Glucose, blood level monitoring

Monitor blood glucose several times daily in patients with CFRD or those taking systemic corticosteroids. Follow glycosylated hemoglobin levels on an outpatient basis to assess long-term glucose control. Levels may be falsely low in CF due to a shorter red blood cell half-life. 

Short-term adverse effects from corticosteroids include fluid retention, hyperglycemia, central nervous system stimulation, weight gain, and increased risk of infection. Patients with diabetes should have blood glucose levels monitored carefully during the corticosteroid course. 

Microalbuminuria Close monitoring of blood pressure, blood glucose and blood lipid levels Monitor urinary protein Aim for BP <125/75 mmHg Add further antihypertensive drugs if necessary Add ACE I/ARB if possible Aim for total cholesterol <3.5 mmol/L... 

All CHC users should have at least annual blood pressme monitoring. Glucose levels should be monitored closely when CHCs are started or stopped in patients with a history of glucose intolerance or diabetes meUitus. Contraceptive users should have at least annual cytologic screening (more often if they are at risk for STDs), and they should also be regularly... 

Blood glucose should be monitored hourly at the bedside until less than 1.5 mmol/l. Thereafter checks may continue 2-hourly. The plasma glucose should be confirmed in the laboratory every 2-4 hours. The frequency of monitoring of blood gases depends on the severity of DKA. In severe cases it should be performed 2-hourly at least for the first 4 hours. The serum potassium level should be checked every 2 hours for the first 6 hours, while urea and electrolytes should be measured at4-hourly intervals (Fig. 3). 

Another, but less frequently monitored body fluid is the cerebrospinal fluid. However, its concentration profile is important for neurodiagnostics. The glucose concentration is 60-80% of the blood level with concentration profiles delayed due to diffusion by 4h. The reference interval is between 1.1 and 4.4 mmol 1. ... 

The hydantoins may affect the blood glucose levels. In some patients these drugs have an inhibitory effect on the release of insulin in the body, causing hyperglycemia The nurse closely monitors blood glucose levels, particularly in patients with diabetes. The nurse reports any abnormalities to the primary health care provider. 

Urine testing has been widely used to monitor glucose levels in die past, but this metiiod has largely been replaced witii blood glucose monitoring. 

Hyperglycemia is the most common metabolic complication. A too rapid infuson of amino add-carbohydrate mixtures may result in hyperglycemia, glycosuria, mental confuson, and loss of consciousness Blood glucose levels may be obtained every 4 to 6 hours to monitor for hyperglycemia and guide the dosage of dextrose and insulin (if required). To minimize these complications the primary health care provider may decrease the rate of administration, reduce the dextrose concentration, or administer insulin. 

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