Self monitoring of blood glucose (SMBG) is very crucial for those diabetics who are on insulin or on certain oral anti-diabetic drugs which can cause hypoglycemia. It is easier for a diabetes specialist to adjust drugs or to adjust insulin dose if good SMBG record is maintained by the patient. Normally we check fasting and 2 hr post prandial blood sugar levels in lab for routine follow up. In practice I have seen several patients who had fasting and post prandial blood glucose lab tests in normal range but HbA1c levels below 7 is not achieved because they might have high blood sugars in other post meals which has got unnoticed. To achieve best blood glycemic control it is important to control blood sugar levels within normal limits during entire day and not just fasting or post breakfast levels. In the above image of SMBG chart I have mentioned 7 point charting system where you can fill your blood glucometer readings which you take on several spots in an entire day. This seven point SMBG charting approximately covers entire day glucose fluctuations to some extent (ofcourse  not as accurate as CGMS). I have also mentioned a comment column in the above SMBG chart where you can note down change in food or change in insulin dose or any other changes that you have made which probably caused unusual readings like for example if Hypoglycemia occurs at before lunch reading and you have skipped breakfast or had very little snack at breakfast you can mentioned that. You do not need to check daily all the 7 points, you can check any one or 2 points randomly depending upon your sugar control.


Monitoring of blood glucose at home in case of diabetic pregnancy or gestational diabetes is also important where frequent monitoring and SMBG charting of glucometer readings helps a lot to patient. If you find that some of the post meal or pre meal readings are high or low, please consult your diabetologist with SMBG chart to adjust your medication or insulin dosage. JANUVIA is a once-daily pill that, along with diet and exercise, helps lower blood sugar levels in adults with type 2 diabetes. Because JANUVIA works less when blood sugar is low, it is not likely to cause hypoglycemia. JANUVIA works when your blood sugar is HIGH…and works less when your blood sugar is LOW. Sitagliptin  (marketed as the phosphate salt under the trade name Januvia) is an oral antihyperglycemic (antidiabetic drug) of the dipeptidyl peptidase-4 (DPP-4) inhibitor class. One of the goals of treating type 2 diabetes is to lower blood sugar, but you should also be careful of it going too low. JANUVIA is not approved to treat the serious problems that may result from high blood sugar.
High blood sugar can be lowered with diet and exercise and with certain medications, when necessary.


JANUVIA is a once-daily prescription pill that, along with diet and exercise, helps lower blood sugar levels in adults with type 2 diabetes. JANUVIA should not be used in patients with type 1 diabetes or with diabetic ketoacidosis (increased ketones in the blood or urine).
To achieve best glycemic control it is essential to know how your daily blood glucose levels are fluctuating in entire day.
There is bright chance of sugar excursions in the other post meal readings which gets unnoticed. When sugar (glucose) builds up in the blood, over time it can lead to serious medical problems. If you have had pancreatitis (inflammation of the pancreas), it is not known if you have a higher chance of getting it while taking JANUVIA.



Neonatal hypoglycaemia ppt
Normal blood sugar level for 14 year old 70cl
When blood glucose levels are high the pancreas
Treatment of hypoglycemia diabetic coma


Comments

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