Monitoring Blood Glucose Level: How It Can Help You to Manage Diabetes? These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. Every 1 percent drop in glycated hemoglobin (A1C) is associated with improved outcomes with no threshold effect. Talk about what services you provide. For patients with type 1 DM or insulin-dependent type 2 DM, clinical trials have demonstrated that SMBG plays a role in effective glycemic control because it helps to refine and adjust insulin doses by monitoring for and preventing asymptomatic hypoglycemia as well as preprandial and postprandial hyperglycemia. If blood glucose is 5 mmol/l, take carbohydrate before driving and if <4 mmol/l, don't drive. Disclaimer Statements: Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. Before exercising, test your urine for ketones substances made when your body breaks down fat for energy. Rationale 10: To obtain informed consent. quinton city ranch new mexico; waved goodbye in a sentence; Or a particular site may be contraindicated. Analytical method or technology or enzyme system used glucose-specific GDH-NAD enzyme and low applied voltage to minimize interference; -hydroxybutyrate, . Your body takes carbohydrates found in foods like grains and fruits and converts them into glucose. The USA company Genteel have developed a new lancet device that is reported to be painless and can be used successfully for blood sampling in a variety of sites. Rochester Ny Police Incident Report, how to fast forward on samsung smart tv remote, GoogleCookieCookie, johnson funeral home anderson sc obituaries, new construction homes under $200k in georgia, Truly Anti Cellulite Serum Before And After, how does walker think we should approach fear quizlet, how much is a membership at odessa country club, unlimited vacation club membership levels. A blood glucose monitoring system may consist of a blood glucose meter, lancing device, controls and test strips. Oral glucose tolerance test. Assess adherence to infection control recommendations for blood glucose monitoring and insulin administration by periodically observing staff who perform or assist with these procedures and tracking use of supplies. Rationale 16: To prevent damage to underlying structures, e.g. Rhetorical Appeals Analysis, While this collection method has been in use for many years, especially for blood glucose testing, transmission of hepatitis B virus from infected blood and accidental injuries is on the rise as the number of tests performed involving . Physical activity recommendations and precautions may vary by diabetes type. Provide staff members who assume responsibilities for fingersticks and injections with infection control training. This is a test system for use at home or in health care settings to measure the amount of sugar (glucose) in your blood. Sviatoslav Richter Best Recordings, They must be calibrated with traditional fingerstick tests. Various blood tests can detect diabetes, vitamin deficiencies, liver or kidney dysfunction, other metabolic disorders, infections and signs of abnormal immune system activity. Severe orthopedic conditions, acute thyroiditis, elevated or low potassium levels, uncontrolled diabetes, blood pressure greater than 200 systolic or 110 diastolic, an orthostatic hypotension, recent blood clot, acute illness, fever or dehydration. Quale JM, Landman D, Wallace B, Atwood E, Ditore V, Frucher G. Deja vu: nosocomial hepatitis B virus transmission and fingerstick monitoring. A typical system consists of a glucose sensor placed subcutaneously, a non-implanted transmitter, and a receiver worn like a pager, which records blood glucose levels at frequent intervals and monitors trends. Figure 9.8 Homeostatic Regulation of Blood Glucose Levels. JAGS2010;58:914-918. The primary types of diabetes are type 1 and type 2. Jordan Graham Obituary 2021, Change gloves that have touched potentially blood-contaminated objects or fingerstick wounds before touching clean surfaces. The products label will include warnings about these limitations. Of course, if you have type 1 diabetes, your daily routine will include insulin injections. CBG - Capillary Blood Glucose. They found that people who test their blood sugar levels four times a day like the idea of using alternative site testing approaches. Diabetes Awareness Month: Why is it so important to take your diabetes medication? Glucometers This Hazard Summary addresses portable Blood Glucose Monitors (BGMs) that are used by diabetic patients to self-monitor glucose levels. Self-Monitoring of Blood Glucose Use of SMBG is an effective method to evaluate short-term glycemic control. Infection Prevention and Control Guidelines For Blood Glucose Monitoring In Care Homes Version 1.0 2 Introduction Routine diabetes care involves monitoring blood glucose levels by taking a sample of capillary blood with a fingerprick lancing device and testing it with a glucometer. This destruction of red blood cells is called . What are the contraindications, warnings, and precautions for insulin? In addition to the benefits mentioned earlier, such as better mood, higher quality sleep, and improving cardiovascular risk factors, patients with type 2 diabetes also experience better control of blood glucose and modest weight loss, two factors that can help reverse the . Performance of the System when used with other implanted medical devices, such as pacemakers, has not been evaluated. Lower than 100 mg/dL (5.6 mmol/L). limit aluminum to <4 mcg/kg/day. You are here: swimming alliteration; tigerbait com lsu football recruiting news forums; name four site specific contraindications for blood glucose testing . The main brand is called the FreeStyle Libre. Text Size: A symptom, condition, or trait that interferes with a given drug or treatment in a dangerous or counterproductive way. Took augmentin for cold, light fever, sinus infection, tooth pain. This condition should be treated with . The doctor tests your blood sugar levels after fasting for 8 hours and it's higher than 126 mg/dL. If group 2 license holder and taking non-insulin medications which may cause hypoglycaemia, test blood glucose at least twice daily (including non driving days) and at times relevant to driving. A blood glucose test is a blood test that mainly screens for diabetes by measuring the level of glucose (sugar) in your blood. The FreeStyle Libre Flash Glucose Monitoring system is a continuous glucose monitoring (CGM) device indicated for replacing blood glucose testing and detecting trends and tracking patterns aiding in the detection of episodes of hyperglycemia and hypoglycemia, facilitating both acute and long-term therapy adjustments in persons (age 18 and older . Hypoglycemia (low blood sugar) Hypersensitivity to insulin or its excipients (inactive co-ingredients) . You will be subject to the destination website's privacy policy when you follow the link. The Wheel Of Fortune Macbeth, Rationale 3: Children with Hyperinsulinism should not have blood glucose of less than 3.5mmol/L without intervention as are unable to produce alternative fuel sources such as ketones and are therefore at high risk of brain damage ( Hussain et al 2007 ). Hazards: Recent FDA and manufacturers notifications and recalls of these devices have proven that there are associated vulnerabilities in the use of glucometers. Polish LB, Shapiro CN, Bauer F, Klotz P, Ginier P, Roberto RR, Margolis HS, Alter MJ. You can also review Medicare resources at www.medicare.gov or by calling 1-800-MEDICARE (1-800-633-4227). For example, if drug A interacts with drug B, the labeling for drug A will list drug B as a contraindication. They should never be used for more than one person. A lower level of 3.0mmol/L ( Campbell 2008 ) may be accepted for children with other conditions before intervention but the named consultant for individual patients must direct this. Due to under-reporting and under recognition of acute infection, the number of outbreaks due to unsafe diabetes care practices identified to date are likely an underestimate. Sixth International Conference on Emerging Infectious Diseases. Some blood glucose meter test strips are calibrated to give results that are comparable with laboratory glucose results and these are termed 'plasma calibrated'. For example, the dietary supplement glucosamine, which is reported to ease the symptoms of osteoarthritis, may be contraindicated in people with diabetes because it has been shown to increase insulin resistance , which can raise blood glucose levels. Khan AJ, Cotter SM, Schulz B, et al. CDC is alerting all persons who assist others with blood glucose monitoring and/or insulin administration of the following infection control requirements: Monitoring of blood glucose levels is frequently performed to guide therapy for persons with diabetes. All of these treatments need to be tempered based on individual factors, such as age, life expectancy, and comorbidities. the cgm group within the working group diabetes technology (agdt) of the german diabetes association (ddg) has defined evidence-based indications for the practical use of cgm in this consensus statement related to hypoglycemia (frequent, severe, or nocturnal) or hypoglycemia unawareness, insufficient metabolic control despite use of all possible Lowering this number is one of the ways that you and your doctors know that you are keeping your diabetes well managed. 250 mg/dL (13.9 mmol/L) or higher. Please let us know. The oral glucose tolerance test (OGTT) is one method of evaluating an individual's apparent insulin sensitivity and insulin resistance. Talk to your doctor about any activities you're contemplating, the best time to exercise and the potential impact of medications on your blood sugar as you become more active. An A1C test is a blood test that reflects your average blood glucose levels over the past 3 months. Change gloves between patient contacts. Hepatic (liver) impairment may reduce the insulin requirement. Correct interpretation is critical. Jul 2, 2022 . Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. Consider these general guidelines relative to your blood sugar level measured in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L). It is also important that you determine the patients understanding of the procedure and the purpose for monitoring blood glucose level. Illness, emotional disturbance, or other stress may alter the insulin requirement. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. It is designed to replace blood glucose testing for diabetes treatment decisions. Appalachian Trail Water Sources Map, A recent view of the prescribing information for 1368 prescription drugs found that 134 (9.8%) included information about a specific lab test interaction, 31 (2.3%) stated . While this collection method has been in use for many years, especially for blood glucose testing, transmission of hepatitis B virus from infected blood and accidental injuries is on the rise as the number of tests performed involving . Counard CC, Perz JF, Linchancgo PC, et al. Plasma calibrated test strips give results that are approximately 12% higher than whole blood results. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. West Creek Houses For Sale, For more information regarding bloodborne pathogen transmission associated with unsafe practices during assisted monitoring of blood glucose, consult the following resources. As with any clinical procedure, ensure that you understand the patients condition, the reason for the test, and the possible outcomes of the procedure. hemoglobin can bind to sugar in your blood, which is known as blood glucose. J Diabetes Sci Technology 2011;5(6): 1307-1311, Klonoff DC, Perz JF. Perform hand hygiene immediately after removal of gloves and before touching other medical supplies intended for use on other persons. When performing blood glucose monitoring staff should be trained in both the theoretical and practical aspects including the use of the device and instruction on calibration of quality control. While bolus (rapid- or short-acting) insulin helps to manage blood glucose at meals. 1 glucose gel tube (15 grams per gel tube), or. Infection Prevention and Control Guidelines For Blood Glucose Monitoring In Care Homes Version 1.0 2 Introduction Routine diabetes care involves monitoring blood glucose levels by taking a sample of capillary blood with a fingerprick lancing device and testing it with a glucometer. name four site specific contraindications for blood glucose testingstaysure customer service twilight fanfiction edward likes bella but is mean to her. The System is not approved for use in pregnant women or persons on dialysis and has not been evaluated in these populations. In primary hyperparathyroidism, one or more of the parathyroid . Aside from exercise testing, there are contraindications to program participation 1. Centers for Disease Control and Prevention. Anonymous genetic report with no identifiable or unique information that could be used to identify a patient. Why is My Blood Sugar High After Exercise? contraindications: the GTT should not be done if the patient is ill, is known to have diabetes mellitus, or has symptoms suggestive of diabetes mellitus (e.g. Dont Do It: Sharing Insulin Pens Jeopardizes Patients [ 3:26 ]external icon The effect of MRI, CT scans, or diathermy on the performance of the System has not been evaluated. Age restrictions apply depending on pump model. best life and beyond katie and spencer. Glyburide Tablets, USP contain glyburide, USP, which is an oral blood-glucose-lowering drug of the sulfonylurea class. To use most blood glucose meters, you first insert a test strip into the device. Therefore, the diabetes team as well as the patients should be well informed about limitations in blood glucose testing. An A1C level of 6.5% or higher on two separate tests indicates diabetes. Additionally, at a hospital in Texas in 2009, more than 2,000 persons were notified and recommended to undergo testing for bloodborne viruses after individual insulin pens were used for multiple persons. 1. Renal (kidney) dysfunction may reduce the insulin requirement. Knowing the onset, peak, and duration of insulin is critical to helping the patient to maintain normoglycemic levels. To speak with a Medtronic teammate who specializes in Medicare, call 1-877-585-0158 on Monday-Friday, 8 AM-6 PM Central Time. They lower blood pressure by preventing a hormone called norepinephrine from tightening the muscles in the walls of smaller arteries and veins. The common belief, presently held by many endocrinologists, is that test blood, drawn from the fingertips, gives a more current and accurate indication of blood glucose than blood drawn from alternate sites, such as the forearm, shoulder and stomach. Between 2 and 10 percent of expectant mothers develop this condition, making it one . For most people, this is a safe pre-exercise blood sugar range. Rationale 19: Alcohol toughens the skin when used frequently. Continue reading >>, Hazard Summary for Blood Glucose Meters (BGMs) a.k.a. They are indicated for individuals with diabetes mellitus type 1 or 2. Glucose testing is primarily done to diagnose or manage type 1 diabetes, type 2 diabetes, and gestational diabetes. Have you ever felt like no matter how much water or juice you drink, it just isnt enough? CGM systems monitor interstitial fluid glucose levels. Figure 9.8 Homeostatic Regulation of Blood Glucose Levels. Taking a blood sugar test can help determine your blood Physical activity recommendations and precautions may vary by diabetes type. The results of genetic testing for cancer markers in a healthy person. No. Glynase PresTab Tablets contain micronized (smaller particle size) glyburide, which is an oral blood-glucose-lowering drug of the sulfonylurea class. Glucose-6-phosphate dehydrogenase deficiency is a genetic disorder that affects red blood cells, which carry oxygen from the lungs to tissues throughout the body. Insulin sliding scales (doses of insulin that are based on the glucose level ) may be used for managing critically ill hospitalized patients. Type 2 diabetes can be described as a syndrome characterized by insulin deficiency, insulin resistance and increased hepatic glucose output. If blood glucose meters must be shared, the device should be cleaned and disinfected after every use, per manufacturers instructions, to prevent carry-over of blood and infectious agents. However, they also found that testing on their palm with. 100 to 250 mg/dL (5.6 to 13.9 mmol/L). The test most commonly involves pricking a finger with a lancet device to obtain a small blood sample, applying a drop of blood onto a reagent strip, and determining the glucose concentration by inserting the strip into a reflectance photometer for an automated reading. CONTRAINDICATIONS Glyburide tablets are contraindicated in patients with: Known hypersensitivity or allergy to the drug. Blood glucose monitors are devices that measure blood glucose levels electronically. After this test . For most people, this is a safe pre-exercise Outbreaks of hepatitis B in care homes have been attributed to Glyburide Tablets are indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. If blood glucose is 5 mmol/l, take carbohydrate before driving and if <4 mmol/l, don't drive. Relative contraindications include the following: Severe coagulopathy. The main reason for a lumbar puncture is to help diagnose diseases of the central nervous system, including the brain and spine.Examples of these conditions include meningitis and subarachnoid . Figure 9.8 Homeostatic Regulation of Blood Glucose Levels. Capillary blood collection involves puncturing the dermis layer of the skin to access the capillary beds that run through the subcutaneous layer of the skin. If blood glucose concentration rises above this range, insulin is released, which stimulates body cells to remove glucose from the blood. Once blood is drawn, the healthcare provider may apply pressure to the puncture site with a cotton swab. Continue reading >>, Rationale 1: To achieve an accurate reading. Never reuse lancets. For example, phone #: 123-333-4567. For example, is the patient fasting? Record results on a memory meter (~ 3 months). Protection from bloodborne viruses and other infections is a basic requirement and expectation anywhere healthcare is provided. Before exercise: Check your blood sugar before your workout Before jumping into a fitness program, get your doctor's OK to exercise especially if you've been inactive. Outbreaks of hepatitis B virus (HBV) infection associated with blood glucose monitoring have been identified with increasing regularity, particularly in long-term care settings, such as nursing homes and assisted living facilities, where residents often require assistance with monitoring of blood glucose levels and/or insulin administration. Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. To date, only one randomized clinical trial has demonstrated a ben Analytical method or technology or enzyme system used glucose-specific GDH-NAD enzyme and low applied voltage to minimize interference; -hydroxybutyrate, . What Is It Called When Your Blood Sugar Is Too Low? With a basal-bolus regimen, you may have four or more injections per day. Testing is used to help diagnose von Willebrand disease (VWD) and distinguish between the various types of VWD. International Chat Support Jobs, Blood sugar tests provide instant results and let you know the following: your diet or exercise routine needs to change your diabetes medications or treatment is working your blood sugar levels are high or low your overall treatment goals for diabetes are manageable Your doctor may also order a blood sugar test as part of a routine checkup. Leonard Roberts Husband, Av. An underappreciated risk of blood glucose testing is the opportunity for exposure to bloodborne viruses (HBV, hepatitis C virus, and HIV) through contaminated equipment and supplies if devices used for testing and/or insulin administration (e.g., blood glucose meters, fingerstick devices, insulin pens) are shared. abdominal . Then with a special needle, you poke a clean fingertip to get a drop of blood. The goal of SMBG is to collect detailed information about blood . Other glucose-elevating agents are diazoxide (Proglycem) and glucagon. As a medication, insulin is any pharmaceutical preparation of the protein hormone insulin that is used to treat high blood glucose. Inactive ingredients: colloidal silicon dioxide, corn . Read on to learn more about blood sugar tests, who they are for, and what the results mean. Relative contraindications include the following: Severe coagulopathy. Use the lancing device to pierce the side of your finger, next to the fingernail (or another recommended location). Primary hyperparathyroidism is a disorder of the parathyroid glands, four pea-sized glands located on or near the thyroid gland in the neck. The System is not approved for use in people under 18 years of age and Sensor readings in this population may be inaccurate. Relative contraindications include the following: Severe coagulopathy. A continuous blood glucose monitor (CGM) assesses blood glucose levels on a near-continuous basis. A neurological exam includes tests that may identify the cause of the neuropathic disorder as well as the extent and type of nerve damage. Rationale 18: To prevent pain and tissue damage ( Naughten 2005 ). Turn on the glucometer. N Engl J Med1992;326(11):7215. For example, if drug A interacts with drug B, the labeling for drug A will list drug B as a contraindication. Hypersensitivity to insulin or its excipients (inactive co-ingredients) Hypoglycemia may occur and is the most common side effect of insulin treatment. To exercise safely, it's crucial to track your blood sugar before, during and after physical activity. What Should Your Blood Sugar Level Be First Thing In The Morning? Coverage includes all Medicare patients with diabetes who use insulin and who meet the eligibility criteria2. Home; Mine; Mala Menu Toggle. Diabetes is a condition that causes your blood glucose levels to rise.. Notes from the Field: Deaths from Acute Hepatitis B Virus Infection Associated with Assisted Blood Glucose Monitoring in an Assisted-Living Facility North Carolina, August-October 2010. The System detects trends and tracks patterns aiding in the detection of episodes of hyperglycemia and hypoglycemia, facilitating both acute and long-term therapy adjustments. Rationale 7: To avoid blood glucose levels rebounding above and below normal levels as a result of change to rates and subsequently a rapid change to glucose administration. Establish responsibility for oversight of infection control activities. The primary types of diabetes are type 1 and type 2. Check your blood sugar. They help us to know which pages are the most and least popular and see how visitors move around the site. Introduction Blood Glucose is performed to provide an indication on how the body is controlling glucose metabolism. Anonymous genetic report with no identifiable or unique information that could be used to identify a patient. For the best health benefits, experts recommend at least 150 minutes a week of moderately intense physical activities such as: Fast walking Lap swimming Bicycling If you're taking insulin or medications that can cause low blood sugar (hypoglycemia), test your blood sugar 30 minutes before exercising. Outbreaks of hepatitis B in care homes have been attributed to 2010 Mar. This is a blood sugar test without a needle. If blood glucose is 5 mmol/l, take carbohydrate before driving and if <4 mmol/l, don't drive. This adds an extra layer of safety for the patient and the provider. If shared, blood glucose meters should be cleaned and disinfected after every use. Get Permissions. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. Before you begin, you should also determine if there are any conditions present that could affect the reading. Prior to performing a blood glucose test, ensure that you have read and understood the manufacturers instructions and your agencys policy for the blood glucose monitoring machines (see Figure 9.1) used in your clinical setting, as these vary. Side effect? The common belief, presently held by many endocrinologists, is that test blood, drawn from the fingertips, gives a more current and accurate indication of blood glucose than blood drawn from alternate sites, such as the forearm, shoulder and stomach. Inactive ingredients: microcrystalline cellulose . Cost is greatly reduced for the care and treatment of diabetic patients for all parties involved: the patient, the healthcare facility, insurance providers and the physician. A melhor frmula do mercado name four site specific contraindications for blood glucose testing A continuous blood glucose monitor (CGM) assesses blood glucose levels on a near-continuous basis. SMBG works by having patients perform a number of glucose tests each day or each week. A National Effort to Prevent Type 2 Diabetes: Participant-Level Evaluation of CDCs National Diabetes Prevention Program, November is National Diabetes Awareness Month, Diabetes and Sleep Apnea: How Sleep Affects Blood Glucose and Diabetes, New Skin Patch Monitors Glucose and Delivers Diabetes Drugs, Diabetes monitors are getting closer to their iPhone moment. 1. Type 1 diabetes (5%-10% of cases) results from cellular-mediated autoimmune destruction of the pancreatic -cells, producing insulin deficiency ().Although it can occur at any age, -cell destruction rates vary, typically occurring more rapidly in youth than in . Glycemic Control Two primary techniques are available to assess a patient's glycemic control: Self-monitoring of blood glucose (SMBG) and interval measurement of hemoglobin A1c (HbA1c). ACM, Edf. high levels of ketones in the urine. Assisted Monitoring of Blood Glucose: Special Safety Needs for a New Paradigm in Testing Glucose, Eliminating the Blood: Ongoing Outbreaks of Hepatitis B Virus Infection and the Need for Innovative Glucose Monitoring Techniques. Record results on a memory meter (~ 3 months). Infect Control Hosp Epidemiol2002;23:313-318. Your risk for diabetes increases if any of the following factors are true: you are 45 years old or older you are overweight you dont exercise much you have high blood pressure, high triglycerides, or low good cholesterol levels (HDL) you have a history of gestational diabetes or giving birth to a baby who weighed over 9 pounds you have a history if insulin resistance you are Asian, African, Hispanic, Pacific Islander, or Native American you have a family history of diabetes Checking your blood sugar levels can be done at home or at a doctors office. The Centers for Disease Control and Prevention (CDC) has become increasingly concerned about the risks for transmitting hepatitis B virus (HBV) and other infectious diseases during assisted blood glucose (blood sugar) monitoring and insulin administration. The aim of this publication is to review the current knowledge on limitations and interferences in blood glucose testing with the perspective of their clinical relevance. Diabetes Technol Ther . To protect yourself, you should be sure that all your doctors know about your diabetes, any other medical conditions you may have, and any drugs that you are taking. Review regularly individual schedules for persons requiring assistance with blood glucose monitoring and/or insulin administration. the cgm group within the working group diabetes technology (agdt) of the german diabetes association (ddg) has defined evidence-based indications for the practical use of cgm in this consensus statement related to hypoglycemia (frequent, severe, or nocturnal) or hypoglycemia unawareness, insufficient metabolic control despite use of all possible "Primary" means this disorder begins in the parathyroid glands, rather than resulting from another health problem such as kidney failure. It is usually the responsibility of the nurse to perform blood glucose readings. The fasting blood glucose (sugar) test is used to detect diabetes. The System is not approved for use in these patients. limit aluminum to <4 mcg/kg/day. Saving Lives, Protecting People, Dont Do It: Sharing Insulin Pens Jeopardizes Patients [ 3:26 ], CDCs Diabetes and Viral Hepatitis: Important Information on Glucose Monitoring, FDA: Information for Healthcare Professionals: Risk of Transmission of Blood-borne Pathogens from Shared Use of Insulin Pens, FDA Communication: Guidance for Industry and Food and Drug Administration Staff Blood Lancet Labeling, FDA Communication: Letter for Manufacturers of Blood Glucose Monitoring Systems Listed with the FDA [PDF 39 KB], FDA Communication: Use of Fingerstick Devices on More than One Person Poses Risk for Transmitting Bloodborne Pathogens, FDA Patient Safety News: Preventing Bloodborne Infections When Using Fingerstick Device (YouTube Video), Nosocomial hepatitis B virus associated with spring-loaded fingerstick blood sampling devices Ohio and New York City, 1996, Notes from the Field: Deaths from Acute Hepatitis B Virus Infection Associated with Assisted Blood Glucose Monitoring in an Assisted-Living Facility North Carolina, August-October 2010, Transmission of hepatitis B virus among persons undergoing blood glucose monitoring in long-term-care facilitiesMississippi, North Carolina, and Los Angeles County, California, 2003-2004.