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Glycemic Targets
#1
ASSESSMENT OF GLYCEMIC CONTROL
Two primary techniques are available for health providers and patients to assess the effectiveness of the management plan on glycemic control: patient self-monitoring of blood glucose (SMBG) and A1C. Continuous glucose monitoring (CGM) or interstitial glucose may be a useful adjunct to SMBG in selected patients
Recommendations
1.  When prescribed as part of a broader educational context, self-monitoring of blood glucose (SMBG) results may help to guide treatment decisions and/or self-management for patients using less frequent insulin injections B or noninsulin
therapies.
2.   When prescribing SMBG, ensure that patients receive ongoing instruction and regular evaluation of SMBG technique, SMBG results, and their ability to use
SMBG data to adjust therapy.
3.  Most patients on intensive insulin regimens (multiple-dose insulin or insulin pump therapy) should consider SMBG prior to meals and snacks, occasionally
Postprandial, at bedtime, prior to exercise, when they suspect low blood glucose, after treating low blood glucose until they are norm glycemic, and prior to critical tasks such as driving.
 
4.   When used properly, continuous glucose monitoring (CGM) in conjunction with intensive insulin regimens is a useful tool to lower A1C in selected adults (aged $25 years) with type 1 diabetes.
5.   Although the evidence for A1C lowering is less strong in children, teens, and younger adults, CGM may be helpful in these groups. Success correlates with adherence to ongoing use of the device.
6.   CGM may be a supplemental tool to SMBG in those with hypoglycemia unawareness and/or frequent hypoglycemic episodes.
7.   Given variable adherence to CGM, assess individual readiness for continuing CGM use prior to prescribing.
8.   When prescribing CGM, robust diabetes education, training, and support are required for optimal CGM implementation and ongoing use.
9.   People who have been successfully using CGM should have continued access after they turn 65 years of age.
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#2
(09-25-2016, 06:14 AM)Dr.Bahar Ahadian Wrote: ASSESSMENT OF GLYCEMIC CONTROL
Two primary techniques are available for health providers and patients to assess the effectiveness of the management plan on glycemic control: patient self-monitoring of blood glucose (SMBG) and A1C. Continuous glucose monitoring (CGM) or interstitial glucose may be a useful adjunct to SMBG in selected patients
Recommendations
1.  When prescribed as part of a broader educational context, self-monitoring of blood glucose (SMBG) results may help to guide treatment decisions and/or self-management for patients using less frequent insulin injections B or noninsulin
therapies.
2.   When prescribing SMBG, ensure that patients receive ongoing instruction and regular evaluation of SMBG technique, SMBG results, and their ability to use
SMBG data to adjust therapy.
3.  Most patients on intensive insulin regimens (multiple-dose insulin or insulin pump therapy) should consider SMBG prior to meals and snacks, occasionally
Postprandial, at bedtime, prior to exercise, when they suspect low blood glucose, after treating low blood glucose until they are norm glycemic, and prior to critical tasks such as driving.
 
4.   When used properly, continuous glucose monitoring (CGM) in conjunction with intensive insulin regimens is a useful tool to lower A1C in selected adults (aged $25 years) with type 1 diabetes.
5.   Although the evidence for A1C lowering is less strong in children, teens, and younger adults, CGM may be helpful in these groups. Success correlates with adherence to ongoing use of the device.
6.   CGM may be a supplemental tool to SMBG in those with hypoglycemia unawareness and/or frequent hypoglycemic episodes.
7.   Given variable adherence to CGM, assess individual readiness for continuing CGM use prior to prescribing.
8.   When prescribing CGM, robust diabetes education, training, and support are required for optimal CGM implementation and ongoing use.
9.   People who have been successfully using CGM should have continued access after they turn 65 years of age.
This is very informative, tq
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