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Self-monitoring Blood Glucose in T2DM: It's Essential

Self-monitoring Blood Glucose in T2DM: It's Essential


  • Glycemic control targets include fasting and postprandial glucose as determined by self monitoring of blood glucose (SMBG). --AACE/ACE Comprehensive type 2 Diabetes Management Algorithm Executive Summary 2017

  • Why SMBG? A1c is not always accurate and should not be used to adjust medications. Self monitoring provides critical feedback to patients to help modify behavior and allows physicians to adjust Rx based on blood glucose patterns over time.

  • Glucose targets for adults. Individualize based on age, comorbidities, disease duration, hypoglycemia risk; ≤ 6.5 for most but based on safety. FPG, 110 mg/dL; 2h PPG, 140 mg/dL.

  • Blood sugar log values let physicians identify patterns that indicate times of day when management tactics may require change.

  • Blood glucose meter download showing 2 weeks worth of glucose values; green indicates values within range, red shows values outside of range.

  • Glucose meter download Typical goal range: 70 – 180 mg/dL which allows for moderate after-meal excursions.

  • Glucose meter download snapshot. Although this patient's A1c is 8.4, not all blood sugars are above goal; PPGs are the problem and adjustment to mealtime insulin is probably a good solution.

  • If your office can't download meter data, there are many commercially available. It is also simple to create a log.

    Continue to Part 4: T2DM: Intensifying Rx When Diet, Lifestyle and OADs Aren't Enough

The American Association of Clinical Endocrinologists/American Academy of Endocrinology recommend that patients be taught early in treatment how to self-monitor blood glucose (SMBG). Feedback helps patients become aware of the impact of food choices on blood sugar and they tend to be more adherent with treatment plans. For physicians, the patterns revealed by daily recording of SMBG are essential to help fine-tune treatment and specifically insulin therapy. Glucose meter readings plotted for a week will show whether fasting or post-prandial glucose is affecting A1c and direct timing for intensification.

Click through these slides for a brief review of the essentials.

Content in this portion of Type 2 Diabetes Back to Basics Special Report is based on the AACE/ACE  Clinical Practice Guidelines for Developing a Diabetes Mellitus Comprehensive Care Plan 2015.

Comments

I agree.

jayalakshmi @

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