Self-Monitoring Blood Glucose (SMBG)

Managing diabetes plays an important role in diabetes management. Unlike other diseases that mainly rely on medical treatment or medication, whereas diabetic requires active participation for the patient itself. By monitoring your blood glucose on a regular basis, it is believed to be one of the crucial parts of the treatment process.

When someone is diagnosed with diabetes, they might be told by the health professionals to get a blood sugar meter. As SMBG has been recommended in order to achieve a specific level of glycemic control and to prevent hypoglycemia.

The key in managing diabetes is the balance between food, lifestyle and medication. By checking your blood sugar level, the number will help you understand the link between blood glucose, food, exercise as well as medication or insulin.

By maintaining a good blood glucose control, it will reduce the risk of developing complication from diabetes, including blurry vision, damage to the kidney, diabetic foot ulcer, and slow recovery from wound and so on.

Blood Glucose Control

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SMBG can aid in diabetes control by :-

  • Develop an individualized blood glucose profile which is able to guide healthcare professionals in the planning for individualized diabetic regime.
  • Giving the ability to make appropriate day to day treatment choices in diet, physical activity and insulin.
  • Manage patient’s hypoglycemia and hyperglycemia well.
  • Empower patient on the effect of lifestyle and pharmaceutical intervention on glycemic control.

Who Should Check?

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Talk to your doctor or the healthcare team whether you should be checking your blood sugar level. People that might benefits from SMBG level are:

  • People who are on insulin
  • People who are diagnosed with gestational diabetes mellitus (high blood glucose during pregnancy)
  • Frequent hypoglycemia (low blood glucose)
  • Hard to control blood sugar

There are numerous trials that have been carried out in order to determine the effectives of SMBG on glycemic control. Evan et al have reported that SMBG has been associated with improved health outcome among type 1 diabetic patients. It also shows that by increasing the frequency of self-monitoring blood glucose was correlated with reduction in HbA1c.

On the other hand, a higher frequency of SMBG was associated with better glycemic control among type 2 diabetes patient who is on insulin where they are able to adjust the regime. Besides that, a data from the Third National Health and Nutrition Examination Survey (NHANES III) concluded that there was little correlation between self-monitoring blood glucose frequency and glycemic control

How Often Do I monitor blood glucose?

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The frequency of blood sugar monitoring for diabetic patients varies from person to person. Most experts agreed that insulin treated diabetic patients should monitor their blood sugar level at least four times per day including fasting, before meals and before bed. A few studies reported that there is a positive correlation between frequency of SMBG and glycemic control among type 1 and type 2 diabetes patients who are treated by insulin. By obtaining postprandial blood glucose levels, it is able to help them to adjust their insulin regime more accurately.

For diabetic patients who are having issues in controlling blood glucose or those having medication initiate. SMBG can be helpful in creating or modifying the diabetes management regime. For example, patients who undergo persistent fasting hyperglycemia might indicate excessive hepatic glucose output which may derive benefit from using metformin (Glucophage), which has been shown to decrease nocturnal hepatic glucose output.

What Do I Need?

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In order to test blood sugar level, one needs three things including:

  • A blood glucose meter (Glucometer)
  • A lancing device
  • Test strips

Blood glucose meter which is also known as glucometer are usually sold in a box providing all the equipments that you need. However, there are many different types offering different features at different prices in order to meet individual meets. A glucometer is available at any pharmacy outlets, healthcare, hospital or even clinics.

How Do I Check?

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  1. Wash your hand with soap and dry them. By using warm water, it may help with the blood flow.
  2. Turn on the meter as outlined in the user’s manual booklet.
  3. Prepare a test strips
  4. Prepare the lancing device and get a drop of blood from the side of your fingertip or other approved site ( please do not prick at the same finger all the time)
  5. Touch and hold the opening of the test strip to the drop of blood and wait for the result.
  6. The blood glucose level will appear on the device.
  7. Discard the used lancet in a proper way.
  8. Record the result in a log book.

Please note that every meters are slightly different, do refer to the user’s manual booklet for specific instruction.

Summary

SMBG plays an important role in improving glycemic control in diabetic patients. SMBG is recommended to diabetic patients who are treated by insulin and desirable for all diabetic patients. The values provided by the meter are essential in selecting diabetic regime, control in the diet and physical activity as well.

However, there is several blood glucose meters available on the market. Please consult doctors, diabetic educator or health professional if you have any question regarding SMBG.

Reference

  1. http://www.diabetesselfmanagement.com/managing-diabetes/blood-glucose-management/blood-glucose-monitoring-when-to-check-and-why/
  2. Evan MB. Self-Monitoring of Blood Glucose: The Basics. Clinical Diabetes. 2002 Jan; 20 (1): 45-47. Available from:http://clinical.diabetesjournals.org/content/20/1/45
  3. Evans JMM, Newton RW, Ruta DA, MacDonald TM, Stevenson RJ, Morris AD: Frequency of blood glucose monitoring in relation to glycemic control: observational study with diabetes database. BMJ319:83–86, 1999
  4. Harris MI: Frequency of blood glucose monitoring in relation to glycemic control in patients with type 2 diabetes. Diabetes Care 24:979–982, 2001
  5. Jungheim K, Koschinsky T: Risky delay of hypoglycemia detection by glucose monitoring at the arm.Diabetes Care 24:1303–1304, 2001

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