Table 4 Diagnosis of diabetes and blood glucose monitoring guidelines
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. |