Texas Diabetes and Endocrinology, Austin, TX 78731, USA.
Postgrad Med. 2013 May;125(3):191-204. doi: 10.3810/pgm.2013.05.2668.
Self-monitoring of blood glucose (SMBG) levels provides important information regarding glycemic control for patients with diabetes, and is recommended by European and American diabetes organizations as an essential adjunct to periodic glycated hemoglobin (HbA1c) level monitoring. The benefits of SMBG in improving glycemic control in patients with type 1 diabetes and those with type 2 diabetes (T2DM) who are being treated with insulin are well recognized. In contrast, the potential role of SMBG in patients with T2DM not treated with insulin remains controversial, which may lead to underutilization of SMBG in this population. Structured SMBG, introduced as part of a treatment intervention, has been associated with modest but significant improvements in HbA1c levels in patients with T2DM who are not taking insulin as part of their management plan. Patient-obtained readings provide valuable real-time feedback on glucose responses to meals and exercise, and provide the patient with guidance on the day-to-day management of their diabetes. Studies have shown that when patients perform self-monitoring as part of their treatment interventions, support through appropriate educational initiatives is critical to ensure that patients understand the rationale for SMBG. Patients should be trained in correct testing technique and data recording for SMBG, as well as target blood glucose and goal HbA1c levels so that they will know when their SMBG readings are out of range. Technology has a potential role in facilitating SMBG-based interventions by improving patient-physician communication and optimizing glycemic control through the use of remote data uploading, data analysis tools, and, perhaps, even text messaging. This review outlines the benefits of SMBG in the management of patients with T2DM not treated with insulin, and highlights strategies for improving the effectiveness of SMBG-based treatment interventions in this population.
自我血糖监测 (SMBG) 水平为糖尿病患者的血糖控制提供了重要信息，并且被欧美糖尿病学会推荐为定期糖化血红蛋白 (HbA1c) 监测的重要辅助手段。SMBG 在改善 1 型糖尿病和接受胰岛素治疗的 2 型糖尿病 (T2DM) 患者的血糖控制方面的益处已得到广泛认可。相比之下，SMBG 在未接受胰岛素治疗的 T2DM 患者中的潜在作用仍存在争议，这可能导致该人群对 SMBG 的利用率不足。作为治疗干预的一部分引入的结构化 SMBG 与未接受胰岛素治疗的 T2DM 患者的 HbA1c 水平的适度但显著改善相关。患者获得的读数提供了有关进餐和运动时血糖反应的有价值的实时反馈，并为患者提供了日常糖尿病管理的指导。研究表明，当患者将自我监测作为其治疗干预的一部分时，通过适当的教育计划提供支持对于确保患者理解 SMBG 的原理至关重要。患者应接受 SMBG 的正确测试技术和数据记录以及目标血糖和目标 HbA1c 水平的培训，以便他们在 SMBG 读数超出范围时能够知晓。技术在促进基于 SMBG 的干预方面具有潜在作用，通过远程数据上传、数据分析工具以及可能的短信等方式，改善医患沟通并优化血糖控制。本文综述了 SMBG 在未接受胰岛素治疗的 T2DM 患者管理中的益处，并强调了改善该人群基于 SMBG 的治疗干预效果的策略。
