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Monitoring
SMBG
The DCCT demonstrated the benefits of intensive glycemic control on diabetes complications with SMBG as part of a multifactorial intervention, suggesting that SMBG is a crucial component of effective therapy. SMBG allows patients to evaluate their individual response to therapy and assess whether glycemic targets are being achieved. SMBG results are useful in preventing hypoglycemia, adjusting medications (particularly prandial insulin doses), and understanding the impact of appropriate nutrition therapy and physical activity. More frequent SMBG is correlated to lower A1C levels (55,56).
SMBG frequency and timing should be dictated by the patient’s specific needs and goals. When prescribing SMBG, providers must ensure that patients receive ongoing instruction and regular evaluation of their SMBG technique and their ability to use SMBG data to adjust therapy (insulin and/or food). Furthermore, SMBG results should be downloaded and reviewed at each visit.
SMBG is especially important for patients with type 1 diabetes to monitor for and prevent asymptomatic hypoglycemia and hyperglycemia. Type 1 diabetic patients should perform SMBG prior to, and sometimes after, meals and snacks, at bedtime, before and after 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 times daily, although individual needs may vary. For example, sick children may require up to 10 SMBG tests per day or more.
Previous SectionNext Section
Monitoring
SMBG
The DCCT demonstrated the benefits of intensive glycemic control on diabetes complications with SMBG as part of a multifactorial intervention, suggesting that SMBG is a crucial component of effective therapy. SMBG allows patients to evaluate their individual response to therapy and assess whether glycemic targets are being achieved. SMBG results are useful in preventing hypoglycemia, adjusting medications (particularly prandial insulin doses), and understanding the impact of appropriate nutrition therapy and physical activity. More frequent SMBG is correlated to lower A1C levels (55,56).
SMBG frequency and timing should be dictated by the patient’s specific needs and goals. When prescribing SMBG, providers must ensure that patients receive ongoing instruction and regular evaluation of their SMBG technique and their ability to use SMBG data to adjust therapy (insulin and/or food). Furthermore, SMBG results should be downloaded and reviewed at each visit.
SMBG is especially important for patients with type 1 diabetes to monitor for and prevent asymptomatic hypoglycemia and hyperglycemia. Type 1 diabetic patients should perform SMBG prior to, and sometimes after, meals and snacks, at bedtime, before and after 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 times daily, although individual needs may vary. For example, sick children may require up to 10 SMBG tests per day or more.
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