Self Monitoring Of Blood Glucose

Smbg Barriers And Possible Support

Using data available from all clinics, 176 answers for the question Reasons for not performing more frequent SMBG were obtained. Lack of time and Not remembering were the most frequent reported reasons for not performing more frequent measurements, n=89 and n=94 , respectively.

These two reasons were associated with lower age , shorter diabetes duration , higher education , and full-time occupation . In addition, Not remembering was associated with higher HbA1c , higher insulin dose , and fewer SMBG .

Self-consciousness was reported by 37 patients and Pain/discomfort from the measurement itself by 24 . A total of 10 patients reported Not wanting to know as a main reason.

Using data available from all clinics, 278 answers for the question What could make you perform SMBG more often? were obtained. Other reason and Nothing were the most frequent reported reasons, n=95 and n=97 , respectively. Smaller and more user-friendly tools were reported by 68 patients and IT tools by 25 .

The corresponding figures are presented for the clinics with highest and lowest response rate separately in online .

How Do You Check Glucose Levels

You can check your blood glucose using a small battery-operated meter. A drop of blood, usually from a finger prick or forearm, is placed on a chemically-coated strip and inserted into the meter. In the U.S., meters display the glucose level in milligrams per deciliter .

Different meters have different ways of measuring how much glucose is in the blood sample. When choosing a meter, here are some features to consider:

Meter size

Smbg According To Guidelines

The proportion of subjects with SMBG 4 daily in the last 30days was 43.9% . For the three clinics with highest response rate, 41.3% performed 4 SMBG/day . SMBG for individuals within the same clinics were essentially independent and a sensitivity analysis accounting for within-clinic correlation gave similar results to those presented in . The distribution of SMBG frequency is shown for each group in A.

The number of SMBG measurements performed during the last 30days correlated with patient perceptions of the mean number of measurements performed per day, r=0.89 in all clinics. Patient apprehension of the recommended number of SMBG measurements showed a weaker yet statistically significant correlation to the actual number of measurements, r=0.42, p< 0.0001.

Using data from all clinics, predictors for performing more frequent SMBG were older age and female sex , using multiple regression analysis . In univariate analyses, residential status and high physical activity showed a significant association with SMBG frequency . The association with high stress level was of borderline significance . When using the same methodology for the three clinics where response rate was 70%, age was the only significant predictor . Results are shown in . When using a model that accounted for dependencies within clinics, a non-significant intraclinic correlation was seen and similar results in the analysis of predictors of more frequent SMBG were obtained .

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Outcome Variable: Glycemic Control

Glycemic control was assessed using HbA1c level, which was regarded as a continuous variable for analysis. HbA1c levels were measured upon enrollment into the DCMP and at 3, 6, 9, and 12 months thereafter. Serum HbA1c was measured through ion-exchange high-performance liquid chromatography using the VARIANTTM II Turbo system.

Self Monitoring Of Blood Glucose

Self monitoring of blood glucose or SMBG refers to home blood glucose testing for people with diabetes.

Self monitoring is the use of regular blood testing to understand ones diabetes control and inform changes to improve ones control or wider regime.

Self monitoring of blood glucose levels has been a hotly disputed issue for a number of years, particularly with regards to people with type 2 diabetes who are not on insulin.

For information and advice on what to do if your access to testing supplies is restricted, see our availability of test strips page.

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Significance Of This Study

What is already known about this subject?

• Frequency of self-monitoring of blood glucose correlates with hemoglobin A1c and is considered an important factor for obtaining good glycemic control.

• Earlier studies on patients with diabetes type 1 have shown varying compliance to previous and current American Diabetes Association guidelines, from two thirds of patients not performing daily SMBG, to 85% of patients measuring three times per day or more.

What are the new findings?

• Less than 50% of persons with type 1 diabetes in Sweden perform SMBG4 per day according to current ADA guidelines.

• 30% of patients are unaware of guidelines.

• The top two most reported reasons for not performing more frequent SMBG were not remembering and lack of time.

How might these results change the focus of research or clinical practice?

• Our results indicate a need for further supporting SMBG with repeated and focused information on current guidelines as well as continued development of user-friendly glucose-monitoring devices.

Traditional Blood Glucose Meters

Traditional blood glucose meters are used with accompanying lancets and test strips. To use a traditional BGM, you typically insert the strip into the meter, prick your finger with a lancet, and place a drop of blood on the test strip. If your meter has Bluetooth connectivity, it can upload your result to the meters accompanying mobile app.

While traditional BGMs are the most common method of self-monitoring blood glucose, they can present several challenges. For one, they require you to use separate test strips and lancets, which makes checking your blood sugar more tedious since you have to keep track of multiple testing components. With a busy lifestyle and a lively household, it can be difficult to test with traditional BGMs.

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Why Is It Important To Control Glucose Levels

If you have diabetes, controlling blood sugar is key to preventing serious problems that can occur from glucose levels that are too high or too low . Both conditions can be very serious if not treated right away. If you are pregnant, controlling glucose is important not only for your health but also your baby?s.

Long-term problems associated with diabetes include heart disease, stroke, kidney disease, blindness, and nerve damage.

Choosing A Blood Glucose Meter

Barring any special needs of the patient, meters are often selected on the basis of the patients insurance coverage for self-monitoring supplies , because of the high cost of test strips when purchased out-of-pocket. Meters themselves are usually relatively inexpensive, since the manufacturers commonly give them away as free samples to providers, who pass them along to patients. They also can often be purchased using coupons at a significant discount.

Without insurance coverage, test strips can cost $0.83 to $1.76 per strip for the most popular brands of meters. For patients without insurance coverage for supplies, the lowest-cost test strips currently available are for the ReliOn Prime Blood Glucose Monitoring System sold at Walmart. Although ReliOn meters are not given out as samples in providers offices, the manufacturers suggested retail price is $16.24. More importantly, the suggested retail price for ReliOn Prime test strips is $9.00 for a bottle of 50 strips, or $0.18 per strip.

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Key Questions Answered By The Report

• What is the growth prospect of the Self-Monitoring Blood Glucose Strips market? What are key factors, such as drivers, opportunities, and trends, that govern the market?
• What are the key sustainability strategies adopted by leading players operating in the Self-Monitoring Blood Glucose Strips market?
• What are the new emerging technologies and use cases disrupting the Self-Monitoring Blood Glucose Strips market?
• What are the key trends and opportunities in the Self-Monitoring Blood Glucose Strips market across different regions and their respective countries?
• Who are the key players and innovators in the ecosystem of the Self-Monitoring Blood Glucose Strips market?

Reducing Pain When Testing

A common complaint about glucose self-monitoring is that it hurts. Below are some tips for reducing pain when testing:

• Use a new lancet for each blood glucose check.

• Choose a lancet device with a depth gauge and select the lowest setting that allows for a sufficient sample size.

• Lancets come in a variety of sizes, typically from 28 gauge to 33 gauge, so choose a lancet with a smaller gauge .

• Poke the side of the fingertip instead of the end or the middle.

• Alternate the fingers instead of repeatedly using the same finger.

• To minimize pain from forceful squeezing of the fingertip to get a sufficient blood sample, start squeezing the palm and push the blood progressively into the fingertip.

• Consider alternate-site testing, especially if you have painful upper-extremity neuropathy.

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Benefits Of Self Monitoring Of Blood Glucose

There are a number of benefits of home blood glucose testing:

• Helps to determine which foods or diet are best for ones control
• Helps inform the patient and doctor about how well the medication regime is working
• Reduces anxiety about, and increases understanding of, hypoglycemia
• Its important for undertaking dangerous tasks which could be influenced by high or low blood sugar, such as driving and handling dangerous machinery

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Disadvantages Of Home Blood Glucose Testing

The disadvantages are mainly seen when either the patient lacks motivation to test or does not have sufficient education on how to interpret the results to make sufficient use of home testing equipment.

Where this is the case, the following disadvantages may outweigh the potential benefits:

• Anxiety about ones blood sugar control and state of health
• The physical pain of finger pricking

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Unlocking The Full Potential Of Self

Christina M. Bookwalter, PharmD, BCPSClinical Pharmacist

US Pharm. 2019 44:29-32.

ABSTRACT: In 1987, the American Diabetes Association first recommended that patients monitor their blood glucose. Since then, self-monitoring of blood glucose has become an integral part of diabetes management. Self-monitoring provides real-time data to influence medication selection, alert patients to hypoglycemia, and inspire lifestyle modifications to help diabetic patients achieve their A1C goal. Patients are often given insufficient training in the nuances of SMBG. Pharmacists can help diabetic patients fill this knowledge gap and unlock the full potential of SMBG by teaching them proper monitoring techniques, when to test, and how to use results.

The first diabetes blood glucose test strip was developed in 1965, but the first glucometer did not reach the market until 1970.1 The first glucometer, which was available for use only within the healthcare system, weighed 1.2 kg . It was not until 1980, when a digital display was developed, that the glucometer was recommended for home use.1 At that time, glucometers were typically used only by patients with type 1 diabetes. In 1987, the American Diabetes Association established guidelines for self-monitoring of blood glucose .2 Since then, SMBG has become an integral part of diabetes management.2

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What Is The Evidence Of Effectiveness Of Smbg

SMBG is commonly used in developed nations as an integral part of diabetes management . In a survey conducted in Canada in 2011, almost 90% of the patients with type 2 DM reported using SMBG. Further, there was no significant difference between patients using insulin only and those taking insulin plus oral medication or an oral medication only although frequency of SMBG was lower in these patients . In another survey conducted in the UK, 80% of the 554 respondents reported high satisfaction with SMBG. They also reported that SMBG helped them feel more âin controlâ of their diabetes management .

Smbg Use And Frequency

SMBG works by having patients perform a number of glucose tests each day or each week. The test most commonly involves pricking a finger with a lancet device to obtain a small blood sample, applying a drop of blood onto a reagent strip, and determining the glucose concentration by inserting the strip into a reflectance photometer for an automated reading. Test results are then recorded in a logbook or stored in the glucose meters electronic memory. People with diabetes can be taught to use their SMBG results to correct any deviations out of a desired target range by changing their carbohydrate intake, exercising, or using more or less insulin.

The frequency with which patients with diabetes should monitor their blood glucose level varies from person to person. Most experts agree that insulin-treated patients should monitor blood glucose at least four times a day, most commonly fasting, before meals, and before bed. In addition, patients using insulin can benefit by obtaining postprandial blood glucose readings to help them more accurately adjust their insulin regimen. A positive correlation between frequency of SMBG and glycemic control among patients with insulin-treated type 1 or type 2 diabetes has been demonstrated., Patients treated with intermediate, short-acting, or rapid-acting insulin may benefit from SMBG data to make adjustments in their regimen.

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Are There Problems With Self

A person with diabetes may find self-monitoring problematic for several reasons: the need to carry materials and prick themselves several times per day, frustration with unexpected results. Nevertheless, when a person self-monitors according to the recommendations, and understands the benefits of this approach, self-monitoring becomes an important resource.

Self-monitoring lets you:

• Check the impact of different treatment elements on your blood glucose and make adjustments, if necessary.
• Complete the information provided by glycated hemoglobin .
• Identify, quickly treat and prevent hypoglycemia or hyperglycemia.
• Develop confidence, autonomy and feel safe.

Automatic Blood Glucose Monitors

All-in-one, automatic blood glucose monitors make self-monitoring blood glucose at home or on the go fast, accurate, and discreet. The POGO Automatic® Monitor is the first FDA-cleared automatic monitoring system with 10-test cartridge technology that eliminates the need for separate test strips and lancets. With POGO Automatic, you simply press a button, and lancing and blood collection are done for you. Your results are displayed within seconds, and they sync with the free Patterns® for POGO Automatic app via Bluetooth. The Patterns app helps with paired testing because it allows you to track and manage specific trends, whether youre pairing to meals, exercise, or other significant factors. POGO Automatic also offers an easy way to share your results with your healthcare provider.

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Choose The Best Monitor For You

Self-monitoring blood glucose at home is one of the most valuable strategies available for people living with diabetes. Choosing a monitor that makes self-monitoring blood glucose simple can help you stay on track with your diabetes management plan and ensure that you and your healthcare provider have the information you need to support your health.

Frequency And Timing Of Smbg

A consensus on the frequency and timing of SMBG has not yet been established. Different SMBG regimens should be followed based on factors such as diabetes type, treatment approach , glycemic control, available resources, and patientâs level of education. While patients on intensive insulin regimens may require up to 10 tests daily, patients on diet and oral medication may only need 6 to 8 tests per week .

The IDF guideline for non-insulin-treated type 2 DM describes focused and low-intensity SMBG regimens. Focused regimens include the 5- and 7-point profiles in which blood glucose is measured 5 or 7 times a day, respectively, for 3 consecutive days . Another focused regimen is the staggered regimen in which blood glucose levels are measured pre- and post-meal for alternating meal over a period of 1 week. Low-intensity SMBG regimens include meal-based testing , detection/assessment fasting hyperglycemia , and detection of asymptomatic hypoglycemia .

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How Often Should You Check Glucose Levels

Diabetes is a complex condition that differs from patient to patient. It is important that you monitor your glucose levels regularly and get familiar with your pattern of readings at different times of the day. Checking your blood sugar levels before and two hours after meals several times per week will help you identify your glucose patterns throughout the day:

Patients with type 1 diabetes should check 3 or more times a day.

When Should You Monitor Your Blood Glucose At Home

Its important to talk to your healthcare provider about how often to check your blood sugar. Doctors typically recommend that SMBG be done more frequently by people with type 1 diabetes than those with type 2 diabetes, but this can vary depending on what diabetes medication youre taking and your circumstances. The following are some of the most common times to self-monitor:

• Before meals/snacks
• Before and after exercise
• Shortly before bedtime

Your healthcare provider may recommend more frequent monitoring when youre starting a new medication, when youre sick, or when theres a significant change in your daily routine. Its also important to check your blood sugar if youre experiencing symptoms of hypoglycemia, including any of the following:

• Excessive hunger

Your healthcare provider can determine what your target range should be and provide guidance on what you should do in the event of a high or low blood sugar event.

You can also consider paired testing. Paired testing refers to checking your blood sugar before a meal, exercise, or other activity and again 1-2 hours after those activities. This approach gives you insight into how variables like food, exercise, and medications affect your blood sugar so you can make informed choices.

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