Self-Monitoring of Blood Glucose in Type 1 Diabetes Patients with Insufficient Metabolic Control: Focused Self-Monitoring of Blood Glucose Intervention Can Lower Glycated Hemoglobin A1C

Skeie, Svein; Kristensen, Gunn B.B.; Carlsen, Siri; Sandberg, Sverre

doi:10.1177/193229680900300109

Cited by 43 publications

(35 citation statements)

References 22 publications

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“…The magnitude of the benefit was small, with (absolute) A1C reductions in these meta-analyses ranging from 0.2% to 0.5%. These analyses demonstrated greater A1C reductions in those performing SMBG when the baseline A1C was >8% (17,35,38,42). SMBG has been demonstrated to be most effective in persons with type 2 diabetes within the first 6 months after diagnosis (43).…”

Section: Type 2 Diabetes Not Treated With Insulinmentioning

confidence: 90%

Monitoring Glycemic Control

Berard¹,

Blumer²,

Houlden³

et al. 2013

Canadian Journal of Diabetes

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Glycated hemoglobin (A1C) is a valuable indicator of treatment effectiveness and should be measured every 3 months when glycemic targets are not being met and when diabetes therapy is being adjusted. Awareness of both measures of glycemia, self-monitoring of blood glucose (SMBG) results and A1C, provide the best information to assess glycemic control. SMBG should not be viewed as an intervention but rather as an aid to assess interventions and hypoglycemia.Timing and frequency of SMBG should be determined individually based on the type of diabetes, the treatment prescribed, the need for information about blood glucose (BG) levels and the individual's capacity to use the information from testing to modify behaviours or adjust medications. SMBG and continuous glucose monitoring (CGM) should be linked with a structured educational and therapeutic program designed to facilitate behaviour change for improving BG levels.

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Section: Type 2 Diabetes Not Treated With Insulinmentioning

confidence: 90%

Monitoring Glycemic Control

Berard¹,

Blumer²,

Houlden³

et al. 2013

Canadian Journal of Diabetes

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“…[28][29][30][31] Evidence also suggests that more structured, focused SMBG intervention in suboptimally controlled patients with type 1 diabetes can provide significant improvements in HbA1c compared with regular guideline-based care. 32 Like in type 1 diabetes, the rationale for the use of SMBG in insulin-treated type 2 diabetes is compelling and is supported by data from large prospective and observational trials. 30,33,34 Similar to the Diabetes Control and Complications Trial, the Kumamoto study showed that intensive insulin therapy guided by SMBG can reduce the risk of microvascular complications compared with conventional therapy in type 2 diabetes.…”

Section: What Do the Guidelines Say On Smbg In Diabetes?mentioning

confidence: 99%

Self-Monitoring of Blood Glucose in Diabetes: From Evidence to Clinical Reality in Central and Eastern Europe—Recommendations from the International Central-Eastern European Expert Group

Czupryniak

Barkai

Bolgarska³

et al. 2014

Diabetes Technology & Therapeutics

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Self-monitoring of blood glucose (SMBG) is universally considered to be an integral part of type 1 diabetes management and crucial for optimizing the safety and efficacy of complex insulin regimens. This extends to type 2 diabetes patients on intensive insulin therapy, and there is also a growing body of evidence suggesting that structured SMBG is beneficial for all type 2 diabetes patients, regardless of therapy. However, access to SMBG can be limited in many countries in Central and Eastern Europe. A consensus group of diabetes experts from 10 countries in this region (with overlapping historical, political, and social environments)-Bulgaria, Croatia, Czech Republic, Hungary, Poland, Romania, Serbia, Slovakia, Slovenia, and Ukraine-was formed to discuss the role of SMBG across the spectrum of patients with diabetes. The group considered SMBG to be an essential tool that should be accessible to all patients with diabetes, including those with non-insulin-treated type 2 diabetes. The current article summarizes the evidence put forward by the consensus group and provides their recommendations for the appropriate use of SMBG as part of individualized patient management. The ultimate goal of these evidence-based recommendations is to help patients and providers in Central and Eastern Europe to make optimal use of SMBG in order to maximize the efficacy and safety of glucose-lowering therapies, to prevent complications, and to empower the patient to play a more active role in the management of their diabetes.

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“…', Skeie et al [41] designed the 'MEASURE' (Metabolic Effects of Accurate Blood Sugar Results and Education in Type 1 Diabetes) trial. They evaluated the effect of a simple, structured, realistic SMBG intervention on the metabolic Normal daily life At least prior to meals and snacks, occasionally postprandially, at bedtime [27] Person injecting 1-2 times/day At least 2 times a day [37] Person who alters insulin doses at mealtimes At least 4 times a day [37] Hypoglycemia To confirm hypoglycemia, every 15 min after treating low blood glucose until the euglycemia [27] Driving Before driving and at 2-hour intervals during long journeys [37] Before driving and at regular intervals for journeys of 1 h or longer in drivers who are at risk for developing hypoglycemia [52] Intercurrent control in patients with T1DM and long-standing experience in performing SMBG.…”

Section: Starting/changing Therapymentioning

confidence: 99%

Self-Monitoring in Diabetes: When and How Much?

Pintaudi¹,

Nicolucci²

2014

Frontiers in Diabetes

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Self-monitoring of blood glucose (SMBG) is an integral component of diabetes care for patients with type 1 diabetes mellitus (T1DM). It is an essential tool for the improvement of glycemic control and to increase patient empowerment and adherence to treatment. The standard recommended frequency of SMBG in T1DM is 3-4 times daily, even though many patients might require more frequent monitoring in special conditions. The frequency of testing should be agreed upon by the patients and their healthcare teams. As a general rule, more blood glucose tests are needed as the therapy becomes more intensive. People using insulin pump therapy should perform SMBG at least 4-6 times daily, and especially during establishment of pump therapy. To confirm hypoglycemia, patients must perform SMBG and repeat it every 15 min until euglycemia. Patients undergoing frequent asymptomatic hypoglycemia should perform SMBG more often. During intercurrent illness, patients need to monitor their blood glucose levels at least every 4 h, or every 2 h when blood glucose levels keep rising, to avoid diabetic ketoacidosis. With physical activity, patients should perform SMBG before, during, and after exercise. While driving, SMBG should be performed before leaving and at 2-hour intervals during long journeys. The issue of SMBG in women with T1DM deserves specific attention, especially during the menstrual period, preconception time, pregnancy (at least 7 tests/day), and breastfeeding.Between 1964 and 1967, a new method for measuring glucose, Dextrostix, was introduced. Based on finger puncture with a lancet or with an injection needle, these strips extemporaneously determined capillary blood glucose, and provided an alternative for the sticks that determined urinary glucose. The test was performed by putting a thick drop of blood on the stick, washing it under water for the elimination of other blood constituents, and then comparing it, after 1 min of reaction, with a color scale ranging from light yellow to darker colors, depending on the amount of glu-

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Self-Monitoring of Blood Glucose in Type 1 Diabetes Patients with Insufficient Metabolic Control: Focused Self-Monitoring of Blood Glucose Intervention Can Lower Glycated Hemoglobin A1C

Cited by 43 publications

References 22 publications

Monitoring Glycemic Control

Monitoring Glycemic Control

Self-Monitoring of Blood Glucose in Diabetes: From Evidence to Clinical Reality in Central and Eastern Europe—Recommendations from the International Central-Eastern European Expert Group

Self-Monitoring in Diabetes: When and How Much?

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