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 Monitoring when unwell

During Illness there is an acute risk of both hyper- and hypoglycaemia, self-blood glucose monitoring whilst ill should therefore be considered the norm if effective management strategies to reduce risk are to be employed.

When to test?

As oral carbohydrate intake usually reduces during illness, the key monitoring times are pre-meal and pre bed (ie 4 times daily). These timings will identify those who have a risk of hypoglycaemia and additionally if blood glucose (BG) is elevated at these times will reliably indicate a need for additional therapy

What is ‘good control’ during illness?

Pre-meal testing              for illness managed at home                      for hospital-managed illness

Ideal control =                   BG 4-10mmol/L                                                 BG 4-8mmol/L

Acceptable control =        BG 4-14mmol/L                                                 BG 4-10mmol/L

If pre-meal blood glucose levels are above 14 at home it should ALWAYS prompt a therapy change, as control at this level will prolong the index illness and make complicating morbidity (& mortality) 3-6 times more likely.