As we have seen in acute pancreatitis and postoperativelyin pancreas surgery,
there is a need to monitor blood glucose due to the potential of hyperglycaemia
and its associated complications. As part of
the APACHE score, a blood glucose level greater than
10mmol/litre is one factor that might indicate a
poor prognosis for the patient (Clark and Kumar
1998). There is nothing in the literature that describes
the rate of serum glucose growth during an acute
episode of pancreatitis. This is because there are so
many other contributing factors that impact on these
serum levels: previous diet, current nutrition status,
degree of autogenesis, previous liver disease, consciousness
levels relating to its uptake in the brain and
whether any insulin had been prescribed for the
patient. It is impossible, therefore, to prescribe a set
frequency regime; it can only be determined by the
clinical status of the patient (AARC 1994). This is also
replicated in diabetes with the condition diabetic
ketoacidosis. The British Diabetic Association (1997)
(now known as Diabetes UK), in its guidelines for
practice, advised a glucose monitoring regime of
between one and four-hourly. They also stated that
any alteration to the glucose regime must be followed
by a measurement one hour later, whereas Aronson
(1998) maintains that a six-hourly blood glucose testing
regime would be sufficient.