Guidelines for Self monitoring of blood glucose

All diabetic patients should regularly get their blood sugar level checked at frequent intervals at pathogy clinic, but self monitoring of blood glucose of SMBG is equally important in some cases as mentioned here.

Though self blood glucose monitoring values are generally 10% to 25% (not 10-25 points) less than concurrent plasma glucose values by the laboratory. Various factors can interfere the accuracy of results in a glucometer which include environment temperature and humidity, patient factors like hypotension, hypoxia, very high or low glucose concentrations, uric acid more than 13mg/dl, bilirubin more than 10 mg/dl, triglyceride more than 3000 mg/dl, total cholesterol more than 500 mg/dl and hematocrit.
Thus there are some guidelines for self monitoring of blood glucose which are-

Guidelines for self monitoring of Blood Glucose

Self monitoring of blood glucose is required in the following conditions.

Type 1 Diabetes Mellitus

for
Conventional therapy
Or Intentional therapy
Or Intensive treatment using 4 or more injections a day (multiple day injections)
SMBG should be regarded as integral part of treatment for all those with Type 1 diabetes mellitus.

The majority of people with type 1 diabetes mellitus should consider monitoring their blood glucose levels between 2-4 times daily depending on their treatment, lifestyle and individual needs. Those on insulin pump should monitor 4-6 times daily.
During illness more frequent self monitoring is needed and should be at least 4 times as blood sugar level fluctuates rigorously during illness.

Pregnancy with Diabetes

This section will be dealt in detail in separate article but self monitoring of blood glucose in pregnancy is required in
i. Women with pre-existing type 1 or type 2 diabetes mellitus.
ii Women with gestational diabetes. It is recommended that those women with gestational diabetes carry out intensive SMBG between 4 to 6 times daily.

Type 2 Diabetes Mellitus

In type 2 diabetes mellitus which are non insulin dependent SMBG should be done when the patient is on
Insulin therapy
Patients with type 2 diabetes mellitus who follow a multiple daily insulin regime should self monitor their blood glucose levels in the same ways as those with type 1 diabetes mellitus ie upto 4 times a day.

Those on twice daily insulin therapy should be supported to test once or twice daily.

Those with unstable HbA1c or SMBG levels should be encouraged to monitor more frequently.

Combined Insulin or hypoglycemic agents
Self monitoring of blood glucose should be at least once daily, varying the time between fasting, pre meal, and post meal.

Under lifestyle modification with or without Metformin or thiaxolidinediones
Glycemic control is best monitored through regular HbA1c testing at least 6 monthly if stable or 2 to 3 monthly if it remains unstable. SMBG should be done weekly.

Sulphonylurea alone or in combination with other oral hypoglycemic drugs
SMBG should be used to reveal if hypoglycemia is being experienced by those using Sulphonylurea or combination therapy. Test during physical activity is beneficial.

Above are the guidelines for self monitoring of blood glucose or SMBG. To know how to use glucometer and other detail about SMBG see SMBG.
To know what diabetic should eat see diet of diabetics.
If you want to assess as you are diabetic or not see Am I diabetic.