U.S. Department of Health and Human Services
Indian Health Service: The Federal Health Program for American Indians and Alaska Natives
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Friday, August 22, 2014

Division of Diabetes Treatment and Prevention - Leading the effort to treat and prevent diabetes in American Indians and Alaska Natives


Quick Guide Cards

Folder tab graphic with Overview, How To and Other Resources tabs

Self-Monitoring of Blood Glucose (SMBG)

Self-Monitoring of Blood Glucose (SMBG) Quick Guide

Key Points

  • Think about a shift from ‘self-monitoring’ of blood glucose to ‘Self-Management’ of blood glucose.
  • Give patients clear and consistent message on when and how often to test.
  • Set goals that are realistic based on individual patients and agreed upon by patients.
  • Teach patients how to respond to high and low blood testing results.
  • Look for glucose patterns – teach difference between individual readings and patterns.

 

 

Sample Protocols for SMBG

Treatment Regimen/Plan Event * Start Phase Adjust Phase Maintain Phase

Tips for Providers to Share with Patients:

* Event – Meal or snack, exercise or hypoglycemia

Meal or Snack – a ‘snack’ is 100 calories or less

Remember: If your blood sugar before your meal is at goal, and it's too high after a meal, think about what kind of food you just ate and how much.

  • Did you drink something with sugar in it (for example regular soda, tea, sports drink, coffee with 'real' sugar)?
  • Did you eat a lot of starchy food like bread, tortilla, potato, rice?

Exercise – ask your provider for an exercise plan

Remember: when you first begin to exercise, you MAY see your blood sugar go up a little bit because your body thinks you need extra energy to deal with this 'stress'. Just stay with your exercise plan and you'll see your blood sugars start to go down after exercise.

Hypoglycemia – low blood sugar symptoms

Remember: if you are dizzy, shaky, have blurred vision or frequent urination, or you feel "some way" - test your blood sugar. If your blood sugar is below 70 mg/dL , drink 1/2 glass (4 ounces) of juice or regular soft drink or 1 glass (8 ounces) of milk or eat some soft candies (but not chocolate).

Bedtime Insulin – The purpose of bedtime insulin is to control the blood sugar while you are sleeping. Checking your blood sugar before breakfast will tell you if the dose is correct. Don't hesitate to check your blood sugar if you wake up in the middle of the night and are shaky, hungry, having nightmares, etc.

Diet and Exercise Only Meal or snack
Exercise
1-3 times daily for 2 weeks. Before and after an event. Test around one or two events per week. Before and after meals or exercise. Weekly; one test before and after an event.
Oral Medications Meal or snack
Exercise
Hypoglycemia
2-4 times daily for 2 weeks. Before and after an event. 2-3 days/week for 1-3 months. Before and after an event. Weekly; one test before and 1 test after an event.
Oral Medications and Bedtime insulin Meal or snack
Exercise
Hypoglycemia
Fasting daily for 1 week and return to clinic for adjustments. Fasting daily for 1-2 weeks AND before and after an event 1-2 days per week. Fasting and 1 test before and after an event each week.
Insulin Meal or snack
Exercise
Hypoglycemia
4 times or more daily; before and after an event. 2-4 times daily; before and after an event. 2-4 times per day at least 2 days per week; before and after an event.

Overview How To Other Resources

Division of Diabetes Treatment and Prevention | Phone: (505) 248-4182 | Fax: (505) 248-4188 | diabetesprogram@ihs.gov