Insulin monitoring methods -
Cluster of hepatitis B infection among residents of an assisted living facility—New York, In Final Program and Abstracts.
Sixth International Conference on Emerging Infectious Diseases. Atlanta, GA. March , Thompson ND, Barry V, Alelis K, Gui D, Perz JF. Evaluation of the Potential for Bloodborne Pathogen Transmission Associated with Diabetes Care Practices in Nursing Homes and Assisted Living Facilities, Pinellas County.
JAGS ; Thompson ND, Perz JF. Eliminating the Blood: Ongoing Outbreaks of Hepatitis B Virus Infection and the Need for Innovative Glucose Monitoring Techniques.
Thompson ND, Schaefer MK. Skip directly to site content Skip directly to page options Skip directly to A-Z link. Injection Safety. Section Navigation. Facebook Twitter LinkedIn Syndicate. Infection Prevention during Blood Glucose Monitoring and Insulin Administration.
Minus Related Pages. On This Page. If the manufacturer does not specify how the device should be cleaned and disinfected then it should not be shared.
Insulin pens and other medication cartridges and syringes are for single-patient-use only and should never be used for more than one person. Blood Glucose Monitoring and Insulin Administration.
Unsafe Practices during Blood Glucose Monitoring and Insulin Administration. CDC Medscape Commentary. Unsafe practices during assisted monitoring of blood glucose and insulin administration that have contributed to transmission of HBV or have put persons at risk for infection include: Using fingerstick devices for more than one person Using a blood glucose meter for more than one person without cleaning and disinfecting it in between uses Using insulin pens for more than one person Failing to change gloves and perform hand hygiene between fingerstick procedures.
Best Practices for Assisted Blood Glucose Monitoring and Insulin Administration. Fingerstick Devices. Reusable Devices: These devices often resemble a pen and have the means to remove and replace the lancet after each use, allowing the device to be used more than once.
Some of these devices have been previously approved and marketed for multi-patient use, and require the lancet and disposable components platforms or endcaps to be changed between each patient. However, due to failures to change the disposable components, difficulties with cleaning and disinfection after use, and their link to multiple HBV infection outbreaks, CDC recommends that these devices never be used for more than one person.
If these devices are used, it should only be by individual persons using these devices for self-monitoring of blood glucose. Single-use, auto-disabling fingerstick devices: These are devices that are disposable and prevent reuse through an auto-disabling feature.
In settings where assisted monitoring of blood glucose is performed, single-use, auto-disabling fingerstick devices should be used. Blood Glucose Meters. Blood glucose meters are devices that measure blood glucose levels. Whenever possible, blood glucose meters should be assigned to an individual person and not be shared.
A simple rule for safe care: If shared, blood glucose meters should be cleaned and disinfected after every use. Recommended Practices for Preventing Bloodborne Pathogen Transmission during Blood Glucose Monitoring and Insulin Administration in Healthcare Settings. Fingerstick Devices Restrict use of fingerstick devices to individual persons.
They should never be used for more than one person. Select single-use lancets that permanently retract upon puncture. This adds an extra layer of safety for the patient and the provider.
Dispose of used lancets at the point of use in an approved sharps container. Never reuse lancets. Blood Glucose Meters Whenever possible, blood glucose meters should be assigned to an individual person and not be shared. General Unused supplies and medications should be maintained in clean areas separate from used supplies and equipment e.
Do not carry supplies and medications in pockets. Insulin Administration Insulin pens should be assigned to individual persons and labeled appropriately.
Multiple-dose vials of insulin should be dedicated to a single person whenever possible. If the vial must be used for more than one person it should be stored and prepared in a dedicated medication preparation area outside of the patient care environment and away from potentially contaminated equipment Medication vials should always be entered with a new needle and new syringe Dispose of used injection equipment at point of use in an approved sharps container.
Never reuse needles or syringes. Hand Hygiene Hand washing with soap and water or use of an alcohol-based hand rub Wear gloves during blood glucose monitoring and during any other procedure that involves potential exposure to blood or body fluids.
Change gloves between patient contacts. Change gloves that have touched potentially blood-contaminated objects or fingerstick wounds before touching clean surfaces. Discard gloves in appropriate receptacles.
Perform hand hygiene immediately after removal of gloves and before touching other medical supplies intended for use on other persons. Provide a full hepatitis B vaccination series to all previously unvaccinated staff persons whose activities involve contact with blood or body fluids.
Establish responsibility for oversight of infection control activities. Provide staff members who assume responsibilities for fingersticks and injections with infection control training. Inaccurate readings can be caused by the use of expired strips, improper storage of strips exposure to high temperature and humidity , inadequate cleansing of your skin, and ingestion of vitamin C and acetaminophen.
It's a good idea to check the accuracy of your blood glucose meter occasionally by bringing it with you when you have an appointment to get blood testing. This way, you use your home monitor to check your blood glucose at the same time that blood is drawn and compare the results. If the results differ by more than 15 percent, there may be a problem with your meter or other equipment; your provider can help you figure out what's going on and how to correct the problem.
Help for people with vision impairment — People with vision impairment a common complication of diabetes sometimes have difficulty using glucose meters.
Meters with large screens and "talking" meters are available. If you have impaired vision, you can get help from the American Association of Diabetes Care and Education Specialists ADCES at Continuous glucose monitoring CGM is a way to monitor your glucose levels every 5 to 15 minutes, 24 hours a day.
Because of reliability issues, warm-up periods, and the need to calibrate some of the devices, CGM does not eliminate the need for at least occasional fingersticks.
CGM systems are described in detail above see 'Continuous glucose monitoring' above. Who should use CGM? CGM systems are most often used by people with type 1 diabetes. Periodic use of CGM can also help you and your health care provider determine when your glucose is low or high and how to adjust your medication doses or food intake to prevent these fluctuations.
Devices that combine an insulin pump with a CGM system are also available. See "Patient education: Type 1 diabetes: Insulin treatment Beyond the Basics ". Advantages — There is evidence that people with type 1 diabetes who use a CGM system consistently and reliably rather than blood glucose monitoring [BGM] have modestly better managed blood glucose levels.
The "real-time" CGM devices automatically display your glucose level every five minutes, using numbers, graphics, and arrows so you can easily tell if your level is increasing, decreasing, or stable figure 3.
The receiver recording device can also be set to trigger an alarm if your glucose level gets above or below a preset level, which can be especially helpful for people who cannot feel when they have low blood glucose also known as "impaired awareness of hypoglycemia".
Most CGM systems permit real-time "sharing" of your CGM readings with others eg, family members or caregivers. Some, but not all, of these intermittently scanning CGM devices are able to alert you of low or high glucose readings. You can download glucose results from the CGM system to your computer, tablet, or smartphone, allowing you to see glucose trends over time.
If you take insulin, your health care provider can help you figure out how to use this information to adjust your insulin dose if needed. Drawbacks — CGM systems may show lower glucose values than blood glucose meters, especially when blood glucose levels are rapidly rising.
In addition, the costs associated with CGM are greater than those of traditional glucose meters. Not all continuous glucose meters and supplies are covered by commercial health insurance companies.
Glucose testing — The results of glucose testing with blood glucose monitoring BGM or continuous glucose monitoring CGM tell you how well your diabetes treatments are working.
Glucose results can be affected by different things, including your level of physical activity, what you eat, stress, and medications including insulin, non-insulin injectable medications, and oral diabetes medications. To fully understand what your glucose levels mean, it is important to consider all of these factors.
When keeping track of your results, you should include the time and date, glucose result, and the medication and dose you are taking.
Additional notes about what you ate, whether you exercised, and any difficulties with illness or stress can also be helpful but are not generally required every day.
You should review this information regularly with your health care provider to understand what your results mean and whether you need to make any changes to better manage your glucose levels. Need for urine testing — If you have type 1 diabetes, your health care provider will talk to you about checking your urine for ketones.
Ketones are acids that are formed when the body does not have enough insulin to get glucose into the cells, causing the body to break down fat for energy.
Ketones can also develop during illness, if an inadequate amount of glucose is available due to skipped meals or vomiting. Ketoacidosis is a condition that occurs when high levels of ketones are present in the body; it can lead to serious complications such as diabetic coma.
Urine ketone testing is done with a dipstick, available in pharmacies without a prescription. If you have moderate to large ketones, you should call your health care provider immediately to determine the best treatment.
You may need to take an additional dose of insulin, or your provider may instruct you to go to the nearest emergency room. Meters that measure ketone levels in the blood are also available, but due to their cost, urine testing is more widely used.
ADJUSTING TREATMENT. Checking your glucose either with blood glucose monitoring [BGM] or continuous glucose monitoring [CGM] provides useful information and is an important part of managing your diabetes.
If you use insulin, your glucose results will help guide you in choosing the appropriate doses from meal to meal. When you first start treatment for diabetes, you will need to work with your health care provider as you learn to make adjustments in treatment.
However, with time and experience, most people learn how to make many of these adjustments on their own.
Your health care provider is the best source of information for questions and concerns related to your medical problem.
This article will be updated as needed on our website www. Related topics for patients, as well as selected articles written for health care professionals, are also available.
Some of the most relevant are listed below. Patient level information — UpToDate offers two types of patient education materials. The Basics — The Basics patient education pieces answer the four or five key questions a patient might have about a given condition.
These articles are best for patients who want a general overview and who prefer short, easy-to-read materials. Patient education: Type 2 diabetes The Basics Patient education: Using insulin The Basics Patient education: Treatment for type 2 diabetes The Basics Patient education: Low blood sugar in people with diabetes The Basics Patient education: Care during pregnancy for people with type 1 or type 2 diabetes The Basics Patient education: My child has diabetes: How will we manage?
The Basics Patient education: Managing blood sugar in children with diabetes The Basics Patient education: Managing diabetes in school The Basics Patient education: Hemoglobin A1C tests The Basics Patient education: Giving your child insulin The Basics Patient education: Checking your child's blood sugar level The Basics Patient education: Diabetic ketoacidosis The Basics Patient education: Hyperosmolar hyperglycemic state The Basics Patient education: Diabetes and infections The Basics.
Beyond the Basics — Beyond the Basics patient education pieces are longer, more sophisticated, and more detailed. These articles are best for patients who want in-depth information and are comfortable with some medical jargon.
Patient education: Type 1 diabetes: Overview Beyond the Basics Patient education: Care during pregnancy for patients with type 1 or 2 diabetes Beyond the Basics Patient education: Type 2 diabetes: Overview Beyond the Basics.
Professional level information — Professional level articles are designed to keep doctors and other health professionals up-to-date on the latest medical findings.
These articles are thorough, long, and complex, and they contain multiple references to the research on which they are based. Professional level articles are best for people who are comfortable with a lot of medical terminology and who want to read the same materials their doctors are reading.
Glucose monitoring in the ambulatory management of nonpregnant adults with diabetes mellitus Measurements of chronic glycemia in diabetes mellitus Overview of the management of type 1 diabetes mellitus in children and adolescents Treatment of type 2 diabetes mellitus in the older patient.
org , available in English and Spanish. Why UpToDate? Product Editorial Subscription Options Subscribe Sign in. Learn how UpToDate can help you. Select the option that best describes you. View Topic.
Font Size Small Normal Large. Patient education: Glucose monitoring in diabetes Beyond the Basics. Formulary drug information for this topic. No drug references linked in this topic. Find in topic Formulary Print Share. Author: Ruth S Weinstock, MD, PhD Section Editor: David M Nathan, MD Deputy Editor: Katya Rubinow, MD Contributor Disclosures.
All topics are updated as new evidence becomes available and our peer review process is complete. Literature review current through: Jan This topic last updated: Apr 06, GLUCOSE TESTING OVERVIEW If you have diabetes, you have an important role in your own medical care and monitoring your glucose sugar level is a key part of this.
FREQUENCY OF GLUCOSE TESTING Studies have proven that people with diabetes who maintain normal or near-normal blood glucose levels reduce their risk of diabetes-related complications.
ADJUSTING TREATMENT Checking your glucose either with blood glucose monitoring [BGM] or continuous glucose monitoring [CGM] provides useful information and is an important part of managing your diabetes. The Basics Patient education: Managing blood sugar in children with diabetes The Basics Patient education: Managing diabetes in school The Basics Patient education: Hemoglobin A1C tests The Basics Patient education: Giving your child insulin The Basics Patient education: Checking your child's blood sugar level The Basics Patient education: Diabetic ketoacidosis The Basics Patient education: Hyperosmolar hyperglycemic state The Basics Patient education: Diabetes and infections The Basics Beyond the Basics — Beyond the Basics patient education pieces are longer, more sophisticated, and more detailed.
Patient education: Type 1 diabetes: Overview Beyond the Basics Patient education: Care during pregnancy for patients with type 1 or 2 diabetes Beyond the Basics Patient education: Type 2 diabetes: Overview Beyond the Basics Professional level information — Professional level articles are designed to keep doctors and other health professionals up-to-date on the latest medical findings.
Glucose monitoring in the ambulatory management of nonpregnant adults with diabetes mellitus Measurements of chronic glycemia in diabetes mellitus Overview of the management of type 1 diabetes mellitus in children and adolescents Treatment of type 2 diabetes mellitus in the older patient The following organizations also provide reliable health information.
org , available in English and Spanish [ ]. Translating the A1C assay into estimated average glucose values. Diabetes Care ; ElSayed NA, Aleppo G, Aroda VR, et al.
Diabetes Technology: Standards of Care in Diabetes
Contributor Disclosures. Please read the Disclaimer insulin monitoring methods ineulin end iinsulin this insulin monitoring methods. GLUCOSE TESTING OVERVIEW. If you have diabetes, you have an important role in your own medical care and monitoring your glucose sugar level is a key part of this. Although diabetes is a chronic condition, it can usually be managed with lifestyle changes, medication, and self-care measures. Noninvasive methods of measuring blood glucose omnitoring have insulin monitoring methods monitooring in Top fat burners trials and could be potential replacements insulin monitoring methods glucose monitoring in the future, insulin monitoring methods to a review. A review monihoring in Biosensors found that 4 methods of noninvasive blood glucose monitoring demonstrated the potential to measure blood glucose and manage diabetes in an affordable, accurate, and pain-free way. Approximately million individuals worldwide have a diagnosis of diabetes, according to estimates by the World Health Organization. Currently, there are 2 ways to monitor blood glucose for diabetes management. The hexokinase method uses a blood sample of 1.
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