Self-Monitoring of Blood Glucose: An Underutilized Tool

I magine trying to bake a cake without knowing the temperature of the oven or trying to judge how much gas is left in the car's tank during a long trip without a gas gauge. Although it would not be impossible to do these tasks without the proper measurement tools, it would take much more time and you wouldn't have the information you need to solve any problems that occur. Similarly, during previous generations, people with diabetes, working only with urine testing or retrospective laboratory glucose results, had limited information on which to base day-to-day self-care decisions. The advent of self-monitoring of blood glucose (SMBG) in the late 1970s gave people with diabetes a valuable tool for self-management. No longer dependent on inconvenient laboratory diagnostics or inaccurate urine testing, patients now had accurate glucose values within minutes, using a hand-held meter and a small drop of blood. Having access to blood glucose values whenever they choose to perform the test enables patients to improve their glycemic control, preventing acute and chronic complications. The frequency for performing SMBG varies depending on the needs of each patient. Insulin-using patients (with type 1 or type 2 diabetes) are advised to perform SMBG three or more times daily.1 Most practitioners agree on the relevance of glucose monitoring in this group. There has been much controversy about the efficacy of SMBG among patients who do not use insulin. However, guidelines for these patients with type 2 diabetes are vague, and no specific frequency is recommended. When first developed, this innovation in diabetes care held such promise: it would encourage a new level of patient-provider collaboration, empower patients to become more active participants in their own care, and act as a personal guide for trouble-shooting glucose control issues related to diet, physical activity, travel, and …