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Table 4 Diagnosis of diabetes and blood glucose monitoring guidelines

From: Management of endocrino-metabolic dysfunctions after allogeneic hematopoietic stem cell transplantation

Diagnosis of diabetes - glycaemia ≥2 g/L, associated with clinical signs
- fasting blood glucose ≥1.26 g/L on two occasions
- blood glucose ≥2 g/L 2 hours after OGTT
HbA1c >6% - should trigger more frequent blood glucose monitoring,
- given that the anemia frequently observed in transplant patients
can alter HbA1c
In patients with weight loss, thirst and polyuria (particularly at night), - capillary blood glucose monitoring must be performed
- before a meal and two hours thereafter
- with a ketone research.
If 2 capillary blood glucose values >1.50 g/L, - monitoring must be continued
- regardless of whether or not the patient is symptomatic.
When corticosteroid therapy is initiated - check postprandial blood glucose ++
- may be elevated even when pre-prandial glycaemia is
normal regardless of the clinical signs.
During a steroid therapy step-down phase - frequent monitoring recommended, to avoid hypoglycemia.
During the period of insulin adjustment - capillary glycaemia should be monitored
- 6 x/day (before each main meal and 2 hours thereafter).
If not possible to obtain regular self-monitoring - try to obtain 6 or 7 measurements over 2 or 3 days
- or refer the patient for a 3- to 7-days continuous
ambulatory glucose monitoring
When nocturnal enteral nutrition is initiated, - perform 1 or 2 night-time and a morning capillary blood glucose to adjust the evening dose of insulin.