Blood sugar – wikipedia, the free encyclopedia, The blood sugar concentration or blood glucose level is the amount of glucose (sugar) present in the blood of a human or animal. Blood sugar log – apidra, By recording your blood sugar readings and sharing them with your doctor , you can both get a better idea of how your treatment plan is working and if it should be. Blood glucose monitoring – wikipedia, the free encyclopedia, Blood glucose monitoring is a way of testing the concentration of glucose in the blood . Blood glucose – webmd, A blood glucose test measures the amount of a type of sugar, called glucose, in your blood. DAFNE Carbohydrate Portion Booklet This booklet provides the carbohydrate content of a range of common foods. DAFNE Food Plate Models A boxed set of 30 life size high quality food plate photographs, each with a different common British meal. This article exemplifies the AAFP 1999 Annual Clinical Focus on management and prevention of the complications of diabetes.
Severe hyperglycemia: effects of rehydration on endocrine derangements and blood glucose concentration.
Salutary effects of modest fluid replacement in the treatment of adults with diabetic ketoacidosis. The efficacy of low-dose versus conventional therapy of insulin for treatment of diabetic ketoacidosis. Hypocalcemia, hypomagnesemia, and transient hypoparathyroidism during therapy with potassium phosphate in diabetic ketoacidosis. Adult respiratory distress syndrome complicating severely uncontrolled diabetes mellitus: report of nine cases and a review of the literature.
Pediatric diabetic ketoacidosis: pathophysiology and potential for outpatient management of selected children. Treatment of diabetic ketoacidosis by internists and family physicians: a comparative study.
When using an insulin pump, part of the process is entering your blood glucose levels (BGL) from your meter after testing. Entering your BGL during the day, and then entering BGL with the grams of carbs you’re about to eat, will allow the pump to accurately suggest how much insulin it should give. Because of what the pump records and the reports it produces, I have not yet needed to record anything manually. Looking at the report, I see if any adjustments need to be made to any of the pump settings. Last week, I made a huge effort to keep my carbs fairly low, lower than my usual under 120 grams per day.
At the far right, you’ll see the average BGL for the day, the total carbs for the day and the total insulin bolus for the day. At the bottom of the report, the last 3 rows are the averages for the time of day, and the averages for the week on the right. I wanted to share because it was something I wanted to know and see before I decided which insulin pump to get. If you are even remotely thinking of getting an insulin pump, please feel free to contact me and ask me why I love mine and what a huge difference it's made to my life.
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The incidence of this condition may be increasing, and a 1 to 2 percent mortality rate has stubbornly persisted since the 1970s. Even in comatose patients, information documenting a history of diabetes or insulin therapy may be available. Patients should not discontinue insulin therapy when they are ill, and they should contact their physician early in the course of illness. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. It’s done on an incredibly complicated algorithm and it also knows how much bolus insulin you still have active at the time. I have mine set to remind me every two hours after entering my BGL, which I test several times a day. As you may have already read, I totally love my pump and I’m extremely happy with the choice I made. In case of trademark issues please contact the domain owner directly (contact information can be found in whois).
As noted previously, however, overly rapid rehydration or overcorrection of hyperglycemia appears to increase the risk of cerebral edema.
Indications for hospitalization include greater than 5 percent loss of body weight, respiration rate of greater than 35 per minute, intractable elevation of blood glucose concentrations, change in mental status, uncontrolled fever and unresolved nausea and vomiting.
Insulin therapy of diabetic ketoacidosis: physiologic versus pharmacologic doses of insulin and their routes of administration.
When is bicarbonate appropriate in treating metabolic acidosis including diabetic ketoacidosis?
This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. After any entry, the reminder comes on screen for you to confirm it or change the reminder time – 1 hour, 2 hours and so on. They can then see trends, averages, total insulin and more, and perhaps suggest  adjustments. The log book only has BGL value in any given hour – the average of all tests done in that hour. The management of patients with diabetic ketoacidosis includes obtaining a thorough but rapid history and performing a physical examination in an attempt to identify possible precipitating factors. Blood glucose levels are monitored every four hours, and regular insulin is given subcutaneously every four hours using a sliding scale (Figure 2). Onset of headache or mental status changes during therapy should lead to consideration of this complication. When I sleep, I set the reminder to zero hours, so it doesn’t do the reminder alarm and wake me. You can’t see in the chart below how many times I might have tested for any one BGL shown. If you find something you want to try here, please check with your medical team before making any changes.
The major treatment of this condition is initial rehydration (using isotonic saline) with subsequent potassium replacement and low-dose insulin therapy.


Intravenous mannitol in a dosage of 1 to 2 g per kg given over 15 minutes is the mainstay of therapy. Cerebral edema, one of the most dire complications of diabetic ketoacidosis, occurs more commonly in children and adolescents than in adults. Either of these treatments should be continued until the blood glucose level falls by 50 to 70 mg per dL. Patients with an increased alveolar to arterial oxygen gradient (AaO2) and patients with pulmonary rales on physical examination may be at increased risk for ARDS. Dept of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Arthritis, Diabetes, and Digestive and Kidney Diseases, 1985; NIH publication no.
Continuous follow-up of patients using treatment algorithms and flow sheets can help to minimize adverse outcomes. Low-dose insulin therapy typically produces a linear fall in the glucose concentration of 50 to 70 mg per dL per hour.12More rapid correction of hyperglycemia should be avoided because it may increase the risk of cerebral edema.
Monitoring of oxygen saturation with pulse oximetry may assist in the management of such patients.Hyperchloremic metabolic acidosis with a normal anion gap typically persists after the resolution of ketonemia.
Preventive measures include patient education and instructions for the patient to contact the physician early during an illness.
This dreaded treatment complication occurs in approximately 1 percent of children with diabetic ketoacidosis.5 The typical presentation is onset of headache and decreased mental status occurring several hours after the start of treatment.
At this time, potassium chloride is added to intravenous fluids in the amount of 20 to 40 mEq per L.
The exact amount of potassium that is administered depends on the serum potassium concentration. Urinary losses then lead to progressive dehydration and volume depletion, which causes diminished urine flow and greater retention of glucose in plasma. Dehydration can be estimated by clinical examination and by calculating total serum osmolality and the corrected serum sodium concentration. These presentations can distract the physician from the underlying diagnosis of diabetic ketoacidosis.The laboratory tests needed to confirm the presence of diabetic ketoacidosis and to screen for precipitating events are summarized in Table 14 and Figure 2. Therefore, the use of bicarbonate in a patient with a pH greater than 7.0 is not recommended. If bicarbonate is used, it should be given as a nearly isotonic solution, which can be approximated by the addition of one ampule of sodium bicarbonate in 300 mL of sterile water.
The bicarbonate solution is administered over a one-hour period.1,2,8A small percentage of patients who have diabetic ketoacidosis present with metabolic acidosis and a normal anion gap. During insulin therapy, phosphate reenters the intracellular compartment, leading to mild to moderate reductions in the serum phosphate concentration. One protocol is to administer two thirds of the potassium as potassium chloride and one third as potassium phosphate.



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Comments

  1. 29.06.2015 at 16:31:16


    Measures your blood glucose was in there for about a week.

    Author: FREEBOY
  2. 29.06.2015 at 15:34:49


    Blood sugar before meals and after disease characterized by the 4.4 million of Iranian adults.

    Author: Lihon