) is generally performed by non-laboratory staff who often lack an understanding on the quality control and quality assurance programs. The purpose of this study was to understand the current status of quality management of point of care (POC) blood glucose testing in a single institution where non-laboratory staff perform the tests. Materials and Methods: From July to August 2020, management status of glucometer, test strips, quality control (QC) materials, quality assurance program, and operators’ response to processing of displayed results was monitored in all Soonchunhyang University Bucheon hospital departments that performed POC blood glucose test. Results of the POC blood glucose test conducted from January 2019 to May 2020 were analyzed retrospectively. Results: A total 124 glucometers were monitored in 47 departments. Insufficient management of approximately 50% of blood sugar, test strips, and QC materials was observed. Although daily QC was conducted by 95.7% of the departments, the QC records were inaccurate. The method of recording test results varied with departments and operators. Various judgments and troubleshooting were performed on the unexpected or out of measurable range results, including some inappropriate processes. In POC blood glucose test results review, 4568 atypical results were identified from a total of 572,207 results. Conclusions: Sufficient training of the non-laboratory staff and ongoing assessment of competency through recertification is needed to maintain acceptable levels of POCT quality. In this study, various problems were identified in glucometer and reagent management, QC and post-analytic phase. We believe that these results provide meaningful basal information for planning effective operators’ training and competency evaluation, and the development of an efficient POCT quality management system.

Magnitude and predictors of poor glycemic control among patients with diabetes attending public hospitals of Western Ethiopia

Background Diabetes is one of the most prevalent non-communicable diseases globally, which rapidly is increasing in developing countries. Ethiopia is also facing growing morbidity and mortality related to diabetes complications. Thus, dealing with glycemic control is essential for controlling the development of devastating acute and chronic complications related to diabetes. Therefore, this study aims to assess the magnitude and predictors of poor glycemic control among diabetic patients in western Ethiopia. Methods The cross-sectional study design was employed on a sample of 423 diabetic patients. A systematic random sampling method was employed. An interviewer-administered structured questionnaire was used. The data entered into Epi data version 3.1 and exported into Statistical Package for the Social Sciences window version 24 for analysis. All variables significant at p-<0.25 in bivariate were entered into multivariate analysis. The multivariable logistic regressions were used to determine predictors’ poor glycemic control by considering the Adjusted Odds Ratio at CI 95% and the significance level was set at p <0.05. Results The magnitude of poor glycemic control was 64.1%. Being females (AOR = 1.684,95%CI = 1.066,2.662), duration of diabetes >8years (AOR = 2.552,95%CI = 1.397, 4.665), presence of diabetes complication (AOR = 2.806,95%CI = 1.594,4.941), negligence of blood glucose test at home (AOR = 1.720, 95%CI = 1.078, 2.743), poor self-care behavior (AOR = 1.787, 95%CI = 1.083,2.959) and poor self-efficacy (AOR = 1.934, 95%CI = 1.078,3.469) were significant predictors of poor glycemic control. Conclusion The proportion of poor glycemic control was high which was nearly comparable to that reported from many countries. This could be due to factors that were significantly associated with poor glycemic control like lack of home blood glucose test, increased duration of diabetes, presence of diabetes complications, poor self-efficacy, and poor self-care behaviors. Each were significant independent predictors of poor glycemic control. Thus, we recommend patients with diabetes and health care providers enhancing self-monitoring practices, and preventing potential complications should be a priority concern to improve blood glucose levels. Further studies are also recommended to explore important factors which were not identified by the current study.

TELAAH KOMPREHENSIF DIABETES MELITUS: KLASIFIKASI, GEJALA, DIAGNOSIS, PENCEGAHAN, DAN PENGOBATAN

Diabetes mellitus is a metabolic disorder characterized by hyperglycemia. In general, diabetes is classified into type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM), gestational, and other specific diabetes. The causes of diabetes are genetic disorders and environmental. Common symptoms of diabetes include: polydipsia, polyphagia, glycosuria, polyuria, dehydration, fatigue, weight loss, reduced vision, cramps, constipation, and candida infection. Test for diagnosis of diabetes include: fasting plasma glucose test, plasma glucose test after 2 hours of 75 g oral glucose administration, the glycated hemoglobin test (HbA1C), and random blood glucose test. Prevention of T1DM is still difficult because of the limited knowledge of metabolic, genetic, and immunological processes in the development of T1DM. T2DM is prevented by lifestyle and medical intervention. Insulin is the only drug for T1DM, whereas T2DM is treated with metformin as drug’s primary choice for reducing blood glucose levels. Diabetes melitus merupakan penyakit kelainan metabolisme yang ditandai dengan hiperglikemia. Secara umum, diabetes diklasifikasikan menjadi: diabetes melitus tipe 1 (DMT1), diabetes melitus tipe 2 (DMT2), gestasional, dan diabetes spesifik lain. Penyebab diabetes adalah kelainan genetik dan lingkungan. Gejala umum diabetes antara lain: polidipsia, polifagia, glikosuria, poliuria, dehidrasi, kelelahan, penurunan berat badan, daya penglihatan berkurang, kram, konstipasi, dan infeksi candida. Pemeriksaaan untuk diagnosis diabetes meliputi: pemeriksaan glukosa plasma saat puasa, pemeriksaan glukosa plasma setelah 2 jam pemberian glukosa oral 75 g, pemeriksaan hemoglobin terglikasi (HbA1C), dan pemeriksaan glukosa darah acak. Pencegahan DMT1 masih sulit karena terbatasnya pengetahuan proses metabolisme, genetik, dan imunologi pada perkembangan DMT1. DMT2 dicegah dengan intervensi gaya hidup dan intervensi medis. Insulin merupakan satu-satunya obat untuk DMT1, sedangkan DMT2 diobati dengan metformin sebagai pilihan utama dan non obat untuk menurunkan kadar glukosa dalam darah.

Meeting the New FDA Standard for Accuracy of Self-Monitoring Blood Glucose Test Systems Intended for Home Use by Lay Users

The OneTouch Verio Reflect blood glucose monitor (BGM) has market clearance in several countries based in part on fulfilling the lay user and system accuracy criteria described in ISO15197:2015. However, the Food and Drug Administration (FDA) does not recognize the accuracy criteria in ISO15197 as a basis for gaining regulatory clearance for these devices. The current study evaluates the BGM using the accuracy guidelines issued by the agency for self-monitoring blood glucose test systems for over-the-counter use. Glucose results were accurate vs comparator over a wide glucose range and met lay user and glucose accuracy criteria at extreme glucose values as described in the FDA guidance. Clinicaltrials.gov NCT03851549