Here at Henry Ford Cardiac Rehab here is our policy:
For patients with NIDDM who are controlled by oral agents or diet discontinue BG monitoring after three sessions if pre/post exercise values are stable(between 70-250 mg/dl.
For all patients taking insulin, BG testing will take place the first three sessions as long as the pre/post exercise values are above 100mg/dl and below 250 mg/dl
Patients that have three consecutive BG reading of above 300 ml/dl will be allowed to exercise however their physician that monitors the BS ( endocrinologist or PCP) will be notified.
Exercise session will be held when BG is greater than 400 mg/dl and physician will be contacted for recommendations regarding treatment.
All IDDM patients with BG below 100 mg/dl will be treated with juice/crackers or glucose gel (depends on value and or symptoms)
Here at UNC Cardiac Rehab, we measure pre/post exercise blood glucose levels on all of our TIDM and T2DM patients. We do this for the first 3 exercise sessions regardless of what medications they are taking. If we have concerns from those first 3 readings, we may continue checking their glucoses if needed.
As per parameters, there is some gray area. Generally, if they are bellow 100 mg/dL we will have them consume CHO until it is above 100 mg/dL. If values are above 350 mg/dL, we will not allow them to exercise.
I hope this helps!
We're trying to make our procedure more time efficient.
How do you manage BG testing in cardiac rehab in patients with type 2 diabetes? Do you test all regardless of what med they take? How often do you test? What are your parameters?