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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Wednesday, September 17, 2014

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


Quick Guide Cards

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Why is this important?

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NOTE: Access to this information is not restricted; however, the information found here is intended for use by medical providers. Some videos contain graphic images. Patients should talk with their medical providers about any specific concerns.

  • Self-monitoring of blood glucose (SMBG) is useful especially for patients on insulin and for pregnant patients with diabetes.
  • Patients prescribed a SMBG regimen should be educated initially and then periodically on SMBG technique and on how to use the data to adjust their diet/exercise/medication.
  • SMBG results should be reviewed with patients at each diabetes visit.
  • Early intensive treatment of diabetes reduces long-term risk for microvascular disease, heart attacks and death.
  • Achieving HbA1c (A1C) targets is an important priority. It can be challenging to reach those targets with lifestyle changes and medication.
  • A1C targets should be individualized:
    • In general, the A1C target is <7% in non-pregnant patients.
    • Aggressive glycemic control (A1C <6.5%) has been shown to further decrease the risk of microvascular complications and may have long-lasting benefits (“legacy effect”).
    • However, recent studies have shown that intensive control in older patients and those with multiple comorbidities may pose hazards.

Diabetes Diagnosis (dx)

  • Methods to dx diabetes; for methods one through three, unless unequivocal hyperglycemia, confirm dx with a second test on a separate day:

    1. A1C ≥6.5%
    2. Fasting plasma glucose ≥126 mg/dL
    3. 2-hour plasma glucose ≥200 mg/dL during an oral glucose tolerance test (OGTT) using a 75 g oral glucose load
    4. Random plasma glucose ≥200 mg/dL plus symptoms of diabetes: e.g., polyuria, polydypsia, or unexplained weight loss

Target Blood Glucose Levels**

  • Fasting and premeal blood glucose target =70 to 130 mg/dL
  • Peak postprandial blood glucose target <180 mg/dL
  • A1C target <7%

**Individualize targets based on patient characteristics (e.g., age, life expectancy, comorbid conditions including advanced CVD or microvascular complications, social situation).

 
Overview How To Other Resources

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