Prescribing Notes

Diagnostic tests and appliances

Urinalysis, which obtains an approximate and delayed estimation of blood glucose, is often adequate in the management of stable type II diabetic patients. However, blood glucose monitoring may be more appropriate where precise control of glucose levels is essential (eg type I diabetes, pregnancy, renal problems or frequent hypoglycaemic episodes) or where urinary glucose testing would give misleading results (eg abnormal renal glucose thresholds). Regular blood glucose monitoring can assist in the formulation and management of individual patient regimes to achieve tight glucose control (4-7 mmol/l) which in turn reduces the risk of diabetic complications.

Blood and urine test strips work on the same principle, the colour reaction being proportional to the amount of glucose present. The tests can be interpreted visually by comparison with a colour chart or, in the case of most blood-glucose tests, read in a meter. Audio-glucose meters are available for the blind or partially sighted. Meters are not available at NHS expense.

Blood ketone testing is recommended in patients with severe hyperglycaemia or symptoms of ketoacidosis.
Pads that detect sudomotor dysfunction (lack of sweating) can be used to screen for diabetic neuropathy.