Self-Monitoring Recommendations For Your Diabetes Patient

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Record the agreements concerning self-monitoring

with the patient, including aim and evaluation Request permission from

health insurer, stating indication, frequency and time period until evaluation OFFER SELF-MONITORING,

POSSIBLY TEMPORARILY, IN CASE OF: • Suspicion of dysregulation (high/low) • Pregnancy or desire for it

• Use of other blood glucose-affecting medication (such as corticosteroids) • Preparation for insulin therapy • Other indication (justify)

RECOMMEND UNTIL STABLE VALUES: • Daily fasting

• Once every one or two weeks a four-point day curve (before meals and before bed) • On indication, once every one or two weeks

a seven/eight-point curve (before and after meals, before bed and if necessary during the night)

• At subsequent check-ups modify frequency if necessary

• Four or five times a day self-monitoring, measurement times to be agreed • If necessary more often, upon indication

(justify)

• Self-management is vital

EDUCATION

• Offer in structured form, preferably in (group) programme Targeted at encouraging self-management

• Evaluate (annually) and record

IMPLEMENTATION

• Individual instruction at start of self-monitoring, repeat annually • Have blood glucose meters checked annually, record

• Let the patient use the first drop of blood provided that hands have been washed (with soap) and properly dried

• If hand washing is not possible, then incidentally the first drop of blood may be wiped away and the second may be used

• Prevent application of pressure when obtaining blood drop

SELF-MONITORING RECOMMENDATIONS

FOR YOUR DIABETES PATIENT

Source: EADV/NDF Self-Monitoring Guideline 2012

ONLY TABLET USAGE? INSULIN ONCE OR TWICE A DAY? ≥ THREE TIMES A DAY INSULIN/PUMP THERAPY? YES YES YES National guideline De ontwikkeling van deze richtlijn is mede m

ogelijk gemaakt door financiering van het Nationaal Actieprogramma Diabetes. Juni 2012

FROM INDICATION STATEMENT TO IMPLEMENTATION

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osewaarden

Landelijke richtlijn

A multidisciplinary guideline

about self-monitoring of

blood glucose values

by people with diabetes

EADV Guideline self-monitoring omslag-07.indd 1

(2)

Recommendations Guideline

A multidisciplinary guideline about

self-monitoring of blood glucose

values by people with diabetes

Source: EADV/NDF Self-Monitoring Guideline 2012 • For information: eadv@eadv.nl

Please also consult www.eadv.nl for the full-text guideline

Partly made possible by financial support from

1. There is no evidence that self-monitoring in people with type 2 diabetes without insulin therapy leads in general to improvement of clinically relevant outcomes.

Self-monitoring can be worthwhile for people with type 2 diabetes without insulin therapy in situations where, in consultation with the diabetes practitioner, it is desirable to gain insight into the blood glucose values.

2. For people with type 2 diabetes with once or twice daily insulin injection therapy, self-monitoring with conditions is considered worthwhile. Agreements with respect to self-monitoring must be recorded and evaluated in a care plan prepared jointly by patient and care provider. The patient’s individual goal, established in discussion with the practitioner, must be determining for the number of measurements and the times when these are done.

3. For people with diabetes with an intensive insulin programme of three or more injections per day or insulin pump therapy, targeted self-monitoring with an average of four to five times a day is to be recommended. Here, self-management is vital.

4. Structured education is an essential part of diabetes care and must be offered to all people with diabetes, in any event at the time the diagnosis is made.

Conditions: education must link up with the individual needs and goals of the diabetes patient and be clear to understand. It must be available locally and be integrated into the conventional care. Education programmes are preferably evidence-based and should be evaluated. The NDF Standard of Care serves as basis for the content.

5. As a follow-on to the NVKC-KNMP-NVZA Guideline, the workgroup recommends giving individual instruction at the start of self-monitoring and to repeat it annually.

National guideline De ontwikkeling van deze richtlijn is mede

mogelijk gemaakt

door financiering van het Nationaal Actieprogramma Diabetes.

Juni 2012

FROM INDICATION STATEMENT TO IMPLEMENTATIO N

Zelfcontrole bloedglucosewaarden