Can blood glucose self-monitoring improve treatment outcomes in type 2 diabetes?

BACKGROUND

Increased cardiovascular risk in diabetes cannot be attributed to the higher prevalence of classic risk factors.

IMPORTANCE OF POSTPRANDIAL HYPERGLYCEMIA

Most of the cardiovascular risk factors have shown to be directly related to the degree of postprandial glycemia (PPG). PPG should be recognized as a marker for the increased risk of cardiovascular disease.

ASSESSMENT OF TARGETS FOR GLYCEMIA CONTROL

Two important methods available-self-monitoring of blood glucose (SMBG) reveals immediate hour-to-hour blood glucose, while long-term glycemia is assessed by HbA1c. Reducing PPG and glycemia excursions is as important as lowering fasting plasma glucose and HbA1c levels.

EFFECTIVENESS OF SMBG

SMBG plays a key role in diabetes care, and has proven to be effective for insulin treated type 2 diabetic patients. Debate continues on the effectiveness of SMBG in non-insulin treated type 2 diabetes. Whether non-insulin treated type 2 diabetic patients benefit from SMBG, a large-scale randomized controlled trial with the follow-up period to investigate long-term effects should be carried out. A general recommendation is that insulin treated patients perform SMBG at least three times per day. SMBG frequency for non-insulin users should be individualized to treatment regimen and level of control.