EDITORIAL
SA JOURNAL OF DIABETES & VASCULAR DISEASE
6
VOLUME 7 NUMBER 1 • MARCH 2010
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Post-meal blood glucose testing in adults with diabetes: 2009 UK and Ireland consensus group recommendations
M
anaging post-meal blood glucose
(PMBG) as well as fasting plasma
glucose levels makes a significant contribu-
tion to overall glucose control in all people
with diabetes (‘glucose triad’).
1
Specifically
targeting PMBG can help optimise aver-
age long-term glucose levels.
1
Recently
published UK and Ireland 2009 consensus
group recommendations provide guidance
as to when PMBG levels can be useful in
various patient groups, and offer practical
advice as to how best to introduce PMBG
testing into existing testing programmes.
An overall self-monitoring strategy,
which includes PMBG testing, can be more
effective when the frequency and timing
of PMBG testing is determined by a clear
problem-solving approach. Goals of treat-
ment should take into account patient pro-
file, duration of diabetes and likely risks of
lowering any aspect of the glucose triad
(i.e. fasting plasma glucose, HbA
1c
or post-
meal glucose). The PMBG testing target of
<
7.8 mmol/l taken two hours after a meal
is acknowledged as the ideal target and
time-point in most, but not all people,
2,3
and care should be taken to manage
people within the limits of maximal safety.
PMBG testing results can then be used to
make changes in individualised care plans
if required, such as adjusting insulin doses
and giving advice on lifestyle and diet.
Prof Antonio Ceriello, chair of endo-
crinology, University of Udine, Italy and
chair of the consensus group commented,
‘the management of PMBG levels is an
important element of glycaemic control;
well informed and motivated patients are
more successful in obtaining and main-
taining good control of their risk factors,
resulting in reduced cardiovascular risk and
slower progression of microvascular dis-
ease’.
Sue Craddock, nurse consultant, Queen
Alexandra Hospital, Portsmouth and a
member of the group said, ‘the consensus
is the first of its kind to offer healthcare
professionals working in diabetes practical
guidance on how to integrate post-meal
testing into a problem-solving approach to
diabetes care, resulting in improved overall
glycaemic control’.
The recommendations concluded that
structured education, supported by well-
trained and experienced healthcare pro-
fessionals, is essential for the clinical and
cost-effectiveness of all glucose monitor-
ing, including PMBG testing, and should
include instruction and interpretation of
results, appropriate action and follow up.
Ceriello A, Colagiuri S. International Diabe-
1.
tes Federation guideline for management of
postmeal glucose: a review of recommenda-
tions.
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2008;
25
: 1151–1156.
American Association of Clinical Endocrinolo-
2.
gists (AACE) medical guidelines for the man-
agement of diabetes mellitus.
Endocrin Pract
2003;
8
: 40–65.
American Diabetes Association. Clinical prac-
3.
tice recommendations 2007: Diagnosis and
classification of diabetes mellitus.
Diabetes
Care
2007;
30
: S42–47.
