Diabetes Guidelines Europe Diet Insulin Control Hypoglycaemia Lipids Type 1 Sections 9-14

If Median blood glucose >7.0 mmol/l ( >125 mg/dl )or median pre-prandial 5.0-7.0 mmol/l ( 90-125 mg/dl ) and 80% 4.0-8.0 mmol/l ( 70-145 mg/dl ) or median post prandial >10.0 mmol/l ( >180 mg/dl ) ( 1.5-2.0 h after meal )Yes?Hypoglycaemia ( symptoms or measured )YesNo change. Review diet and reasonsOrSome tests &LT;4.0 mmol/l ( <70 mg/dl )for hypoglycaemia No ?Stress / illness ( transient hyperglycaemia )YesNo changeNo ( treat acutely if indicated ) IfPre-breakfast hyperglycaemia, andNo change; review diet and evening 0200 h glucose <6.0 mmol/l ( <110 mg/dl )unmodified insulinIfPre-breakfast hyperglycaemia, andIncrease night-time NPH insulin 0200 h glucose >=6.0 mmol/l ( >=110 mg/dl ) IfMorning, or afternoon, or eveningIncrease relevant unmodified insulin hyperglycaemia If0200 h hyperglycaemia, andNo change bed-time <7.0 mmol/l ( <125 mg/dl ) If0200 h hyperglycaemia, andIncrease evening unmodified insulin bed-time >=7.0 mmol/l ( >=125 mg/dl )