From the Research
For patients who have experienced hypoglycemia, capillary blood glucose (CBG) monitoring should be performed every 15-30 minutes until blood glucose levels normalize above 70 mg/dL, then hourly for 4-6 hours, and subsequently every 4-6 hours for the next 24-48 hours. After stabilization, the frequency can be reduced to before meals and at bedtime (typically 4 times daily). For hospitalized patients with severe hypoglycemia, more intensive monitoring may be necessary, potentially including continuous glucose monitoring 1. The monitoring schedule should be individualized based on the severity of the hypoglycemic episode, the patient's symptoms, underlying conditions, and medication regimen. Some key points to consider when monitoring CBG frequency include:
- Patients on insulin or sulfonylureas require more vigilant monitoring 2, 3
- Recurrent hypoglycemia can occur, especially with longer-acting insulin or sulfonylureas, and because hypoglycemia can impair the body's counter-regulatory hormone response, making subsequent episodes more likely and potentially more severe 4
- Patients should be educated to recognize hypoglycemia symptoms and instructed on proper self-monitoring techniques, including when to seek medical attention 2, 1
- Continuous glucose monitoring (CGM) should be considered for all individuals with increased risk for hypoglycaemia, impaired hypoglycaemia awareness, frequent nocturnal hypoglycaemia and with history of severe hypoglycaemia 2