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Use of SMBG results is needed for successful outcomes
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AADE 35th Annual Meeting
WASHINGTON — Many health care providers debate whether self-monitoring of blood glucose should be recommended for non-insulin-treated patients with diabetes. But, according to Mary M. Austin, MA, RD, CDE, self-monitoring of blood glucose is a useful activity if the monitoring results are used by the patient and the health care provider, to make therapy or lifestyle changes.
"SMBG has the potential to reap rewards, but only if the data is used. We've seen an evolution in SMBG and its usefulness has expanded," she said in a Friday morning session at the American Association of Diabetes Educators 35th Annual Meeting.
SMBG became a standard of care in 1993. At that time it was used primarily to help diagnose and treat hypoglycemia in patients with type 1 diabetes in a timely manner. Today, for the type 2 non-insulin-requiring patient, SMBG can provide valuable feedback on the glycemic effects of medications, food, physical activity and stress. Austin, who is owner and president of The Austin Group, LLC in Shelby Township, Mich., addressed getting this message to physicians by providing regular feedback and encouraging them to review patients' SMBG log books or downloaded SMBG data.
"Part of the responsibility of a diabetes educator is not just to educate our patients but also educate the team around us," said Austin, who is also an Endocrine Today editorial board member. SMBG may not improve glycemic control if not utilized, by either the patient or the provider in decision-making.
"It is important to remember that just because a patient is checking his/her blood glucose on a regular basis, SMBG is not a therapeutic intervention. SMBG is useful when the results are used to adjust therapy — this is where the role of the educator can be so powerful," she said.
Currently there are no specific SMBG standards regarding educational content. However, Austin recommended educating patients on calibration and operation of the meter, teaching them how to obtain adequate blood samples, teaching them how to properly dispose of sharps and educating them on how to interpret their results, either through log book or computer-downloaded data and use the information in glycemic management efforts. She also stressed the importance of addressing fears and cost-related issues of SMBG to improve patients' acceptance of monitoring. – by Katie Kalvaitis
For more information:
- Austin M. Monitoring blood glucose: to test or not to test? #F02. Presented at: AADE 35th Annual Meeting; Aug. 6-9, 2008; Washington, D.C.