The frequency of blood glucose measurements should be individualized for better glycemic control. Type-1 diabetes patients and type-2 diabetes patients who are on insulin should measure blood glucose 3 times or more per day to adjust long acting insulin dose and also to adjust mealtime short acting insulin doses. In general patients with type-2 diabetes require less frequent self-monitoring of blood glucose than type-1 diabetes patients, although the optimal frequency can not be defined.
Type-2 diabetes patients on oral hypoglycemic drugs require less frequent monitoring and they should utilize SMBG to assess the efficacy of their medication and the impact of diet. Also plasma glucose fluctuation is less in type-2 diabetes patients; hence one or two blood glucose measurements a day (or even fewer) may be sufficient.
There are different methods for self-monitoring of blood glucose (SMBG). Some of these methods are given below:
Blood Glucose Meters:
Blood glucose meters give accurate results of blood glucose level and many experts recommend Blood Glucose Meters for self-monitoring of blood glucose by diabetes patients.
The blood glucose meter kits have a small lancet, a testing strip and a meter for reading the glucose values. The tip of a finger is pricked with the lancet and a small drop of blood is placed on the strip of the blood glucose meter, which is than inserted into the Blood Glucose Meter, which read the glucose value. The readings of Blood Glucose Meters may be 10-15% higher than the value we get if tested properly in a diagnostic laboratory, but accurate enough for self monitoring of blood glucose at home for adjustment of insulin and oral hypoglycemic drugs.
How to reduce error in Blood Glucose Meters?
To reduce error and deviation of glucose reading, the Blood Glucose Meters should be properly calibrated. Improper calibration may lead to errors. The reagent strips should also be used as recommended by the manufacturer.
What are the advantages self-monitoring of blood glucose (SMBG)?
There are several advantages of self-monitoring of blood glucose (SMBG). Educated patients of diabetes can make important decisions regarding increase or decrease of dose of insulin, diet, and exercise that immediately affects the glucose results. By taking correct decision at correct time the blood glucose control over 24 hours can be much better. Self-monitoring of blood glucose can provide round the clock result to the treating doctor and doses of medication can be adjusted much better, which can be of great help in preventing long term complications of diabetes. Self-monitoring of blood glucose also help in adapting an acceptable lifestyle for the diabetics. Another advantage of self-monitoring of blood glucose is that, the diabetes patients can be managed in outpatient setup.
The results obtained from self-monitoring of blood glucose are important for the patient. Introduction of self-monitoring of blood glucose has helped the diabetics as well as the treating physicians by providing the blood glucose levels for prompt action and better control of diabetes.
Self-monitoring of blood glucose can be used by those who are not on drugs, but using diet and exercise for management of diabetes and blood glucose.
What are the disadvantages of self-monitoring of blood glucose?
The major disadvantages of self-monitoring of blood glucose are the high cost, discomfort in collecting blood frequently (several times a day), inconvenience as it can interrupt the usual activities and lifestyle. Self-monitoring of blood glucose may cause frustration in diabetics when they do not get results as expected.
Blood Glucose Reagent Strips:
Blood glucose reagent strips contain glucose oxidase, an enzyme that reacts with glucose. If a drop of blood is placed on the strip, the enzyme (glucose oxidase) present in the strip reacts with glucose and color of the strip changes. The color change of the strip depends on the glucose level in the blood and this color change is compared with a standard color chart.
The Blood Glucose Reagent Strips method is not accurate and it only gives a rough (idea) estimate about the blood glucose level, which can generally be used to alert the patient about serious changes in blood glucose. Due to the inaccuracy in the measurement of blood glucose, this method is not popular. This is still used in developing countries as it is cheaper and easily available.
To get better results the Blood Glucose Reagent Strips should be stored at room temperature away from moisture and sunlight in a tightly closed dark bottle.
