Give patients advice on self-monitoring their blood glucose
Recommendations for self-monitoring vary depending on the type of diabetes and treatment regimen of individual patients.
The American Diabetes Association (ADA) recommends that persons with type 1 diabetes self-monitor their glucose at least 3 times daily. Patients with type 1 diabetes who use basal-bolus insulin regimens should self-monitor their blood glucose at least four times daily (e.g., before meals and at bedtime) and use the data they gather to adjust insulin dosages on a meal-by-meal, day-to-day basis. Regardless of treatment regimen, patients with type 2 diabetes need to have a blood glucose meter and know how to use it. Self-monitoring of blood glucose should be done frequently enough to provide feedback about progress toward goals and to help patients recognize when glycemic control is deteriorating, such as during times of illness or stress.
- There is no consensus regarding the frequency of self-monitoring in patients who are not taking insulin.
- Patients with type 2 diabetes who use insulin or insulin secretagogues (sulfonylureas, meglitinides) are at risk for hypoglycemia and may need to monitor more frequently compared with those using lifestyle modifications, either alone or in combination with nonsecretagogue oral agents.
- Patients with type 1 or type 2 diabetes may need to monitor their blood glucose more frequently when there are changes in insulin or medication dosages, activity, or meals, or during illness or stressful events.
- In selected adults with type 1 diabetes, continuous glucose monitoring (CGM) in conjunction with intensive insulin regimens has been shown to reduce hemoglobin A1c.
From the ACP Diabetes Care Guide.