Most patients on intensive insulin regimens
(multiple-dose insulin or insulin
pump therapy, including patients with
type 1 diabetes) should consider SMBG
prior to meals and snacks, occasionally
postprandially, at bedtime, prior to exercise,
when they suspect low blood glucose,
after treating low blood glucose
until they are normoglycemic, and prior
to critical tasks such as driving. For many
patients, this will require testing 6–10 (or
more) times daily, although individual
needs may vary. A database study of
almost 27,000 children and adolescents
with type 1 diabetes showed that, after
adjustment for multiple confounders, increased
daily frequency of SMBG was
significantly associated with lower A1C
(20.2% per additional test per day)
and with fewer acute complications (6).