Self-monitoring of blood glucose in Diabetes. Self-monitoring of Blood Glucose (SMBG) is one of the most effective methods to assess diabetic control and plan an optimal treatment regime as well as dietary and lifestyle modifications to achieve perfect glycaemia.
Self- monitoring is done by pricking the fingertip to collect a drop of blood, which is then placed on a test strip. The strip is then inserted into an electronic glucose monitor, which then displays the blood sugar reading on its screen. SBMG can be performed anywhere- at home or at the workplace.
Ideally all diabetic patients should regularly self-monitor their blood sugar levels. These include patients on insulin therapy specially those who are on multiple dose regimes, patients with wide fluctuations in their blood sugar levels and those prone to recurrent or severe hypoglycaemia. Patients who are more prone to hypoglycaemia and pregnant women with gestational diabetes should have regularly SMBG.
SMBG involves the patients conducting glucose tests every day or on a weekly basis at home. The frequency of monitoring one’s blood glucose levels is different from person to person. For patients on insulin, especially type 1 diabetics, it is recommended that they should monitor their blood glucose at least four times a day, usually before meals and before going to bed. Regular monitoring of their blood glucose levels helps them to adjust their insulin regime, maintain normoglycemia and prevent frequent hypos. For other diabetic patients who are not on insulin, monitoring the glucose levels from once a day to once a week if stable, may be sufficient. How often you need to check should be decided by your doctor according to your glycemic profile.
Advantages of Self-Monitoring of Blood Glucose (SMBG):
- Easy and quick blood sugar estimation at any time of the day, thereby enabling the patient to conveniently pick up fluctuations in his glycaemic profile.
- Allows flexibility in lifestyle for the patient.
- Enables the patient to make minor dose adjustments in treatment to achieve optimal control with basic training.
- Immediate diagnosis of hypoglycaemia at the time of occurrence, thus enabling the patient to commence corrective measures instantly.
- SMBG improves the degree of control, thus helping the patient achieve better control as shown by better HbA1c levels.
Limitations of Self-Monitoring of Blood Glucose (SMBG):
- It is essential to cross check accuracy of glucometer reading from time to time. Calibrate your glucometer as and when recommended.
- The results may not be correct if the instructions on how to carry out the tests are not followed carefully.
- There is usually a 10-15 per cent variation between the glucometer readings and the lab values, so atleast once a month a plasma glucose test is essential.
Times of India : *The following article has been written by Dr. Shalini Jaggi, Senior Consultant, Diabetology, Sri Balaji Action Medical Institute