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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.