Prevalences of diabetes 2010

Transcription

1 TESTING WITH A PURPOSE: MAKING SMBG WORTHWILE Prof. Dr. Oliver Schnell Executive Member of the Managing Board Diabetes Research Institute, Diabetes Research Group at the Helmholtz Center Munich / Neuherberg, Germany Prevalences of diabetes Prevalences of diabetes

2 SMBG in diabetes: focus on the individual An Example of Low-intensity SMBG Provided in the IDF Guidelines International Diabetes Federation Guidelines 2009, page 31 An Example of Focused SMBG Provided in the IDF Guidelines International Diabetes Federation Guidelines 2009, page 29

3 Summary of IDF Guidelines Purposes of SMBG: - Enhance the understanding of diabetes as part of patient education - Facilitate/enhance healthy behaviors - Facilitate timely treatment initiation and titration optimization SMBG should be used only when patients and clinicians have the knowledge, skills and willingness to incorporate SMBG monitoring and therapy adjustment into their diabetes care plan SMBG protocols (intensity and frequency) should be individualized to address each individual s specific educational, behavioral and clinical requirements International Diabetes Federation Guidelines 2009 Consensus Statement of Self-Monitoring of Blood Glucose in Diabetes A European Perspective Intensified insulin treatment 4-8 tests every day SMBG should be performed primarily preprandially and at bedtime Postprandial testing 7-10 times per week Nocturnal testing once a week Schnell O, Alawi A, Battelino T, Ceriello A, Diem P, Felton A, Grzeszczak W, Harno K, Kempler P, Satman I, Verges B. European Consensus Statement on Self-Monitoring of Blood Glucose in Diabetes. Diabetes, Stoffw Herz 2009; 18:

4 Consensus Statement of Self-Monitoring of Blood Glucose in Diabetes A European Perspective Individual situations Diabetic patients on oral glucose lowering agents: - To provide information on hypoglycemia - To assess glucose excursions - To assess medication and live style changes - To monitor during intercurrent illness Schnell O, Alawi A, Battelino T, Ceriello A, Diem P, Felton A, Grzeszczak W, Harno K, Kempler P, Satman I, Verges B. European Consensus Statement on Self-Monitoring of Blood Glucose in Diabetes. Diabetes, Stoffw Herz 2009; 18: Consensus Statement on SMBG A European Perspective Diabetes and Coronary Artery Disease, Neuropathy and Hypoglycemia Unawareness - Frequent testings are recommended to help recognize episodes of hypoglycaemia - More frequent nocturnal testings in patients experiencing severe hypoglycemia Schnell O, Alawi A, Battelino T, Ceriello A, Diem P, Felton A, Grzeszczak W, Harno K, Kempler P, Satman I, Verges B. European Consensus Statement on Self-Monitoring of Blood Glucose in Diabetes. Diabetes, Stoffw Herz 2009; 18: Paediatric patient with type 1 diabetes 2. Patient with gestational diabetes 3. Type 2 diabetic patient with elevated postprandial blood glucose 4. Type 2 diabetic patient with lack of motivation and adherence 5. Type 2 diabetic patient at risk of hypoglycemia or with hypoglycemia 6. Obese Type 2 diabetic patient with OAD and initiation of insulin therapy 7. Type 2 diabetic patient with coronary artery disease 8. Type 2 diabetic patient with nephropathy 9. Elderly type 2 diabetic patient Diabetes, Stoffwechsel und Herz 2010; 19:

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6 Diabetes, Stoffwechsel und Herz 2010; 19: Diabetes, Stoffwechsel und Herz 2010; 19: Diabetes, Stoffwechsel und Herz 2010; 19:

7 Making SMBG worthwhile: the flow of implementation Clinical studies, meta-analyses, clinical experience Global and international guidelines Regional guidelines, localization Individual cases and individual strategies SMBG recommendations Guidelines and standardized recommendations are helpful for further implementing SMBG as an efficacious strategy International guidelines need to be broken down to national and regional levels (localization) Individual clinical SMBG strategies are needed Consensus strategies on clinical cases of SMBG support the aim of tailored and patient-focused approaches of SMBG International Diabetes Federation Guidelines 2009