As Bob’s capillary blood glucose (CBG/BM) was 10.8 mmol/l. what would you do next? Select Yes or No for each question. Correct answer in Bold
Q. What would you do next? Correct answers in Bold
1. Advise Bob to avoid sugar rich food but no other action needed?
No: Correct, dietary advice is required but further investigation of diabetes will involve laboratory blood glucose measurements, such as a repeat glycated haemoglobin test (HbA1c) or either random or fasting blood glucose tests if the use if HbA1c is deemed not appropriate.
Yes: Wrong, dietary advice is required but further investigation of diabetes will involve laboratory blood glucose measurements, such as a repeat glycated haemoglobin test (HbA1c) or either random or fasting blood glucose tests if the use if HbA1c is deemed not appropriate.
2. Monitor with further capillary blood glucose CBG/BM tests over next few days?
Yes: Correct, as the CBG is 10.8 it is important to continue to monitor capillary blood glucose (CBG/BM) at least 4 times a day, depending on local policies and guidelines.
No: Wrong, as the CBG is 10.8 it is important to continue to monitor capillary blood glucose (CBG/BM) at least 4 times a day, depending on local policies and guidelines.
3. Perform glycated haemoglobin HbA1c test?
Yes: Correct, this blood test measures the identifies plasma glucose concentration and provides an indication on how high glucose levels have been over a period of time. A glycated haemoglobin (HbA1c) level of >=48mmol/mol or 6.5% indicates diabetes.
No: Wrong, this blood test measures the identifies plasma glucose concentration and provides an indication on how high glucose levels have been over a period of time. A glycated haemoglobin (HbA1c) level of >=48mmol/mol or 6.5% indicates diabetes.
4. Contact the doctor to set up immediate sliding scale?
No: Correct, aggressive glucose control is not recommended in acute stroke if blood glucose due to risk of hypoglycaemia. Intervention may only be required when blood glucose is very high (>15 mmol/L). The management of stroke patients with established diabetes should follow established protocols.
Yes: Wrong, aggressive glucose control is not recommended in acute stroke if blood glucose due to risk of hypoglycaemia. Intervention may only be required when blood glucose is very high (>15 mmol/L). The management of stroke patients with established diabetes should follow established protocols.
Reference: Royal College of Physicians (2016) National clinical guideline for stroke (5th ed). Royal College of Physicians. https://www.rcplondon.ac.uk/guidelines-policy/stroke-guidelines:
Page last reviewed: 04 Feb 2021
