Self‐monitoring of Blood Glucose

Abstract

Self‐monitoring of blood glucose (SMBG) is an essential tool in the management of diabetes. If properly used, SMBG values are employed by the patient to make immediate treatment decisions. The decisions are based on a predetermined action plan that consists of actions designed to achieve blood glucose values within a given target range. Optimal treatment of diabetes is guided by the knowledge of prevailing blood glucose levels. SMBG is an essential component of any intensive therapy program directed toward achieving meticulous glycemic control. SMBG enables therapeutic goals to be clearly defined and permits assessment of glycemic control during ordinary life, thus being complementary to glycated hemoglobin measurements. SMBG determinations are used on an ongoing basis by patients, to aid in the adjustment of the therapeutic regimen. Optimal use of SMBG requires the goals of treatment to be clearly defined and for patients to be taught proper interpretation of the data. Patients need to learn how to use the data to adjust food intake, exercise, or pharmacological therapy to achieve specific glycemic goals. SMBG is the only practical means of detecting asymptomatic hypoglycemia in the outpatient setting. SMBG may also be used to detect temporal glycemic patterns, so that therapy may be modified in an attempt to prevent hypoglycemia. A great advantage of SMBG is its use in intercurrent illness and other emergency situations, in which SMBG allows objective documentation of acute destabilization of diabetic control. Patients may be provided with a home management plan to use during illness. SMBG may be particularly important in children and adolescents who have wide day‐to‐day variations in activity. Instrumental to the use of SMBG is the choice of blood glucose targets. There should be defined blood glucose targets, individualized for the needs of each patient. Frequency of monitoring depends on the treatment program and varies considerably depending on the clinical situation. Knowledge of preprandial, bedtime, and nocturnal blood glucose concentrations is required to determine the appropriate basal and preprandial insulin doses. The best predictor of compliance with SMBG is the perception of improved control with such monitoring. Record keeping is essential to successful treatment, particularly if one is to consider the impact of previous responses. In response to blood glucose fluctuations, the patient must learn how to take appropriate action, predetermined with the diabetes management team.

Home monitoring of the diabetic cat

“…a frequent topic of discussion in human medicine. Factors with a possible effect on the results of glucose measurements include variation in haematocrit, altitude, environmental temperature and humidity, hypotension, hypoxia and triglyceride concentrations (Skyler and Cohen 1997). Overall performance of these systems depends on analytical performance of the meter, quality of the test strips and proficiency of the user.…”