Can blood glucose self-monitoring improve treatment outcomes in type 2 diabetes?

Author(s): Varanauskiene E

Affiliation(s): Department of Endocrinology, Kaunas Medical University Hospital, Kaunas University of Medicine, Eiveniu 2, Kaunas LT-50009, Lithuania.

Publication date & source: 2008-10-27, Diabetes Res Clin Pract., [Epub ahead of print]

Publication type:

BACKGROUND: Increased cardiovascular risk in diabetes cannot be attributed to the higher prevalence of classic risk factors. IMPORTANCE OF POSTPRANDIAL HYPERGLYCEMIA: Most of the cardiovascular risk factors have shown to be directly related to the degree of postprandial glycemia (PPG). PPG should be recognized as a marker for the increased risk of cardiovascular disease. ASSESSMENT OF TARGETS FOR GLYCEMIA CONTROL: Two important methods available-self-monitoring of blood glucose (SMBG) reveals immediate hour-to-hour blood glucose, while long-term glycemia is assessed by HbA1c. Reducing PPG and glycemia excursions is as important as lowering fasting plasma glucose and HbA1c levels. EFFECTIVENESS OF SMBG: SMBG plays a key role in diabetes care, and has proven to be effective for insulin treated type 2 diabetic patients. Debate continues on the effectiveness of SMBG in non-insulin treated type 2 diabetes. Whether non-insulin treated type 2 diabetic patients benefit from SMBG, a large-scale randomized controlled trial with the follow-up period to investigate long-term effects should be carried out. A general recommendation is that insulin treated patients perform SMBG at least three times per day. SMBG frequency for non-insulin users should be individualized to treatment regimen and level of control.