ASSESSING GLYCEMIC CONTROL 

What should be our blood glucose targets for inpatients?

   targets for OUTPATIENTS are between 4-7 mmol/L pre-meal, and 5-10 mmol/L two hrs after eating

 

TAKE HOME MESSAGES:

for INPATIENTS with NON-CRITICAL illness, there is NO CONCLUSIVE EVIDENCE that aiming  for these targets is beneficial

   a good guide is to aim for blood glucose between 7-10 mmol/L during hospital  admission

  REMEMBER: PREVENTION and AVOIDANCE of HYPOGLYCEMIA is JUST AS IMPORTANT!!!

 

Hemoglobin A1C:

  measure an A1C (hemoglobin A1C) for every inpatient known to have diabetes (or those in whom you suspect diabetes) to assess for degree of control

  A1C reflects average glycemic control over the previous 3 months

   target A1C is ≤ 7.0% for most patients.  In patients with frequent hypoglycemia and/or those in whom hypoglycemia could be detrimental (e.g. elderly, unstable cardiac disease), you may want to be less aggressive in achieving this target

   to help explain to a patient what A1C really means, you can estimate the average blood glucose from the A1C result:

          estimated average blood glucose (mmol/L) (2 x A1C) - 4


Example:
If a patient's A1C is 7.5%, what language could you use to a patient to explain what that means?

Answer: estimated avg blood glucose = (2 x 7.5) - 4
                                                             = 11.0 mmol/L

 

Back to Table of Contents

HTML Comment Box is loading comments...