Table 2.
Glucose monitoring | • Blood glucose self-monitoring • Patients treated with insulin: ⩾ 2 times daily and before injection of insulin • Patients treated with oral agents: 2 times weekly (more frequently if poorly controlled or upon revision of therapy) • HbA1c • In patients with adequate glycemic control, HbA1c should be measured twice yearly • In patients with poor glycemic control, HbA1c should be measured 4 times yearly (more frequently if medication is adjusted) |
Treatment goals | • Out-patient non-pregnant adult • HbA1c: < 7% (53 mmol/mol) • FPG: 80-130 mg/dL (4.4-7.2 mmol/L) • Postprandial glucose (after 2 hours): < 180 mg/dL (9.9 mmol/L) • Inpatient non-pregnant adult28,29 • Intensive care unit critically ill patients • Target blood glucose: 140-180 mg/dL (7.7-9.9 mmol/L) • Insulin intravenous desired • Non-critically ill patients • Blood glucose (before meal): < 140 mg/dL (7.7 mmol/L) • Postprandial glucose (after 2 hours): < 180 mg/dL (9.9 mmol/L) • Scheduled subcutaneous insulin preferred • Sliding-scale insulin discouraged • Hypoglycemia • Reassess the treatment when blood glucose level < 100 mg/dL (5.5 mmol/L) • Modify the treatment when blood glucose level < 70 mg/dL (3.8 mmol/L) |
Hypoglycemia | • Random blood sugar < 70 mg/dL (3.8 mmol/L) • Treatment: 15-20 g glucose or fast-acting carbohydrates that contain glucose. If the patient is unable to swallow or is unresponsive, subcutaneous or intramuscular glucagon or intravenous glucose should be given by a trained family member or medical personnel. • Repeated hypoglycemic episodes should prompt clinician to evaluate treatment regimen. |
Abbreviations: FPG, fasting plasma glucose; T2DM, type 2 diabetes mellitus.