DESCRIPTION

• Self monitoring of blood glucose (SMBG) allows patients to evaluate their individual response to therapy and assess whether glycemic targets are being achieved.
• The American Diabetes Association recommends SMBG in people with diabetes on intensive management prior to meals and snacks, at bedtime, occasionally postprandially, prior to exercise, when they suspect low blood glucose, after treating low blood glucose until they are normoglycemic, and prior to critical tasks such as driving. [1] The patient’s specific needs and goals should dictate SMBG frequency and timing.
• Integrating SMBG results into diabetes management can be a useful tool for guiding medical nutrition therapy and physical activity, preventing hypoglycemia, and adjusting medications (particularly prandial insulin doses). SMBG has been shown to improve the efficacy and safety of diabetes therapy and improve A1C in type 1 diabetes and gestational diabetes.[3]
• Factors to consider when choosing a glucose meter include: ease of use, cost, insurance coverage and availability of strips and lancets, display screen, need for “speaking” (audio capability) meter for low visual acuity, memory capacity, download capability to computer or cloud, and dexterity issues.
• Several meters are available and most come with a lancing device. Lancets vary in size with 33 gauge the smallest. The smallest recommended for alternate site (not the fingers) is 28 gauge. Smaller lancet usually means less discomfort. The smaller the number of the gauge, the larger the lancet. The lancing device improves the ease of obtaining a blood sample from the finger or alternate site.
• Most meters for SMBG are simple and can provide a glucose reading within 5 seconds. Previously, glucose meters needed manual coding to match strips to the meter, but most newer meters perform this coding automatically.
• Glucose monitors can have the feature that allows collected data to be downloaded to computer software. This can be viewed and sometimes printed to help note patterns in glucose readings and assist with medication adjustment.
• Many insulin pumps are compatible with a particular meter and automatically relay the result of the glucose testing to the pump to avoid having to manually enter the glucose reading. For example, the Omnipod insulin pump uses Freestyle Lite test strips for a meter in the pump’s control device.
• SMBG should be prescribed with instruction and evaluation of SMBG technique, SMBG results, and their ability to use SMBG data to adjust therapy.[1]