09/09/2022

Nurse-directed point of care (POC)

Blood Sugar blood glucose (BG) testing

amount of sugar in a person’s blood

refers to the process of obtaining a capillary
levels are low in the morning before the blood specimen and using a portable BG meter,
RBS – Random Blood first meal of the day and rises after commonly called a glucometer or glucose
meter
Sugar having a meal
Martin B. Utzurrum BMC, RN, MAN

Who? Hyperglycemia Severe hyperglycemia (i.e., BG level >

Hospital: High levels of blood sugar 240 mg/dL)
Patients receiving Parenteral Nutrition (PN) Severe hyperglycemia (i.e., BG level > 240
Hypoglycemia
Patients with Diabetes Millitus (DM) mg/dL) can lead to diabetic ketoacidosis (DKA)
Low levels of hypoglycemia and hyperglycemic hyperosmolar nonketotic
Non-hospitalized:
syndrome (HHNS), life-threatening medical
symptoms of pre-DM conditions
Diabetes
pregnant women with gestational diabetes Is the result of persistent hyperglycemia
patients who use steroids following organ
transplantation

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Sustained hyperglycemia is associated
with widespread vascular damage:
Long-term complications of DM include:
neuropathy,
retinopathy,
and renal failure
A doctor can prescribe RBS test if
the person complains of the following symptoms;
• Unintended Weight loss
• Dehydration and dry mouth
• Slow healing of wound
• Blurry vision
• Frequent urination
Importance of the test
is to check random blood sugar levels
random blood sugar range of 200mg/dl or
more is a clear indication of the presence of
diabetes mellitus
Test Results
RBS test done within one or two hours of eating then
the RBS normal value should be 180 mg/dl
the RBS normal range should be anywhere between
80 mg/dl and 130 mg/dl prior to eating
Pre diabetic reading is about 140 mg/dl to 199 mg/dl
200 mg/dl and above is most probably diabetic
09/09/2022
A number of factors can contribute to inaccurate
BG readings when using the fingertip method of
blood sampling (Hirose et al., 2011).
• low skin temperature can lead to
underestimation of BG levels
• neglecting to wash hands after peeling fruit prior
to fingertip blood sampling can lead to
overestimation of BG levels
Glucose Conversion Between mg/dl and mmol/L
An easy way to make the conversion from mg/dl
to mmol/L is to divide by 18. Toconvert
mmol/L to mg/dl, multiply by 18.
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Target Glucose Levels
Facts about RBS:
• A level of 200 mg/dL (11 mmol/L) or higher often
means he has diabetes.
• The provider will order a fasting blood
glucose, A1C test, or glucose tolerance test,
depending on his random blood glucose test
result.
Normal goals and target levels for BG
in patients with and without DM
Facts about RBS:
In someone who has diabetes, an abnormal
result on the random blood glucose test may
mean that the diabetes is not well
controlled.
09/09/2022
Note:
glycemic control be achieved with use of a BB
regimen (i.e.,a method of glycemic control that
involves use of longer acting insulin to maintain stable
BG levels throughout the day and during periods of
fasting [sleep], shorter acting insulin is used to control
elevated BG levels resulting from meals.
Typically, the patient using the BB regimen receives a
minimum of four subcutaneous injections daily: one
(of shorter acting insulin) before each meal and one
(of longer acting insulin) at bedtime.
Other medical problems can also cause a higher-than-
normal blood glucose level, this include:
Overactive thyroid gland
•
• Pancreatic cancer
• Swelling and inflammation of the pancreas (pancreatitis)
• Stress due to trauma, stroke, heart attack, or surgery
• Rare tumors,
including pheochromocytoma, acromegaly, Cushing
syndrome, or glucagonoma
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A lower-than-normal blood glucose level

(hypoglycemia) may be due to:

• Hypopituitarism (a pituitary gland disorder)

• Underactive thyroid gland or adrenal gland
•

•
Tumor in the pancreas (insulinoma - very rare)
Too little food
Thank You!
• Too much insulin or other diabetes medicines
• Liver or kidney disease
• Weight loss after weight loss surgery
• Vigorous exercise