NON-INSULIN USING TYPE 2 DIABETES: Decision Tool for Self-Monitoring of Blood Glucose (SMBG)

The Diabetes Care Program of Nova Scotia is pleased to launch a Decision Tool for health care providers (February 2011). This one-page tool titled “NON-INSULIN USING TYPE 2 DIABETES: Decision Tool for Self-Monitoring of Blood Glucose (SMBG),” has been developed to address the need for a more consistent approach to the prescribing and practice of SMBG among and between the different health care provider groups (physicians, pharmacists, diabetes educators, and others). This tool guides, and focuses, group discussion and individual decision on issues of greatest concern when considering SMBG. Four key areas of consideration include safety (risks of hyper- or hypoglycemia); appropriate/timely action based on SMBG results by the Health Care Team (HCT); the individual’s knowledge, skills, and willingness to test, record, and act on results; and self-management education.

This simple tool is color coded to reinforce key concepts, prompts yes/no responses to key questions, and ensures consideration is given to issues that may impact the decision to SMBG. Examples of low and high intensity testing are provided.

Two videos have been produced to support the dissemination and uptake of the Decision Tool.

SMBG Decision Tool for Health Care Providers (~10 minutes) provides rationale for the decision tool (considering available evidence and local considerations) with the help of key opinion leaders (an endocrinologist, internist, psychologist, pharmacist, and diabetes nurse educator).

Use of the SMBG Decision Tool and Case Studies (~15 minutes) offers an introduction to the tool and its application in practice. It introduces the features of the tool, works through a sample case, provides summary caveats and principles to guide future application of the tool, and leaves three cases for the viewers to work through on their own.

  DCPNS Patient & Provider Foot Care Resources

	Foot Care Questionnaire
	Foot Risk Assessment Form (colour, black and white)
	Risk Stratification Form

	Referral Algorithm
	Patient Risk Information Sheets (Low, Moderate, High)
	Patient Foot Care Path

DCPNS Foot Risk Assessment Form Guide

These Diabetic Foot Care Resources are part of a province-wide initiative to address the growing burden of diabetic foot problems and related lower extremity amputations in Nova Scotia. Use of these forms will result in an increased awareness of the diabetic foot, early detection of foot problems, and timely referral to the right foot care provider so the right treatment/management can be provided.

DCPNS is promoting and anticipating uptake of these forms by a variety of foot care providers across multiple health care sectors. This will ensure consistent messaging around foot care to individuals with diabetes and among foot care providers; so please share this information.

The DCPNS would like to thank everyone who has contributed in any way to the development/revision of these forms. Your valuable input was vital to the successful outcome of these foot care resources.

DCPNS Spring Workshop 2009

Program

Provincial Workshop 2008

Program

The Diabetes in Children & Adolescents Management Guidelines Manual, 2nd edition (Under Revision)
Prepared by The Diabetes in Children and Adolescents Subcommittee
Revised July 2003 (view/download)

The Pregnancy and Diabetes Management Guidelines Manual, 2nd edition (Under Revision)
Written by The Pregnancy and Diabetes Subcommittee
Revised March 2000 (view/download)
Revised sections (free for download):

	Management
	Insulin
	Screening

Preventing Type 2 Diabetes in Families at Risk

Interpreting and Acting on Estimated Creatinine Clearance (CrCl) Using the Cockcroft-Gault Formula

The Diabetic Foot in Nova Scotia: Challenges and Opportunities (new March 2008)
 

Standardized Documentation Forms Used by Diabetes Centres in Nova Scotia
Adult Diabetes Population:

	Prediabetes Initial Assessment
	Initial Assessment
	Education Checklist
	Flow Sheet
	Medication Sheet Client Self-Assessment Prediabetes Self-Assessment Diabetes Self-Assessment Medication Sheet

Pediatric Diabetes Population:

	Pediatric Assessment Newly Diagnosed
	Pediatric Assessment Not Newly Diagnosed New Referral
	Pediatric Assessment Follow-Up
	Pediatric Education Checklist
	Pediatric Flow Sheet

Pregnancy Diabetes Population:

	Pregnancy Initial Assessment
	Pregnancy Education Checklist

All Populations:

	Physician Referral Form
	Meal Plan Sheet
	Continuous Subcutaneous Insulin Infusion (CSII) Education Checklist
	Re-Referral Form

To view patient education material, click here.