Self-Monitoring of Blood Glucose in the Management of Diabetes Mellitus: Clinical Utility and Relationship to Patient Outcomes

The benefits of tight blood glucose control in decreasing the incidence and progression of microvascular and macrovascular complications in type 1 and type 2 diabetes had been well established in the last 2 decades. Major trials conducted used self-monitoring blood glucose (SMBG) as a mean to achieve tight glucose control in the intensively treated patients. Lower glycohemoglobin (hemoglobin A1c) level was the main target that separated the intensively treated from the conventionally treated patients. The value of SMBG in the management of patients with diabetes has been emphasized by experts and different diabetes societies. Benefits may include the following: patients coping more independently with their disease, better understanding of factors affecting control, improving adherence to treatment, and motivating patients to make appropriate lifestyle changes. However, studies are highly controversial regarding the effects of SMBG on glucose control and outcomes in patients with diabetes. Trials that demonstrated benefits from SMBG were mostly in insulin-treated patients and had used SMBG as part of multidisciplinary intervention. In a small structured intensive diabetes program in our center, improvements in hemoglobin A1c and other metabolic parameters were achieved in the short term using multidisciplinary approach that emphasized SMBG.