Download Blood Glucose Meter Formulary and SMBG

Blood Glucose Monitoring Meter Formulary
NHS
Important considerations:
GESTATIONAL DIABETES - Please do not change test strips for these patients. These patients may need
to test up to 10x a day
INSULIN PUMP USERS - Please do not change test strips for these patients
Check pack expiry
PAEDIATRIC USE - Children under 18yrs - Please do not change their test strips. on container before
considering use
Cost-effective Meters
Glucomen Areo (Menarini) - uses Glucomen GM sensors strips 50 (£9.95)
-Expiry: 6 months from vial opening
Performa Nano (Roche) - uses Accu-chek Performa strips 50 (£9.95)
-Expiry: Up to expiry on the strip pack. Unaffected by opening
MyLife Pura meter - uses Mylife Pura strips 2x25 (£9.50)
-Expiry: 6 months from opening each vial (12 months effective expiry for full pack)
GlucoRx Nexus - uses GlucoRx nexus test strips 2x25 ( £9.95)
-Expiry: 6 months from opening each vial (12 months effective expiry for full pack)
Contour TS (Bayer) - uses Contour TS test strips 50 (£9.50)
-Expiry: Up to expiry on the strip pack. Unaffected by opening
Glucomen LX PLUS (Menarini)- uses Glucomen LX sensors test strips 50 (£15.52)
-Expiry: 9 months from vial opening
GlucoMen LX Ketone Test Strips 10 test strips (£20.75)
•Blood glucose / Testing Ketones
FreeStyle Optium Neo - uses FreeStyle Optium Glucose strips 50 (£15.64)
-Expiry: up to 18 months from vial opening
•Testing Ketones - uses FreeStyle Optium B-Ketone strips 10 (individually foil packed) (£21.04)
-Expiry: Up to expiry on the strip pack. Unaffected by opening
•Blood glucose / Good for pump patients
For Patients who are Carbohydrate Counting
Accu-Chek® Aviva Expert Bolus Advisor System - uses Aviva strips 50 (£15.72)
-Expiry: 18 months after vial opening
•Secondary
care initiation
Accu-Chek®
Mobile (Roche) -uses Mobile Strips 100
(£31.90)
Patients
should see a dietician before starting
•Patients
with
dexterity
problems
such
as
disabled
/stroke
patients
to
use
these
meters for carbohydrate counting
Insulix (Abbott) - uses FreeStyle Lite strips 50 (£15.73)
•Patients
who
drive
a
lot
(
easy
to
use
and
not
as
fiddly
as
other
meters
-Expiry: Up to expiry on the strip pack. Unaffected by opening
as no
need
for strips)
•Secondary
care
initiation
•Poor sighted patients
Type•One-handed
1 and 2 patients
patients
•Patients who find it hard to pick strips out of the pots
One Touch Verio IQ (Lifescan)- uses One touch Verio test strips 50 (£15.12)
All meters comply to ISO 15197:2013 standards
Type 1 unstable
-Expiry: 6 months from vial opening
•For patients who would benefit from pattern detection of their highs and lows.
Easy to Use – All – in – One
Accu-Chek® Mobile (Roche) -uses Mobile Strips 100 (£32.18)
-Expiry: 3 months from opening each cassette
•Patients with dexterity problems such as disabled /stroke patients
•Patients who drive a lot ( easy to use and not as fiddly as other meters as no need for strips)
•Poor sighted patients
•One-handed patients
•Patients who find it hard to pick strips out of the pots
Insulin Pen needles
•GlucoRx Finepoint pen needles (100) (£5.95)
Lancets
•GlucoRx lancets (200) (£5.50)
Note: Currently not compatible with Fastclix, Multiclix, Softclix and Delicia devices
Patients should be encouraged to use 4 or 5mm needles
March 2015
Self-monitoring of Blood Glucose Guidelines (SMBG)
Diet and
Exercise
Metformin, pioglitazone,
Gliptins, GLP-1 mimetics,
SGLT2 inhibitors as
monotherapy or in combination
• Low risk of hypoglycaemia
• Patients do not routinely need to test unless
there is an agreed purpose to test.
Sulphonylureas nataglinide,
replaginide, as monotherapy
or in combination with other
diabetes drugs
INSULIN as monotherapy or
with or without other
diabetes drugs
• Increased risk of hypoglycaemia
• Test two to three times a week.
• Drivers will need to test before
driving (see DVLA guidance or
Diabetes UK)
• Testing times and targets should be agreed with patients regularly
• Consider using just HbA1c testing, in those who will not benefit from SMBG testing
• Structured education should always be offered when initiating and continuing SMBG
Key questions to think about before continuing SMBG:
1. Is SMBG appropriate for this patient?
2. Is the patient’s blood glucose well controlled?
3. What value does self-monitoring add to the patient’s care?
Consider stepping down or stopping SMBG in the following:
• When patient’s therapy is changed and does not cause hypoglycaemia.
• If patients control is quite stable.
• After pregnancy (if not breastfeeding)
• Once recovered from intercurrent illness ( Including on discharge from hospital)
• If SMBG has a negative effect on wellbeing.
• If no action is being taken on results
• High risk of hypoglycaemia
• Drivers may need to test before driving
(see DVLA guidance or Diabetes UK )
• If on ONCE DAILY insulin with oral agents
then depending on patient circumstances,
one or more blood tests a day, at different
times of the day.
• If on TWICE DAILY insulin regimen then
1-2 blood tests a day often before meals when
insulin is due.
• If on a basal bolus regimen and carbohydrate
counting may need at least 4 blood tests a day.
• If on an insulin pump then 4-6 blood
tests a day.
Blood glucose levels should be taken at various times in the day:
• Before meals
• 2 hours post meal
• At bedtime
Consider stepping up SMBG in the following:
• Initiation or escalation of treatment
• Deteriorating control eg. Increased frequency of hypoglycaemia
• Planning or during pregnancy
• Breastfeeding
• Intercurrent illness (refer to local sick day rules if available)
• Ensure safety during activity e.g. exercise or driving