Self-Monitoring of Blood Glucose as Part of the Integral Care of Type 2 Diabetes

• Published in: Diabetes care Vol. 32; no. suppl 2; pp. S205 - S210
• Main Authors: Boutati, Eleni I, Raptis, Sotirios A
• Format: Journal Article
• Language: English
• Published: United States American Diabetes Association 01-11-2009
• Subjects: Blood Glucose Self-Monitoring - economics; Blood Glucose Self-Monitoring - methods; Blood sugar; Care and treatment; Clinical Trials as Topic; Control; Diabetes; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - psychology; Diabetes Mellitus, Type 2 - therapy; Diabetes Progression, Prevention, and Treatment; Disease management; Glucose; Glucose monitors; Glycated Hemoglobin - metabolism; Glycemic index; Health aspects; Homeostasis; Humans; Multicenter Studies as Topic; Patient Education as Topic; Patient Satisfaction; Reproducibility of Results; Type 2 diabetes; Greece
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/dc09-S312

Results from landmark diabetes studies have established A1C as the gold standard for assessing long-term glycemic control. However, A1C does not provide "real-time" information about individual hyperglycemic or hypoglycemic excursions. Real-time information provided by self-monitoring of blood glucose (SMBG) represents an important adjunct to A1C, because it can differentiate fasting, preprandial, and postprandial hyperglycemia; detect glycemic excursions; identify hypoglycemia; and provide immediate feedback about the effect of food choices, physical activity, and medication on glycemic control. The importance of SMBG is widely appreciated and recommended as a core component of management in patients with type 1 or insulin-treated type 2 diabetes, as well as in diabetic pregnancy, for both women with pregestational type 1 and gestational diabetes. Nevertheless, SMBG in management of non-insulin-treated type 2 diabetic patients continues to be debated. Results from clinical trials are inconclusive, and reviews fail to reach an agreement, mainly because of methodological problems. Carefully designed large-scale studies on diverse patient populations with type 2 diabetes with the follow-up period to investigate long-term effects of SMBG in patients with type 2 diabetes should be carried out to clarify how to make the best use of SMBG, in which patients, and under what conditions.